2:7: “Epidemic”, by Kenneth B. Chiacchia

2:7: “Epidemic”, by Kenneth B. Chiacchia

Sally MacLean laid a hand gently on Yen Ming Chen’s forehead. She almost recoiled at the heat of his young body.

The white room stayed immaculate by virtue of surfaces that repelled dust and dirt, and by a system of small ‘bots that scurried the floors, picking up whatever fell and disinfecting as they went. But no device could keep the human body sanitized: Yen Ming’s fever testified to that much.

As she waited for the boy’s vital signs to register, Sally looked through the large, armored glassine window, at a fine, chilly morning shot with brilliant color from the microscopic debris that still floated in the planet’s atmosphere. The war technology that had rendered the Gotchas’ ancient home so profoundly inhospitable had also made it beautiful.

Sally scanned the readout, which confirmed the obvious symptom of fever. They’d taught Sally about febrile illness, of course. In theory, she knew how to treat it. But this was the first case of the pre-Biological Convention illness that she’d ever seen.

“Geez, Doc, I just don’t know,” said Yen Ming’s father as Sally helped the seven-year-old boy out of the scanner chair. “He’s been so subdued. It’s not like him to pass on visiting the digs with his mother and his sister.”

Sally nodded: troubling that the boy had passed up a chance to visit his mother’s workplace — the digs where human archeologists and technicians unearthed artifacts of the long-dead Gotcha race.

Yen Ming smiled sweetly at her, his eyes slightly glazed.

She said to the boy, “I’m sorry you’re not feeling well, Yen Ming. How is your menagerie doing? Is Mr. Iguana still getting out of his cage?”

Again, Yen Ming smiled faintly. But he only shook his head.

“Please,” said the father, trying to laugh but looking at his son with worry in his eyes. “Between the duck, the iguana, the mice — I hadn’t realized how much work the kid did feeding and taking care of his pets until we had to stand in for him.”

He paused a moment.

“Do you think this could be…serious?” he asked.

“This is almost certainly just a minor illness that will pass as his immune system and his symbiotes adjust to it,” she said. “In the meantime, I’d like to keep him overnight for observation — just to be on the safe side.”

Chen nodded as he stood. The worry on his face hadn’t cleared. Sally knew what was coming next.

“Doctor?” he asked. “Do you — do you think this could be something my wife brought home from the digs?”

Sally thought carefully before framing an answer. “It’s extremely unlikely, Mr. Chen. Let’s just do a few more tests, and work from there.”

Sally and a tech set Yen Ming up in an isolation unit in the infirmary. She ran down the visiting hours with Chen, excused herself, and returned to the lab to process Yen Ming’s samples.

With the analyzer running, she grabbed a monomolecular pliers and peeled away the film that — hopefully — protected her from whatever Yen Ming had. Then she sat for a while at her desk, just thinking.

Chen’s worry that his wife might have brought home a nasty bit of alien handiwork wasn’t entirely unfounded. To call the aliens of G0-TC-239-alpha4 — nicknamed “Gotchas” by the humans who combed through their remains — paranoid would have been an understatement. Humanity had discovered mostly dead races in its explorations, and almost all of these had gone extinct without developing interstellar travel. But the Gotchas had learned how to tunnel between the stars. They also wiped out every race they met — including themselves. Fortunately, they’d committed universal suicide about 3,000 years before humans explored their neighborhood.

Worse, their bellicose ways had become personal for the humans assigned to analyze the ruins of their home planet. The first expedition suffered a staggering casualty rate encountering the ubiquitous weapons, traps, and automatic killing machines that peppered the alien habitations.

For a people who spent less than two centuries in their interstellar period before self-induced extinction, they built to last.

By the time Lieutenant Sally MacLean, Medical Corps, had shipped to Gotcha to serve as the colony’s physician, the UN had partially militarized the project. Spacearm combat engineers and their ‘bots now preceded and accompanied the archeologists, and the work was less dangerous.

At no point, though, had the humans ever detected evidence of biological warfare on Gotcha. Score one for them over us, Sally figured, although no one knew for sure whether the Gotchas had developed such technologies or not. People also didn’t know whether any biowar agents the Gotchas may have used would be capable of harming humans, especially after 3,000 years.

