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Category: Suspense/Thriller
Description: Dr. Terry Ryder is special advisor to the President on bioterror preparedness; he has spent a decade attempting to anticipate which microbes might be weaponized and unleashed. When patients begin to present with slight tremors and numbness in their limbs, it takes him a while to realize that this is an attack. The answers he seeks elude him, and dark episodes from his past appear connected to the mystery. Medical Thriller by Peter Clement, M.D.; originally published by Belgrave House
eBook Publisher: Belgrave House, 2010
eBookwise Release Date: June 2010

8 Reader Ratings:

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Available eBook Formats: OEBFF Format (IMP) [683 KB]
Words: 144448
Reading time: 412-577 min.

Dr. Anna Katasova pressed into the shadows, squeezing her back against a rough stone wall. Its slimy cold penetrated the layers of her surgical clothing, raising yet more goose bumps, and she tried not to shiver. But the icy damp of the subterranean passage won out, and she had to clench her teeth to keep them from chattering.

Fitting entrance to a morgue.

She listened for footsteps.

None.

But her breath leaked out the top of her OR mask and, turning luminous in the icy air, it reached shimmering fingers through the dim streaks of light. Anyone who looked down here would at the very least spot her traces.

Yet Yuri had insisted she not approach the autopsy room at the corridor's end. "Anechka," he said over the phone, using his pet name for her, the Ural dialect of his Russian elongating the a sound. "Just come half-way down the hallway, keep watch, and stop the crypt keeper from interrupting me." His words rasped through the receiver in a raw whisper. She could tell that his vocal cords had tensed to the snapping point.

"What in God's name--"

"Trust me, Anna."

"Yuri--"

He'd hung up.

No sound came from the direction of the elevators that led back upstairs to lights and people. Overhead the old pipes moaned, and scurrying noises inside the air ducts gave her the creeps. But nothing human seemed near. And least none living. A row of sheeted stretchers stood end to end along the opposite wall. Twelve she could count; the rest extended into the gloom like linked segments of a white worm. Each held a corpse.

The shrouded forms were more sinister and suggestive of death than if she could see them lying naked and exposed. The pathologists had been lining them up like that for the last five days. Despite the cold, a cloying whiff of rot penetrated her mask, descended through the back of her nostrils, and played at the base of her tongue until she nearly gagged.

"Careful now, Doctor," she muttered to herself, having already learned that even for a physician, medical cool around a cadaver depended on having something to do--pronouncing it dead, checking it for evidence of foul play, examining it for physical signs that might better yield a diagnosis--anything to keep busy. But with no procedures or duties to hide behind, all her training did squat to protect her imagination from getting the yips. The pale material that outlined the cavity of an open mouth began to rise and fall. A bony imprint of a hand appeared to move beneath its cover.

She tried to distract herself by pressing her gloved palms against the stones behind her. The entire city, since its founding as Ekaterinburg by Czar Peter the Great in 1723, had been hewn from rock by hand, giving rise to generations of master stone cutters. Except in July 1918, those hands picked up rifles instead of tools and, to show there'd be no going back on the revolution, massacred Czar Nikolai II along with the rest of his family, with or without Anastasia. And on May 1, 1960, at the local military base, the hand of a descendant from those stone cutters launched the missile that brought down Francis Gary Powers, setting off a show trial to tweak the nose of America. By then strategic defense industries had dominated the region's work force, and to this day the city remained closed to the outside world, including those who would visit its airspace at an altitude of 50,000 feet. But over the last year rumors hinted that soon the restrictions would be relaxed and the city renamed Ekaterinburg, thanks to the spirit of Peristroika. Unfortunately, one of the most vociferous politicians nipping at Gorbachev's heels was a local drunk named Boris Yeltsin who'd never amounted to much. He might offend enough apparatchniks in Moscow that, just for spite, they'd keep his hometown in a political deep-freeze forever--

A familiar shrill whine from inside the morgue interrupted her rambling train of thought. The sound dropped in pitch, a characteristic deepening that occurred whenever the steel teeth of a bone saw bit into their target. Then it returned to the higher note, having completed the cut.

Was Yuri doing an autopsy?

"Oh, no," she groaned, more worried than ever.

If caught, they'd both end up in prison, or worse.

Of course someone had to have the guts to verify what they were dealing with, but why him?

