“Yeah,” Cole said. “I wondered if something was up earlier in the day, but she swore up and down that she was feeling fine.”
“And didn’t the thought at least cross your mind that she could have been infected with the same thing that’s also killing the baby gorilla she’s been fondling for the last couple days?” She paused. “You know, the virus that’s apparently spreading like wildfire through an aid hospital in Goma right now? The reason I just flew halfway across Africa this morning on official—”
“Of course I thought of it.” Cole couldn’t listen to this any longer. “We all did.”
Why not give him the benefit of the doubt here? He kneeled down at the foot of the bed and laid a firm hand on the mountain of blankets over Marna’s trembling legs.
“I realize it may be hard for you to believe this, but I’m actually not completely off my rocker.”
«Convince me.»
“Are you serious?” It had been a long time since someone had questioned his judgment so blatantly. “You do realize that the normal incubation period for monkeypox is between ten and fourteen days, right? We haven’t even hit forty-eight hours yet. And around here, a fever with headache and abdominal cramping usually just means you ate something you shouldn’t have at the local market.”
“I know, you’re right.” Leila stood up and took a step back from the bed. “Look, again, I’m sorry. I realize I’m doing an awesome job of making friends here.”
Her eyes softened.
“You’re fine, no worries.”
Cole felt his heart slow down.
“You guys can see she’s in a seriously bad way just as well as I can, M.D. or not,” she said. “The real question is where do we go from here?”
“The only hospital that’s worth much is back in Kigali—”
“Hang on, meant to check one more thing,” Leila interrupted, pulling another latex glove over the one already on her right hand. She bent over the bed and lifted Marna’s upper lip. “Nothing there, at least.”
Cole stepped to the other side of the bed for a closer look.
“Mmm, do you have a flashlight in here?” Leila had inserted a thumb wrapped in gauze between Marna’s molars on one side.
He looked to the small table in front of him. There it was, behind a journal and a couple worn paperbacks.
“Here you go.”
“No, just shine it right in here for me.”
He clicked the headlamp onto its brightest setting and set it at a good angle.
“That’s what I was afraid of.” Leila tilted Marna’s head back with her other hand. “See those little raised lesions on her mucosal palate?”
He did.
“That’s often one of the first signs. At least according to the case reports I was reading on the plane.” She pulled her thumb out and straightened back up. “I haven’t seen it myself before—that pet store outbreak happened while I was still an undergrad—but the overall picture here seems to fit the diagnostic criteria pretty well.”
“Back to your question then,” Cole said. “What’s next?”
“Well how can we get her out of here? She needed to be in an ICU isolation ward yesterday. Is that even available here?”
“Like I said, the King Faisal Hospital in Kigali is the best we’ve got. They do have an ICU which is pretty well-equipped, but most expats prefer to get evacced straight out to Nairobi or Pretoria.”
“How about health insurance, emergency medical evacuation, that kind of thing? Didn’t you say she was actually employed by South African National Parks?”
“True,” Cole said. “Best case scenario would probably be to get her on a chartered flight straight back home to South Africa.”
“And start spreading this thing even further?”
“That’s what isolation procedures are for, right? I know some of those medevac companies are set up for it.” He looked to Musamba. “Can you see what kind of wheels we can get rolling down at SANParks? They’d have to be the ones to initiate anything like this.”
“Of course,” Musamba said. “I’ll let you know.”
Leila watched the older veterinarian leave the room. How could she have been so cruel earlier? He seemed like a nice enough guy. They couldn’t blame her, though. This was not how she had expected the visit to start out. Yes, she was an infectious disease doc, and she loved the patient care side of things just as much as the bigger picture epidemiology. But not out here in the bush. Not where she didn’t have the people and the resources she needed to save this poor woman’s life.
She turned back to the bed and saw Cole use a gloved hand to brush a strand of blond hair out of Marna’s face. There must have been something going on between these two. Leila had broken enough hearts to know the look in Cole’s eyes anywhere. That could complicate things just slightly.