———•———

“So let’s go through this again,” Jitendra Malek said to Sally as he waved to bring the lights up in his quarters and shuffled over to his little dry bar. “We’re talking flat-out negative? Even with the sputum samples?”

“Spit, urine, blood: nothing,” Sally answered, plopping down onto a locally manufactured framework-and-film chair, then reaching up to accept the single-malt he’d known, without asking, to pour for her.

Ji knew how to treat a girl.

Sally adored Lieutenant Jitendra Malik. Balding, developing a spare tire, and a bore at parties, Ji was objectively no great catch. But he was sweet and attentive and treated her well. He made her happy, and after a turbulent young adulthood Sally had realized that happiness was what she wanted.

Ji didn’t reply, so she elaborated: “Negative for all known human pathogens. Of course, any Terrestrial mutant that can make its way past the engineered symbiotes and the enhanced immune system would be profoundly mutated compared with its progenitor — nobody knows what it would take to detect that kind of bug. I’m trying not to panic here.”

She watched Ji take a deep breath, then let it out, pursing his lips. “I suppose — just as a hypothesis — we might check out electrolytic and fluid properties,” he said. “I’m talking like specific gravity, conductivity, optical properties: whatever you don’t usually test for. If there were anything…alien there, we might expect it to affect the basic physics of the bodily fluids.”

“But we don’t really know what to look for, do we?”

Ji frowned.

“No, I guess we don’t,” he said. “What little we know about Gotcha physiology indicates that any natural pathogen they produced wouldn’t be able to infect humans, correct?”

“I hate to rule anything out. But yes, the biochemistry would be so different that the pathogen couldn’t reproduce. It would be like you or I trying to eat the organofilm on this chair.”

He nodded, and they were back to their central, unspoken problem again. As colony science officer, he had at his disposal the United Nations’ full technical library, via the same FTL linkage that Sally could use to access the medical library. Sally also had learned to respect his quick — if peripatetic — intellect.

But he was a chemical engineer by trade, not a bioscientist. They’d picked him for his expertise in photochemical triggering agents — a Gotcha specialty — not in the discredited, largely dormant science of biological warfare.

She spoke carefully, not wanting to hurt his feelings: “At what point would we want to bring in some help, Ji?”

He shrugged. “Damned if I know. But I know not yet. ‘Mass is expensive, information cheap.’ I need a damned good reason to tunnel live specialists four-hundred-odd light years. You might have better luck through Medical Corps.”

Sally choked a laugh. “I can try. Well, let’s make our requests any way. The old man will be putting this into his own report, but we should probably make separate reports up the parallel chains of command. I don’t want to hit the panic button yet, but there’s nothing wrong with letting people know we’re concerned.”

She put the half-emptied glass down, and leaned toward him. “Now, I believe we have other business on the agenda….”

———•———

Yen Ming’s condition worsened on his second day in Sally’s infirmary. The AI monitoring his vital signs shrieked a warning as his respiration became labored, too fast, too shallow to keep his blood oxygenated. The boy’s fingertips, nose, lips, and ears were blue when Sally reached him.

Sally and her team fell into the drill of emergency resuscitation silently and efficiently. They’d never had to do it for real before, but they trained frequently. Each member had a rehearsed role that he could perform half-asleep. Which was exactly what they were doing.

As Sally ran the artificial lung assembly through its preinsertion diagnostic, the techs threaded a self-forming airway down his throat, the long tube wiggling and lengthening gently to conform with his upper lung passages. The automatic ventilation system inflated his little lungs with oxygen, an automatic feedback adjusting the volume and rate of ventilation as it did so.

With the oxygenator ready, Sally glanced up at the blood oxygen level readout.

“Shoot,” she said — the first word anyone had uttered.

The boy’s oxygen levels still read frighteningly low — too much mucus was blocking Yen Ming’s lung passages, he was so deep in respiratory shock that they couldn’t pump enough of the gas into his lungs to keep him alive.

Sally glanced down at Yen Ming’s legs, the heads-up display of her visor superimposing a magnetic resonance scan display that charted out his major blood vessels. She chose a vein, held the oxygenator’s business end to the skin over the vessel, and felt the device wiggle as it threaded its way up the vein toward his vena cava.