When the first case came in the door, she'd known the man would die. His ashen face had drained to the color of dusk; his chest wall heaved like a bellows; his eyes flicked right and left, as if a pocket of the air he so desperately needed might be hidden somewhere in the room. She did all the right moves--tubed his trachea, bagged oxygen into his lungs, bolused bronchodilators and steroids into his bloodstream, then topped him off with antibiotics. But his hands restlessly plucked at the covers like a man trying to pick up loose change, a sure sign of severe oxygen depletion. On X-ray the center of his chest bulged with lymph nodes, something normally seen only in cancer patients. But two days earlier, according to a very anxious young wife, he'd been a healthy thirty-five-year-old chopping wood and milking the cows on their farm northeast of the city.

Dr. Anna Katasova had then tried to ventilate him by hand. With each squeeze of the bag, blood-tinged foam poured out the release valve. She nevertheless put him on a respirator, but an hour later, his heart stopped, and no amount of pumping, electrical shocks, or drugs could bring him back.

They'd received twelve more just like him that day. The same the day after, and the day after that.

Within the first twenty-four hours, infectious disease specialists had arrived from Moscow. "Flu," they said after cursorily examining the latest batch of victims who were still breathing.

Oh, sure.

"Better take precautions. Wear masks, gowns, and gloves," they'd added.

We already are, you idiots, she'd wanted to yell at them, but kept her mouth shut. Suits, white collars, and ties didn't disguise their military bearing.

Neither had she nor the other medical students ventured an alternative diagnosis, at least not out loud. Even their teachers remained silent. But people muttered together in small groups, particularly the pathologists. Some old-timers suggested that this had happened once before.

And throughout the hospital, especially in the cafeteria after hits of strong, black tea flooded tongues with courage, whenever anyone nodded knowingly, hinting that they knew what these people really had, everybody glanced toward the northeast, the direction in which a large agricultural experimental farm was situated on the outskirts of town. Officially an arm of the People's Agrarian Co-operative, it had been nicknamed OepMa Tena, or The Body Farm, and been the butt of sly asides since its inception decades ago. "How come the place has more army trucks than tractors?" the good citizens of Sverdlovsk would say to one another, exchanging wicked grins.

The clatter of an elevator door opening and closing snapped her to attention.

Footsteps approached.

The whine of the saw continued at her back.

She watched the lighted arch, expecting to see a figure enter the passageway at any moment.

Within seconds an orderly appeared, hunched over a stretcher bearing yet another shrouded corpse.

The crypt keeper, they called him, because of his creepy manner.

With a final push he glided his load into the lineup, then peered through the darkness toward the autopsy room.

Would he mind his own business, or investigate who'd be cutting up bodies at this hour?

He started down the corridor toward the door.

Time to act.

Anna stepped out from the shadows. "One moment, please!"

The man let out a yelp and jumped backward.

"What is your name?" Anna pressed to keep him on the defensive.

"Pe . . . Pe . . . Pe . . . Petrov--"

"Do you have reason to interrupt the pathologists?" she demanded, striding up to stand toe-to-toe with him. His face was in shadow, and, as did everyone these days, he wore a surgical mask, but enough of his features were visible for her to see the angular scar he bore that extended down his forehead and through his right eyebrow. The mark curved into an arch as he looked up at her.

Like most Russian men, he didn't match her height. At 1.75 meters, or five foot ten as Yuri's American friends in Moscow measured her, she liked the advantage. Yet the tall stature had ended her first dream, a promising career in ballet. She towered over most of the male dancers. "Their loss, medicine's gain," she'd said a million times when people asked if the forced switch had left her with any regrets. If they pushed her for a more complete reply, she'd wave them off with a breezy denial. But to herself she admitted, Yes, I miss the limelight, the fantasy, the wonder of creating something perfect. The selfishness of it is intoxicating. But when I save a life in ER, it's the same rush of exhilaration as opening night. The only difference is, in a white coat it's not proper to admit feeling the diva.

She glowered down at her subject. "Well? Do you have reason to be here or not?"

"Why no--wait a minute. You're only one of the medical students." His thick rural accent suggested an older Russian dialect spoken far to the north. It made the pronunciation of "only" sound like clearing phlegm from the back of his throat. "Katasova, isn't it? What are you doing here?"

She instinctively resorted to a move learned in preparation for the role of Sleeping Beauty that had since helped her win many a confrontation. Ever so slightly arching her back, she raised her shoulders, drew in a breath, and went up on her toes. It made her statuesque, presenting a formidable adversary to man or woman. But in the case of males, and some females, the delicate thrusting forward of her breasts that accompanied the maneuver could be distracting enough for her to completely seize the upper hand. "Yes, I am Dr. Katasova, and you better get out of here. Those men in suits who you've seen around the hospital are putting in extra hours to diagnose what killed all these." She waved her hand at the string of grizzly cargo the way an American game-show hostess she'd seen parodied on Russian TV showed off the prizes. "And don't you breathe a word of the work they're doing. They insist that no one know about the extra effort, lest everybody on staff thinks there's something serious going on and panics."