“Cole, let me ask you something, one professional to another.”
“Go for it.”
“Do you have any reason to think that you might have suffered a more serious exposure of some kind? He cocked his head to the side. “Through your interactions with Marna, I mean.”
“Oh, ha.” He pulled his hand back. “No, I could only wish. She’s way out of my league.”
“Okay.” She was skeptical. “Let me know if you change your mind on that.”
“Besides,” Cole continued. “I had the smallpox vaccine just a few years ago, so my titers should still be pretty protective.”
Leila nodded. “You know that hasn’t actually been proven, for monkeypox. But yeah, you’re probably right.”
Why hadn’t she thought of that? She took off her gloves and felt her shoulder reflexively, imagining the oozing wound that had resulted from her own vaccination. It lasted for weeks before finally drying up into a nasty-looking scab. Everyone in Viral Special Pathogens had to get it, along with the more experimental vaccines for a whole slew of other scary diseases. Not that they got to play with the real thing down in that most-guarded of all the frozen vaults—only her boss had that access—but the vaccine’s effectiveness in inducing immunity against most of the other orthopox viruses meant it was included with all the others. That, and because the powers-that-be thought it might be a good idea for a few health professionals to be ready just in case the virus ever reared its ugly head again. God forbid.
“Why’d you get the vaccine, though?” she asked. It wasn’t a bad idea, given the nature of his work here in Rwanda, but wasn’t it pretty difficult to get for someone without an official requirement?
“Good question. I guess I may as well tell you.”
He sounded uncomfortable.
“Oh, this sounds exciting.”
Or not.
“I’m actually active duty military, if you can believe it.”
She rotated her head slightly. That was not what she expected. There was the heavy scruff poking out from his mask, the overgrown mop hanging way past his ears. But then, she had noticed a certain efficiency in his movements—a distinctive intensity—in that first moment together in the airport earlier.
“Maybe,” she said slowly. “Tell me more.”
“Well, it’s pretty simple, really.” Even with the mask on it was clear he was smiling. “I deployed to Afghanistan a couple years back and got the vaccination along with every other soldier heading that way. You know, just in case the Taliban is hoarding old smallpox scabs in some remote mountain cave.”
“You know that’s not what I meant,” Leila said. “What are you doing hunting gorilla viruses in Africa while looking like some kind of outdoorsy frat boy?”
“Ouch.” Cole lifted a hand to his cheek. “You mean this stuff? I admit, I kind of like being so far from the proverbial flagpole.”
“Flagpole?”
“Sorry, in Army-speak, that just means it’s nice not to have my bosses right here looking over my shoulder all the time.”
“I see.”
Was he deliberately trying to avoid answering her question?
“Here’s the deal,” he said. “I’m on an academic assignment right now. Basically getting paid my regular officer salary to turn myself into some kind of expert on emerging infectious diseases.”
“Okay, now you’re making a little more sense. Kind of like how we sometimes get Army docs in the Epidemic Intelligence Service?”
“Exactly.”
“And why does the military think it’s worth taxpayer dollars to send a someone like you back to school?”
She knew the answer as soon as the question left her mouth, but she wanted to hear his version.
“Honestly, for situations just like this one. Can you imagine what this virus could do if it got into the wrong hands?”
“Yeah, I guess I can.”
It wouldn’t be pretty, no question there.
“People like you at the CDC will help figure out what’s going on behind the scenes, sure. But at the end of the day, you probably won’t be the ones on the receiving end of an actual biological warfare attack.”
“I guess I can’t argue with that.”
As much as she usually loved to hate all things military-related, Leila knew he was right. She was glad to be on her own side of the fence in this division of labor.
“That’s enough about me, though,” he said. “You know how I got my smallpox vaccination, and I assume you’re protected too?”
“Yeah, all of us—”
“Perfect, then back to Marna. Anything else you want to do while we work on getting her out of here?”
Leila looked back at the bed, almost wishing her patient had miraculously disappeared and become someone else’s responsibility. She felt so useless here on her own.