As the device unfolded, parasol-like, to deliver oxygen directly to Yen Ming’s bloodstream, Sally glanced up at the readout again. Only now did she realize she’d been holding her breath.

Ninety nine percent oxygenation. For a moment, she relaxed. But then she saw the metabolic readout: not great. For some reason, the boy’s physiology was still depressed, as if he were oxygen starved, even though he clearly wasn’t.

But it was enough to keep Yen Ming alive. For now.

“Christ, Doc, what the hell is wrong with this poor kid?” asked Tomas, her senior tech. “That oxygenator should be able to support me, and I’ve got at least forty five kilos on him.”

“I know,” she said. “Obviously, something is interfering with oxygen utilization at the level of the erythrocytes. Whatever this thing is, it’s attacking the blood as well as the lungs.”

Sally hardly recognized the child, for all the apparatus now sprouting from his face. She caressed his forehead through the membrane that — again, she could only hope — protected her and her team from his illness, and collected her thoughts. First, a call to the old man to fill him in; then Ji, to warn him that they had a whole new mechanism of toxicity; and then an FTL to Med Corps Central….

“Uh, Doc? I think you’d better take this,” another tech called from a vid screen across the infirmary.

Sally put the feed into her visor; it was Yvonne, one of the techs on roving duty tonight.

“Medical Command, we are en route with a three-zero-year-old female suffering from respiratory arrest, uniformly blocked lung fields, minimal oxygenation upon ventilation. Core temp four-one, uploading other vitals…”

Sally looked at the patient’s address. She lived next door to the Chens.

So the damned thing was infectious, too.

———•———

Sally had met Yen Ming Chen on her first day at the Gotcha colony. The quartermaster had assigned her a billet and she’d taken about 30 minutes of her allotted day to unpack. With no assigned duties until the next morning, she’d reported for work any way — but Captain Vellacott, the colony commander, kicked her out of his office with orders that she take a day off.

Exploring ruins that had been cleared of hazards was a major entertainment for Gotcha’s colonists, she discovered. Ten minutes after visiting what passed for a planetary tourism office, she was on an all-trac as it whined its way through the deserted streets. Sally had seen vids of alien ruins before, but this was her first real-time visit to an extrasolar planet.

She didn’t quite buy the idea of architecture mirroring a species’ psychology, but she had to admit that the Gotchas’ dwellings reflected their brooding, hostile nature. Their buildings were squat, solid, and looked like they could withstand a nuclear blast — which, in fact, many of them had. The dark stratum of dust that lay over everything, the blood-red skies, and the terrible howl of the wind only enhanced the impression.

The Chens had been on this trip as well; Yen Ming, exploring as always, crossed the length of the all-trac’s passenger compartment to introduce himself solemnly.

“You’re our new doctor, aren’t you?” he said, holding out a small hand.

She shook it, wondering how he knew. Then she realized he must have known how to read the insignia on her pale green Medical Corps uniform shirt. An observant boy.

“Yes, I am,” she replied. “Or I will be, beginning tomorrow morning. I’m Sally.”

“I’m Yen Ming,” he said, smiling, and sat next to her. He leaned in close, and said, “It’s OK if you’re a little scared. I was when we came here too. But I know how everything works; I can help.”

Sally had made her first friend on Gotcha.

———•———

Two patients led to four, and then to seven. Soon new cases were hitting one or two per day, the epidemic spreading from the Chens’ apartment outward. About one out of three people exposed to a case developed it themselves, although many of those affected didn’t develop respiratory crash.

Still, Sally didn’t have big enough numbers or a long enough observation period to nail down either the infectivity, incubation period, or typical prognosis. For all she knew, the disease could be 100 percent infectious. Her only consolation was that it hadn’t killed anyone yet.

But the epidemic was young.

Captain Vellacott was supportive enough. “Get on top of this,” he’d said. “I’ll get you what you need.”

Sally made use of Vellacott’s blank check: she set up lines of quarantine immediately. But the disease hopped right over them. She was keeping people alive, but she wasn’t keeping it contained. Finally, she resorted to an overall planetary quarantine in addition to sector-by-sector measures within the colony; nobody was leaving Gotcha until she had this figured out.

She was starting to wonder what she’d missed.