He stood nose to her chin, transfixed by her chest, then shifted his gaze to strip the rest of her with his eyes. Looking over her shoulder toward the autopsy suite, he nodded knowingly as the noise of the saw made a series of quick dips, similar to someone revving up what their Western friends in Moscow called a weed-whacker. "Ribs," he said.

"What?"

"Ribs. That's the sound it makes when the blade's going through ribs." He cocked his head and waited for her response, obviously testing if he could find a squeamish chink in her tough-girl act.

Big mistake. He probably pulled that trick on sweet young things in bars. Well, two could play and she intended to get rid of him fast. "Hearing a corpse get chopped is one thing; seeing it, now that separates the girls from the women." She reached over and whipped the cover off the nearest body. Its silver-gray flesh glistened in the half-light, and gaunt eyes glittered back at them from the depths of a face so tight with rictus it appeared ready to split open on the skull beneath. "I think this one's next. Why don't I tell them in there that you're willing to clean up the parts once they've finished. It'll speed things along--"

His scar shot upward. "No, no, Doctor, I've got my own work to do." He started to back away, arms extended, hands held palms toward her, the way people do when somebody's about to shoot them.

"Are you sure? I could check with a supervisor and get you relieved for special duty--"

"Shut up! I'm too busy, and they're shorthanded upstairs as it is." He turned and quickly headed toward the elevators, practically at a run.

"Then not a word of this to anyone, Petrov," she yelled after him. "Otherwise our visitors will still insist you work with them." She watched him disappear from sight, listening to his retreating footsteps. The rattle of the elevator doors closing and the hum of the cage starting upward confirmed his departure.

"Damn you, Yuri Raskin," she muttered, pivoting on her heel and heading toward the autopsy door. "You and your harebrained scheme. Let others play the hero." Only on nearing the entrance did she realize that all had fallen quiet inside.

She grabbed the handle and yanked it open. "Yuri, we nearly got caught. Now let's get out of here--"

She stopped.

On the table immediately in front of her lay a cadaver with its chest cut open, the blunt ends of the severed ribs pointing upward like amputated claws. The cavity they enclosed was completely empty. On a nearby counter, the freshly removed heart, its arteries and veins drooping out from the different chambers like cut hoses, glistened under the fluorescent ceiling lights. But what held her aghast was the sight of her husband, Dr. Yuri Raskin, holding the dead man's lungs, both lobes still attached to one another, each dripping with the same pink-stained foam she'd seen bubble out the tube of the first patient she treated. The tissue bridging the middle of the specimen was knobby with whitish nodes that resembled a clump of mushrooms.

"Oh my God, what is it?" she gasped.

Tall, slender, slight even to the point of boyish, Yuri looked up. Above his tightly applied mask, the corners of his eyes crinkled and his jet black brows reared back from one another like caterpillars about to fight. "Unless I miss my guess, anthrax," he said, sliding his prize into a large plastic bag and sealing the ziplock top. At his feet lay a Styrofoam picnic hamper filled with frozen packs, the kind used to transport organs.

An icy pressure squeezed her chest. "You're taking the lungs?" she said, horrified.

He gently placed the packet in the container and attached the lid. "Don't worry. It's all arranged. I made a bunch of calls--"

"Yuri, don't! This will get us shot."

He glanced back up at her with those dark brown eyes that never lost their seductive sparkle. "No, Anna. This will get us to America."

You have been much by the dark river--so near to us all--and have seen so many embark, that dread of the old boatman has almost disappeared.

--Sir William Osler, Aequanimitas

The best sentinels to discover a new disease are doctors who have a beer together after work and talk shop.

--Source Unknown

Ten corpses lay in the meat locker below deck.

Two men behind him carried an eleventh.

Unlocking the makeshift morgue, he walked in on what looked like an orgy, the dead who were already there having slid into each other's embrace from the roll of the giant vessel. No one had thought to tie them down. Their poses were all the more suggestive under the partial cover of disheveled shrouds.

"Back-to-back, belly-to-belly, it's the zombie jamboree," an ensign who lugged the head end muttered.

"Shut up," his partner whispered, and they deposited the newest resident on the floor. "You want us to straighten this tangle up, Sir?"