“Do you have anything in the pharmacy that might help? Even Tamiflu would be worth a shot.”
At least it was an antiviral, if that’s really what they were dealing with.
“I think so, but I’ll have to run over there to check.”
“Let’s go ahead and get some samples, though, before we start her on anything else. I’ll take hers back to Atlanta along with the ones you already got from those gorillas.”
“What’re you going to need?”
She thought for a minute.
“Just the basics for blood and some mucosal swabs. You don’t have any viral culture media, do you?”
“Ha, that’s one thing we’ve got plenty of around here. How do you think I’m sending all these new viruses back to my advisor’s lab?”
A quick knock at the window startled her. Musamba was standing outside.
“Just got off the phone with Marna’s parents. They’ll have a plane on the ground in Kigali six hours from now.”
“A plane? That’s all they said?”
“International SOS,” Musamba said. “Straight from Joburg. They’ll have a medical crew ready for isolation procedures and full life support.”
Cole turned back to Leila.
“You hear that? She just might beat this thing.”
Thank you for stopping by, Sohrab.”
“Of course.”
Sohrab closed the door behind him and stood silently before the desk that filled his boss’s tiny office.
“Take a seat, please.” The man motioned to the only other chair in the room. “And don’t look so forlorn—you are not in trouble.”
Sohrab sat down and relaxed his shoulders slightly. That was good news. He had been a government employee long enough to know that it was never a good thing to be called into a private meeting with one’s supervisor. But maybe this was different? Dr. Rahmani actually looked somewhat pleased with the whole situation.
“I saw your father at a meeting today,” the older man continued. “He gives you his greetings.”
“Thank you, doctor. I’m glad he is still in good health.”
The tension returned. This was strange.
“He told me about your mother. I’m very sorry to hear of her illness.”
Sohrab bowed his head. “May Allah be merciful to her.”
“If you need any time away from the lab, just say the word. It is not good to be far from her during these last days.”
“Again, I thank you.”
This was the first time Dr. Rahmani had ever shown any interest in his personal life. What was he trying to get at?
“She has my wife with her now.”
“But that is not why I called you here this afternoon.”
Not a big shock there. Sohrab racked his brain. Had something gone wrong with one of the experimental trials?
“I was surprised to learn that your father is not aware of what you actually do for us here. I know your family has been living with them at the official residence, so I assumed you might have shared about your work.”
“I take my security clearance very seriously, doctor.” Sohrab tried to keep his hands still, resting on the edges of the chair. Did this really have something to do with his father’s job after all? “It would not be my place to discuss our work with anyone else, regardless of family relations.”
“That is good, Sohrab, very good. I respect that about you.”
The older man placed his elbows on the desk and rested his chin on clasped hands. A thin band of pure white hair was plastered against his otherwise bare head. Sohrab had seen photos of him when he was younger, back when he sported an unwieldy thick dark mane. At that time, he was being welcomed as a somewhat famous scientist who had made a name for himself abroad, triumphantly returning home to Iran and bringing modern molecular biology with him.
“Is there something else you wanted to speak with me about, Doctor?”
Sohrab was confused. Normally his boss did not have any trouble getting right to the point. Now he watched as a sly smile crept onto the man’s aging features.
“Yes, I respect that you know how to keep your mouth shut. That is a great gift in the world today.” He paused, his eyes widening as he shifted slightly in his chair. “Congratulations, Sohrab. Our project has proved to be successful.”
«Our project?»
“The work that I started, yes, so long ago. You have brought it further than I ever imagined possible.” The old man sat up straight, a triumphant look growing on his face. “And now I have learned today, from your father, no less, that this shared life’s work has reached its fulfillment. I was somewhat amused when I realized he did not even know of your involvement, but this is what proved to me that you could be trusted with the news.”
Sohrab stared at him, not moving a muscle. This couldn’t be right. Theirs was a defensive project only, a doomsday threat to be pulled out only when under the most extreme duress—just like the nuclear devices his father was working so hard to develop. His father. What could he possibly have to do with this?