———•———

“OK, we’ve just about tapped out the hypothesis that this is purely a respiratory-acting agent,” Ji said, swirling ice cubes in a glass of plain orange juice. “The lung tissues aren’t the only target, we know that. We also know it’s unlikely that we’ve got anything like a natural virus, with molecular receptors that home in on specific target molecules in the host — otherwise, how could it be affecting us? We’ve got a different biochemistry, and the Gotchas never knew we existed.”

“Thank God,” Sally said, nursing her single malt. There wasn’t much of this stuff on the whole planet, and she was not going to rush through it, no matter how much the temptation to belt it down. “What really gets me is the idea that they designed something that could cross interstellar species lines in the first place.”

Ji raised an eyebrow, and she explained: “We know they hated everybody, wiped out several intelligent races. But if you want to kill off all the Mushroom People at N457-B, you design something to specifically target them — not a bug that can skip around and get just about anybody, yourself included. Heck, specificity is one of the few selling points of biowar agents.”

“You’ve cleaned up the consequences of their little traps,” he said. “You know as well as anyone how vicious they were. But what I was saying is that maybe we have to break our preconceptions here. Maybe it’s something vastly different from pathogens as we know them.”

“You sound like you have something specific in mind.”

“Yeah,” Ji said. “I’ve been thinking: What’s the one thing that all life forms we’ve discovered have in common? Everybody has to metabolize highly reduced molecules and transfer that energy to an intermediary energy carrier. For us, it’s ATP. For the ironworms at Tau Ceti, polyvanadates. In every case, you’ve got a highly conjugated chain of inorganic atoms saturated with double-bonded oxygen. Very similar chemistry at that one metabolic chokepoint….”

Sally understood. “That could make sense. If you affect polyphosphate chemistry, you’d get a generalized failure to metabolize, you’d get fluid transport dysfunction leading to thick mucus, even overactivity of the brown fat cells to up the body temperature — all the symptoms we’ve been seeing!”

“So what we need, maybe, is to look for something that can reduce polyphosphates? You think that would be a good avenue?”

“Hell, it’s the best we have so far,” she said. Then a thought hit her. “Only…”

“Only what?”

“Well, I wonder if we should be letting the folks back on Earth in on this quite yet. Maybe we could look into it ourselves.”

“I don’t understand, Sally. You’re killing yourself in the clinic — you’ve got eleven people on life support, and about thirty more on close-watch isolation in their homes last I counted. You haven’t slept more than a few hours in the past week. Don’t you want to take advantage of all the support we can get?”

“I do, but let’s think this through. If we let the folks back home in on this, even if we’re wrong we may be giving them ideas …”

“Ideas?” Ji asked, looking at her uncomprehending.

“Ji,” she continued, thinking in for a penny in for a pound, “I don’t want to see this become a bioweapons project.”

“Sally, this colony’s primary objective is to analyze and develop alien technology. And on Gotcha, that means weapons. That’s why we’re here, aren’t we? Our duty?”

That stopped Sally in her tracks.

Now that she thought of it, she had never spoken with Jitendra about why she’d signed up for Gotcha. Why the prospect of taking care of families and children, and escape from the military life that had been such a colossal mistake for her, had drawn her voluntarily to the worst assignment in the Medical Corps.

It had never occurred to her that Ji was so loyal to Spacearm that he’d help it improve its biowar technology. Since the mutual disaster that ended the West/Islam Wars, the weapons had been clearly proscribed by law, by ethical consensus, even by the post-Biological-Convention Physician’s Oath. But people whispered that Spacearm kept an embryonic research effort going anyway, to keep biowar defense technology alive against a future change in attitudes….

It all depended on who you owed your allegiance to: humanity, or Spacearm. In a brief few words, Jitendra had become as alien to her as the Gotchas.

Ji shook his head finally, saying, “Listen, I can’t keep this under hat. Not indefinitely. I suppose I can justify a few preliminary experiments before I report. Maybe I can give you a day or two, but what good would it do?”

Grasping for what she could get, Sally said, “I’ll take it anyway. Just give me a little time. Maybe I’ll come up with something from the clinical data.”

“My duty has to come first, do you understand?”

“I understand,” she said, feeling like she was falling.