What Dr. Paul Wilson wanted was to get out of there. He shook his head, and waved the two men back into the corridor.

Seconds later he was rushing to where he could find fresh air.

On-board gamblers had given three-to-one odds that the body count would reach twelve before dawn. No takers bet against them, and everyone watched each other while going about their duties, probably wondering who would kill who this time. Some grim-faced wags joked that the next murderer might even turn out to be themselves. Nobody laughed.

He stumbled up the last stairwell and stepped outside. Ninety thousand tons of hull shuddered, then rose beneath his feet, forcing him to grip the rail of the smoker's promenade, a long balcony tucked under the port side of the flight deck. The lurch itself couldn't throw him overboard. He'd have to help it along with a jump to achieve that. What nearly toppled him had been the nauseating swirl in his head, not suicidal intent. At least not yet.

A shadow scurried deeper into the darkness behind him, one of the phantoms that had recently taken up residence along the edges of his vision. A vanishing leg, the flash of an arm, a darting rat--they skirted his days only to become bolder at night.

Lack of sleep, he told himself. To be expected at the end of a six-month stretch in the world's last remaining but most enduring war zone. Nothing that wouldn't clear up once he got off this floating nuthouse.

He focused on the gray walls of water three stories high that surged out from the fog. They split themselves in two at the bow, then sizzled along the hull, their briny spittle licking at the steel in long curling tongues. He understood how primitive mariners on ancient vessels could peer over the side, down into the twisting, hissing foam, and create phantoms of their own, usually in the form of sea serpents.

A wind squall plucked at his uniform, and he shivered, finding the early evening gloom unusually chilly for the tropics. Beyond the colorless sphere where visibility ended, sea bled into murky dusk, and the rest of the ship loomed into shadow. The emptiness out there sucked at him, as if threatening to pull him into its void, portending obliteration. He tightened his hold on the rail, and, for the first time in his life understood the terrors of those who suffered from agoraphobia, the fear of open spaces. Yet he stayed put. Better the bracing wetness of spray, rain, and mist in his face than to go inside. There the walls of this steel warren would close in and squeeze him until he couldn't breathe. But why? Navy veteran, ship's surgeon, chief medical officer to five thousand crew since the vessel's maiden shakedown cruise in 2003--he'd never been bothered by open sea or cramped quarters before.

"The prisoner has been brought to sick bay, ready for you to examine him, Sir," a female voice said from behind his back.

He'd released his grip on the railing and started to turn toward her when his entire left arm began to tremble. The blur of white fingers as he failed to bring them under control disgusted him. "I'll be along in a minute," he said, and grabbed the rail again, hoping the woman wouldn't notice. Outwardly the shaking stopped, but he could still feel the muscles jumping beneath his skin, like frog legs connected to a battery.

"I don't know why I did it, Sir," the nineteen-year-old said. His ID badge read Billy Johnston, and his boyish features were stretched white with earnest bewilderment. Until today, his record as an ensign had been spotless. Sitting on the examining table, stripped to his boxer shorts, wrists cuffed, ankles shackled, he looked puny, and had remained completely docile from the moment they'd subdued him. He'd also been desperately polite, as if a show of good manners might undo the carnage of his sixty-second rampage.

A few hours ago down in the engine room he'd grabbed a lug wrench and cracked open the skull of a second lieutenant who'd ordered him to wipe up an oil spill. Before the MPs could pull him off, his victim's head resembled a hollowed out melon, the kind with a decorative zig-zag cut around its edge and used to hold fruit salad at fancy buffets, except this offering contained shards of bone protruding from a white and gray puree of brain matter.

The ten others in the morgue had been killed under similar circumstances, each a victim of inexplicable, out-of-proportion rage. And ten other murderers were in shackles below decks, each as stunned by what they'd done as the one who sat before him now.

It had all occurred during the last seven days.

"Hold out your hands, Billy," Paul ordered.

The young man complied.

It wasn't obvious, but to a trained eye, the fingers had a tiny vibration.

Paul once more clasped the promenade rail with both hands and breathed in the night air. He kept turning over in his mind what he'd done, and what he should have done.

A dark shape flitted along the back of the promenade.

He swung around and saw nothing.

He glanced right and left.

Nobody near enough to worry about

He turned back to face the sea.

