I spent the next few minutes pacing up and down the Quiet Ward’s main hallway in nervous circles.

Letty.

This had gone far beyond royally botching things up. I’d imperially botched things up. Possibilities raced through my mind, mostly about who might be able to handle her case. If this had been a science-fiction film, this would be the part where we would get to see the elite cadre of heroes being gathered, only instead of being marines, or physicists, or microbiologists, these heroes would be physical therapists and occupational therapists, and that was just what would be needed to get to be able to move again after a lifetime’s worth of muscle atrophy. Nurse Costran agreed with me that it was a miracle Letty was able to move at all, but Yuth chalked it up to the exercise she and her predecessors had been mandated to force upon Letty’s unconscious body day-in and day-out for decades and decades. Had it not been for that…

I shuddered at the thought of what might have been.

Suddenly, my console pinged. Checking it, I saw I’d gotten a patient referral from Dr. Rathpalla, along with a quaint doodle of a winged frog. Ibrahim Rathpalla was a talented Dalusian psychiatrist with a knack for therapy—both the cognitive and behavioral sorts—and psychopharmacology. Year before last, we’d co-authored a study on the psychiatric and neurophysiological effects of guided psilocybin use in a clinical context in conjunction with cognitive therapy for the treatment of major depressive disorder. Since mice couldn’t talk, there was a limit to what could be learned by dosing them with magic mushrooms and then slicing into their brains to see what happened, hence the study. For Dr. Rathpalla to refer a patient to me meant that he suspected that there was a physiological component to the patient’s condition. Alternatively, it was something so off-the-wall that he wanted me to give him a second opinion. Given how my day was already turning out—Kurt had Nalfar’s; Letty was awake—I sincerely hoped it was the former. Ordinarily, I relished opportunities to help my colleagues, but, with all that had happened, I had definitely been left with uncomfortable foreboding.

I walked over to Yuth and the reception desk. The Costranak nurse’s dark caramel skin didn’t have its usual luster. She seemed like she wasn’t entirely there.

“Yuth…” I called her name to get her attention.

She blinked and shook her head.

“Could I borrow your console for a moment?” I asked.

She covered her mouth and coughed.

“Sure.”

She spun the console around on its swiveling mount to face my side of the reception desk countertop. I flicked my hand across the scanner, opening my account. A couple quick taps brought me to the patient menu. Dr. Rathpalla’s referral was at the top of the list.

One of the weirder features of the hospital’s IT network was that, for legal reasons, certain procedures—such as accepting case referrals—could only be done using an on-site console, rather than a personal console like mine. Weird, I know.

Tapping the icon brought up the case file. As usual, Ibrahim’s description of the case was informal and to-the-point:

Patient displays severe psychosis, believes that they are dead and that “the world is ending”. Never seen anything like it.

FUDGE!

My blood ran cold. It was like I’d gotten a call from a murderer from inside my own house. Nalfar’s Syndrome was so rare that it wasn’t even in the IDMMI. Meanwhile, I had three cases of the darn thing on my plate. Logic dictated the three cases had to be connected. In all likelihood, as frightening as it sounded, something had caused their Nalfar’s. Something that could be caught… and, maybe, something that could be spread. Granted, logic also dictated that inordinately rare, hyper-specific proprioceptive delusions that made people believe they were dead and that the world was ending were not the sort of thing that obeyed the laws of epidemiology, but…well, in an ideal world, I wouldn’t have had to find out about the “but”.

Unauthorized reproduction: this story has been taken without approval. Report sightings.

I must have done a pretty bad job of maintaining my outwardly sunny disposition, given the way Nurse Costran was staring at me as I looked up from the console screen.

“Genneth…?” She inhaled sharply.

Best case scenario?

Could there be a “best case” scenario? Hmm…

Mass hysteria. Best case scenario was mass hysteria. During the Second Crusades, there were several “dancing plagues” where distressed, impoverished, malnourished peasants took to the streets in groups of hundreds or thousands wandering from town to town flailing their limbs and spinning and leaping about while lost in an unresponsive, seemingly catatonic state. They could travel dozens of miles like that before finally stopping.

Medium case? A chemical spill was to blame, or some other environmental factor. Whether or not it was reversible (or survivable)… that was a different question altogether. Mass organoquicksilver poisonings were not unheard of, thanks to contamination of the water table by industrial waste (such as from DAISHU’s LCD manufacturing plants, both the ones here in Trenton and at home in Mu), but the Tonevay Wastewater Facility had been built expressly to prevent a recurrence of that problem. You had to go out into the countryside and eat shark meat or swordfish fished straight from the ocean in order to come down with erethism. For better and for worse, though, Merritt and Kurt’s symptomatology was that of a sudden onset, and that didn’t match with quicksilver poisoning. While it was not beyond the realm of possibility that quicksilver (especially lipid-soluble organoquicksilver) poisoning could have caused the Nalfar’s, it, like most forms of heavy metal poisoning, had a gradual onset, so it didn’t seem to match.

I was still going to order blood assays for both of them.

So, best case, medium case… only the worst case was left.

The worst case? Something infectious. Something alive.

I needed to tell somebody.

Of course, I also needed the results of Merritt’s MRI; hopefully, it along with any biopsies taken in the sequel (though I hoped to God it wouldn’t come to that) would be enough to determine the culprit. But that was just the tip of the iceberg. If this turned out to be something new—or, worse, contagious—information about this new, contagious malady needed to get into the right hands ASAP if there was going to be any chance of mounting an effective response. Time was of the essence, even more so than usual. The sooner the cause of this outbreak of Nalfar’s could be identified, the sooner it could be stopped. And if the disease was severe enough to drive Merritt to the edge of suicide, it couldn’t be stopped soon enough.

At the same time, something like an alarm rang out in the corner of my mind.

Pel is going to kill me if I miss Rayph’s play. Dangnabbit!

I opened the phone app on my console and dialed Tira right away. Her face popped up on the screen, green highlights ablaze in her hair.

“Oh! Dr. Howle, Is something the matter?”

“Tira, I…” briefly, I averted my gaze, “I’m going to have to ask you to reschedule my appointments for the day. For now, put as many of them as you can on hold. Please.”

“Alright, let’s see here…”

She pursed her lips.

“Genneth, your schedule is filled to the max. Are you sure you want me to put it all on hold? Director Hobwell is not going to be happy when he hears about this”

“I’m sorry,” I said, “and tell my patients that if you see any of them. This is an emergency. A medical emergency. I’ll fill you in on the details as soon as I can.”

Lost in thought, I grasped at the air.

Heggy… Heggy would help me.

Tira’s brow furrowed with concern. “Will do.” She nodded. “Stay safe.”

“Thanks,” I said, as I hit the “End Call” button. Mascara glittered beneath her eyes in the split second before the screen went black.

“What was that about?” Yuth asked.

“Improbabilities,” I answered.

“What about Letty?”

Setting my console on the table, I ran my hands through my hair.

“I’m asking myself exactly the same question,” I said. “Right now, I think…” gently, I let my hand rest atop her shoulder, “just do what you can. You’ve got a good heart, Yuth.” I glanced over to Room 1. “And that poor woman sorely needs it.”

I nodded. “Keep me posted on Letty’s condition. For now, though, I’m sorry—I have to go.”

I walked off to Heggy’s office as quickly as I could. If there was one consolation in the middle of my desperation, it was that I was positively certain that my day couldn’t get much crazier than this, no matter how hard it tried.

Boy, was I wrong.