Saturday, July 16, 2107

Atlanta, Georgia

Carmen Gandry, age seven, experiences sudden dizziness during a morning tumbling routine. They miscalculate a back handspring, resulting in a spiral fracture in their right wrist. During examination at the Atlanta Regional Medical Hub in North Druid Hills, the admitting doctor observes a minor, intermittent, undulating tremor in the patient's extremities. A head CT scan is normal, but Carmen is admitted for observation.

In the early evening, Carmen's symptoms worsen. They complain of severe, intractable headache, which does not respond to mild pain relievers. As Carmen writhes in the bed, their distraught mother pages a nurse on the medscreen. The nurse's image pops up and insists the doctor is aware of Carmen's condition and will advise of any change in pain management.

A few hours later, at 9:22 pm, Carmen's mother decides her child has waited long enough for relief. She frantically taps the medscreen to no avail—after twelve minutes, there is no response aside from a smiling AI repeating someone will be with you shortly at two-minute intervals.

She briefly squeezes her throbbing temples, stretches out the painful pins and needles in her legs, and puts on what she believes is her best no-nonsense teacher's face. She storms into the hallway, prepared to give the hospital's absentee medical professionals a talking to. As she stands beside the empty nurse's station, she watches the seconds tick away on the institutional black and white wall clock. Mesmerized, her resolve wavers by the minute.

She stares at the clock, noticing something peculiar about it. There is something odd in the way its lower lip quivers just before it cries out, The time! The time! Who's got the time? It is a near-perfect imitation of the March Hare from an old Alice in Wonderland cartoon she once watched at Grandma's house. She claps her hands.

Do Alice! Do Alice!, she squeals. The clock does not respond.

When she hears a frantic commotion in the distance, she follows the muffled din down the hall to a pair of double doors. Pushing one open, she enters another hallway. She hugs the wall and stumbles toward the noise, dragging her sleeping left foot behind her. Toward the end of the hallway, the ambient hum of medical machinery forms a backdrop to shouted orders and sporadic cries of distress.

She turns a corner and screams.

At her feet, a senior woman convulses violently in front of a wheelchair, her eyes bulging as bloody froth seeps from her mouth and nose. The tip of the woman's tongue leaves its resting place on her furrowed cheek and executes a front flip onto the floor beside her.

Beyond the dying woman, throngs of dazed humans wander the hall and adjoining rooms, dragging limbs and babbling incoherently. Several of them hold their arms at odd angles—curled up on their chests or thrust outward behind them—their hands balled tightly into fists.

A man turns to look at her. A line of drool runs from the corner of his mouth to his collar. He raises a tremulous hand toward her as his jaw works in silent accusation.

A young woman slumps to the floor. Her newborn baby rolls from her arms and flops around for a few moments before going still.

Carmen's mother shuffles down the short corridor and through a door marked EMERGENCY. Her eyes scan the room for answers, but the chaos inside only intensifies.

The emergency lobby is a whirlwind of desperation. Anxious family members, eyes wide with fear, hover close to stumbling and immobile loved ones. Anguished wailing overtakes the muffled directives of medical staff, some of whom huddle behind a partition, hurriedly donning protective gear.

Carmen's mother spies a familiar nurse dressed only in scrubs. She crosses the waiting room and taps the nurse on the shoulder. With no hint of recognition, the harried nurse looks at her questioningly.

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Carmen's mother, Audra Gandry, age 29, opens her mouth and says, Guhhhhhhhhhh. She waits for a response from the startled nurse, then repeats with greater urgency, Unguhhhhhhhh.

Sunday, July 17, 2107

At 8:47 am, Dr. Malika Jones, age 42, begins morning rounds dressed in HazMat suit and pleximask. Dr. Jones has not slept in fifty-two hours. She is one of three available emergency department doctors, the rest having been called away to impromptu medical clinics throughout Atlanta.

Dr. Jones places a stethoscope around her neck, adjusts her mask, and closes her eyes briefly to call on the goddess for strength.