Despite armed MPs stationed about the ship, he watched his back, especially out here and, above all, among those wearing the signature, wool-lined, leather jackets of flyboys. They had it in for him because he'd decked them. Not that the other ranks were any more sociable. Everyone remained snarly, suspicious, and hostile. Even those who lined the railing with him kept to themselves, shoulders hunched up as much against company as the damp. Little wonder. People had disappeared from this very spot. Maybe they leapt to escape private demons, but rumors circulated that some had been thrown.

He glanced over his shoulder again.

This time not even a shadow stirred.

Of course there were those on board who'd try and harm him in other ways than with a lug wrench. They'd say that he'd been incompetent, had covered up his own problems while denying the need to get help himself. Well, just let them try. He'd taken precautions on that front. Logged everything. Made detailed entries in the clinical charts of anyone who'd shown symptoms.

He looked at his watch.

The whole mess would soon be PACOM's problem anyway. It was their medical officers at Pearl who'd agreed that the Reagan could push on to port where they'd sort everything out.

"Commander Wilson, Sir!"

He pivoted about, hands raised defensively in front of his face as if to ward off a blow.

A young woman wearing the insignia of second lieutenant stood at attention a safe distance away.

He immediately lowered his guard. "Yes?"

"The captain requests your presence on the bridge, right away, Sir. There's been another incident."

"Incident?"

"Argument, Sir."

An icy burn ignited in the core of his slightly protruding gut. The growing number of shouting matches on the bridge had been the one set of events that he hadn't put on report. He should have, but the captain had pressured him to cover them up. No surprise there. The bridge was a captain's most immediate turf. He'd be held responsible for a failure to rein in undisciplined squabbling amongst his officers anywhere on the USS Reagan, but especially on the bridge. "Anybody hurt?" Paul said, preparing to hear the worst.

"First Lieutenant Peterson has a bloody nose, sir."

He let out a long breath. Thank God no one was dead. Still, this could be trouble with the brass if they investigated and found out the full extent of what he'd kept under wraps. "Well then, that's not very serious, is it?" he said, affecting a breezy manner. When dealing with a screw-up that could be a career breaker, minimize, minimize, minimize.

"Well, actually, Sir, it is pretty serious. The reason First Lieutenant Peterson got popped on the nose is that he misread the global positioning satellite readings, then crashed the tracking system trying to override it with bad data. Some of the officers took exception, Sir. They wanted him busted for incompetence. That's why the captain sent for you--to declare Peterson medically unfit."

"Not fix his nose?" Paul said, allowing himself a slight smile. It seemed he could handle this one easily enough.

"That too, Sir."

They started toward the nearest stairwell. "So there's no problem to navigate home?" he asked, just to make sure that all was once again well on the bridge.

The woman flushed, but said nothing and quickened her stride, pulling slightly ahead of him.

"Lieutenant?" he said, expecting an answer. From a few steps behind he saw the sides of her cheeks glow crimson.

She entered a corridor leading under the carrier's tower. He picked up his pace and followed at her heels, trying to steady the familiar flutter of his heart as the walls pressed in on him. "Answer me, Lieutenant."

She swallowed. "Permission to speak off the record, Sir?"

"Go ahead."

She looked behind her to make sure no one else had followed them into the passageway. It was empty. "Sir, when the captain threatened to relieve First Lieutenant Peterson, the lieutenant accused the captain of being equally unfit for duty. He claimed the man gives an order for a course correction, then repeats it a minute later, as if he's forgotten the first one. It apparently happened several times tonight."

Oh, Jesus, Paul thought, not again. "But we're on course now, aren't we?" He wanted to slam the lid on this fast.

She looked at him in surprise. "I suppose so. Lieutenant Peterson said something about we'd have been up shit creek if the other officers on watch hadn't pointed out both his and the captain's errors, so I guess that meant they corrected all the mistakes."

"Well, then, no harm, no foul, right?"

"Pardon?"

"Everything's worked out fine. I wouldn't make a big deal of it. As for poor First Lieutenant Peterson, he's obviously suffered the same breakdown that's taken everyone else. We can't put much stake in what he says."

She looked puzzled, but nodded.

As he followed her up several flights of stairs, instead of worrying about the woman keeping her mouth shut, he found himself admiring how slinkily her ass moved under her uniform. Christ, he was old enough to be her father. That was another change. He kept getting horny.

When she wasn't looking, he opened a small vial of the Ativans he'd come to rely upon and slipped two of them under his tongue. It was only the third time today, he reassured himself, but then wasn't so certain of the count.

Shadowy movements off in the darker corners of the stairwell continued to plague him, and on one landing, he glimpsed the bristly leg of a giant spider before it scuttled out of sight.