———•———

Metabolic death comes as an anticlimax. After weeks of heroic efforts to save a patient, he simply slips away, his system too worn out to carry on. No last minute rally. No great drama as death claims its inevitable prize.

Sally had seen this happen numerous times with the very old. This was the first time she’d seen it happen to a child.

With Yen Ming’s entire family on life support, she realized, she had no idea of what to do with his body. There were no relatives to release it to, and nowhere to store it — in any case, it would eventually have to be disposed of as biohazardous waste.

But for a little while, at least, she would let him rest. She laid a gentle hand on his face….

She was on the verge of a thought when the com screen blipped. She waved it on; Tomas was at the other end of the link.

“Patient incoming, Doc. Same deal. Only this time, sector epsilon.”

“Sector what?” she demanded. It didn’t make any sense. Epsilon was clear over on the other side of the colony. She was sure she’d contained the contagion better than that.

As the datastream came in, she pulled the patient’s name out and fed it into the tracking program that the folks back on Earth had compiled for her. It fed into the colony’s security program, combing back through the records to determine whether and how an individual had been exposed to the now 87 known patients of the epidemic.

“Received, Tomas. Are you on top of this?”

“Standard treatment, reasonably stable at present.”

“Good. If you need me, shout. Otherwise, I need to make a call.”

She rang Ji. Bleary-eyed, he popped into life before her, twisting a bathrobe.

Sally fought down a surge of anger. A wall stood between them now, a wall that made calling him up in his bathrobe awkward. A wall that distracted her when neither of them could afford distractions.

“Ji, we have a big problem,” she said, diving in. “We have a patient whose separation factor from the Chens is very high. I’m reading nine point eight relative.”

“And?”

“The routine transport that left for Earth just before Yen Ming got sick had six people on it with lower numbers. And Ji, there’s worse news. Yen Ming Chen just died — so we know it can be fatal.”

Ji stood there, clutching his robe, his mouth wide.

“Oh Christ. How long ago did the transport leave? Two weeks?” He was punching at a data input link.

“Oh Christ,” he said again. “Their interstellar ferry tunneled two days ago. They’re in the Solar System now.”

Sally took a deep breath.

“All right,” she said, “Let’s not panic. I’ll get on the FTL to Med Corps Central — we’ll get that ship intercepted, so it can be quarantined. It’s a couple of weeks from Triton Base to Mars — so we still have something like twelve days before they make their first stop on a fully inhabited world. It may be that only the Triton Base has been exposed.”

“Unless another ship left in the meantime.”

“Yes.”

“So get on it,” he told her. “I’ll let the old man know.”

She cut the link, and raised her bosses on Earth. Via a coherent microwave beam threaded through a fragile interstellar tunnel, she gave a duty officer the bad news. He looked at her as if he were gauging her for a messenger-sized noose. But he sounded the alarm.

———•———

By the time she’d worked through the call, Tomas was at the door with the new patient. Nearly an hour passed before she had a moment to herself.

In an unexpected lull, she found herself alone, and absent-mindedly wandered over to Yen Ming’s body, to stroke his face again.

You keep at this they’ll be psyching you for necrophilia, she thought in one of those moments of black, hysterical humor that hit you when someone was dead because of your mistake. She doubled over with shudders of suppressed laughter, lowering herself to the floor as they transformed to bitter tears.

Yen Ming had been more than a patient; he’d been her first friend here. She was going to miss his visits, chatting about him with his animals….

“Shoot,” she said aloud. “Who’s been feeding them?”

Unable to face the possibility of a roomful of dead pets alone, she called Ji.

When she asked, at first he looked angry. Calling him with business was one thing, she realized. But what right did she have to turn to him for something as silly as this?

She had to admit, she wouldn’t have blamed him if he just cut the link and went back to sleep. In that moment, she understood that he, too, was having trouble sorting out what he felt. But then his frown softened.

“It’s OK, Sally,” he answered wearily. “I was up anyway. I’ll get an isolation suit on, and meet you there.”

She shook her head as he signed off. Since when did a chemical engineer keep an isolation suit in his quarters?

Since the epidemic, she thought. That’s when.

———•———

The automatic lighting came up as they entered the apartment. Sally surprised herself by making a direct line for where Yen Ming kept the pets — she’d listened to his stories about them so many times, she realized, she knew where he kept them without once coming here.