Nurse Andrew Bettcher downs a double dose of NSAIDS before gearing up to accompany Dr. Jones. Aware of what his throbbing headache portends, Andrew has left a final message for his mother. Checking her voicemail later that day, she will hear her son’s last words proclaiming his love and regret that he had not returned her calls more often.

In the hallway, Dr. Jones and Nurse Bettcher are met with a wretched sea of sick and dying patients, randomly interspersed with the merely injured. Of the estimated 2,000 patients who flooded the emergency department before Strategic Defense Officers barricaded the entrance at 5:12 am, Dr. Jones has charts for 23.

On a gurney beside them, an unaccompanied woman in the final throes of labor bears down for the final push. Her abdomen peaks, her head lolls, her arms dangle motionless beside her as she loses consciousness. Nurse Bettcher quickly dons gloves and catches the newborn, then cradles the lifeless child as its mother takes her final, ragged breaths.

Dr. Jones clutches a slim, portable medscreen to her chest and steps over bodies lining the path to Room 107 and the first patient on her appointed rounds. The examination room is a microcosm of the hospital's impossible struggle. Five patients fill the small room meant for one. Two patients are accompanied by loved ones. One patient has a bed. The rest lie on the floor atop inadequate hospital blankets.

Dr. Jones swipes through her medscreen, reviewing patient charts. She has memorized the general patterns—tremors, headache, hallucinations, convulsions—but notes that each patient's symptoms differ in type, severity, and progression.

She approaches the bed, which supports a middle-aged woman who lies prone, eyes vacant and limbs trembling. The woman's breath comes shallow and rapid through blue-tinged lips.

Dr. Jones raises her stethoscope. The patient's chest sounds are clear. She says so to wide-eyed Nurse Bettcher, who cannot tear his gaze away from a wildly spasming teenage girl on the floor.

Examining the patient's chart, Dr. Jones notices critically low iron levels. She quickly scans the remaining patient charts. Of the 18 patients with bloodwork results, every one is critically iron deficient.

The teenager convulses one final, frantic time. The gurgling ceases. Her rigid hands fall to her sides. She stares blankly at the ceiling and exhales. When her chest does not rise again, Dr. Jones bends over the body and listens for a heartbeat. Moments later, she writes TOD: 8:53am 7/17/07 on the makeshift paper chart clipped to Jane Doe #1742’s chest.

Dr. Jones picks up her medscreen and orders iron transfusions for 18 of her patients.

The next chart belongs to Carmen Gandry.

Young Carmen rests on one of the room's two beds, their eyes wide with fear. Carmen, who suffers from arachnophobia, insists large black spiders dangle from the ceiling overhead. In their flailing attempts to fight off the predators, Carmen dislodged the IV overnight, showering the examination room with blood. Carmen's arms and legs are now strapped to the bed. Their voice has gone hoarse from hours of impotent howling. As Dr. Jones enters the room, they stare at the ceiling in terror, mouth agape in a perpetual silent scream.

Dr. Jones steps over a man she suspects is dead, and speaks to Carmen in an attempt to soothe them. Carmen does not respond.

Minutes later, Dr. Jones attaches a Doctor-assisted AI Body Scanner (DABS) to the ceiling anchor. The room fills with a soft hum as the DABS powers up and reaches down with thin, black, segmented arms to probe Carmen's body.

The CT scan begins, visually slicing through layers of tissue and capturing intricate images of the patient’s anatomy with Carmen in silent, unceasing protest. Ultrasound waves follow, mapping the contours of organs and soft tissues. The DABS unit maneuvers the transducer with precision, adding the new layers to those of the CT scan. The full body scan completes, revealing, among other things, Carmen's broken wrist. Seeing the spiral fracture, Dr. Jones briefly pictures a carefree child tumbling on a spring floor only 24 hours earlier and winces.

Dr. Jones approaches the three-dimensional rendering of Carmen's internal landscape, probing the hologram in search of anomalies.

She finds a clue in Carmen's brain.