Luckily, Yen Ming had set up a fail-safe autofeed mechanism, so they all had food and water — although the supply was low, it was lucky she’d remembered. At the mouse cage, she paused to watch the little beasts scurry around. Something about that bothered her, but she couldn’t place it.

She made the mistake of opening the iguana’s cage, netting her a sharp, painful whip from the lizard’s tail.

“How’s the duck?” she asked Ji.

“Dead duck,” he joked hollowly as he examined that cage. Then he started and backed away.

His reaction snapped her attention to what was bothering her. If an alien contagion could kill humans, had struck down every member of this family, why were these pets alive?

She took a closer look at the duck. Its nostrils were clogged with a thick, green pus, full of the opportunistic bacteria that grew up when a primary disease caused mucus accumulation and a depressed immune system. She hadn’t seen this in her patients, because their systems carried the engineered symbiotes instituted in the massive genetic cleanup after the West/Islam Wars….

“Oh my God, Ji, we’ve been all wrong.”

He looked at her, his face uncomprehending through the layers of clear plaston.

She said, “Why would an alien bioweapon attack a mammal like humans, skip over another mammal, like the mice, and hit a bird? It’s a suspicious pattern.”

“Pattern?”

She nodded, and said, “What if we’re dealing with a natural, multi-host pathogen? It wouldn’t care about how closely related its hosts are — only whether they interact in a way that lets it hop from one to another. It follows webs of behavioral interactions that allow it to hop between intermediate hosts. Darwin with a vengeance.”

“And ducks and humans make sense to you?”

“Sure does. Leaping between humans and fowl? I need to do some tests to prove it, but I’d bet that we’re dealing with a Terrestrial virus. What we have here is a case of the Gotcha flu.”

———•———

The pathogen was vastly different from its influenza virus progenitor. In retrospect, it had to be: facing an enhanced human immune system and a deadly host of engineered symbiotes, the new virus had had to mutate so profoundly that it was hardly recognizable.

It infected cells only from the inside, spreading through cell-to-cell interactions and seldom existing as a free virus. In that, it was more like a retrovirus than a conventional RNA virus. It had evaded the initial analyses by mimicking the tag sequences that allowed the symbiotes to tell friend from foe. Along the way, it had learned how to hobble red blood cells by infecting them, too, from the inside.

But the new flu bug retained one characteristic of its progenitors — it incubated in avian species, developing new mutations, occasionally making the trip to the human host to test out each new set of tricks. Eventually, it had what it needed and exploded into an epidemic.

Influenza. The alien killer bioweapon was just a breakout mutant of the old-fashioned, nearly forgotten flu bug. Admittedly, a virulent, dangerous one. But one that could be attacked with off-the-shelf human technology.

It took less than 24 hours for a message tunneled to Earth to net authorization from the Biological Convention Committee for Sally to engineer a somatic-cell mutation procedure to counter the virus temporarily. And back in the Conference’s laboratories, they began work on a germline alteration that would allow all humans to fight this virus and its most likely descendants.

———•———

Which only left the question of Ji.

Sally ran into him at the canteen one night. He did a double take when he saw her, and she wondered if he were fighting an urge to walk the other way. She certainly was.

“Hey,” he said. “I hear they’re going to promote you.”

“Yes,” she replied. “I’m going to head an epidemiologic crisis center. Really should have thought about this before, but we’d been too successful at preventing infectious diseases. We’d let ourselves forget that the other side was evolving along with us. You’re doing well, too, I hear…”

“Yeah, that’s me. Hero among heroes.” Then, without warning, he touched her arm gently, and said hesitantly, “Sally …”

“I know,” she answered, pulling away slowly, awkwardly. “I’m…uncomfortable too. I…we need some time to sort it out, I think.”

He smiled, not at all reassured or reassuring, and nodded. He said, “Well, I’ll be around. Maybe we can get together some time.”

“Maybe,” she said as he left.

As she watched him go, she wondered whether they’d get a second shot or not. Epidemics left their mark, on the population and the individual. They brought out unlooked-for defenses — and unexpected vulnerabilities. In their wake, nothing could be the same.

Nothing except the dance of life, the struggle to survive. In that struggle, who knew what was possible?



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