through the notebook in her lap.
“That’s good.” He paused, but when she didn’t speak again he forged ahead. “I guess you live in Atlanta?” That was the location of the CDC’s headquarters, so it stood to reason she’d live there.
“Yes.” She continued to flip pages, the rustle of paper the only sound in the room.
“Ah, apartment or house?” he asked, needing to fill the awkward silence.
Avery apparently found her place in the notebook and looked up. “Apartment. Look, Grant. I appreciate the chitchat, but let’s just get down to business, shall we?”
“Sure,” he said, nodding in agreement. “I’m just glad to see you’re okay.”
She smiled, but the expression didn’t reach her eyes. “I’m great. You look fine, too. And now that we’ve established that, I think we’ll both be better off if we focus on the outbreak.”
She was right, of course. And really, he should be relieved that she didn’t want to spend time going over their past. But part of him was disappointed—how was he going to apologize if she didn’t want to talk about the elephant in the room?
“What can you tell me about this outbreak?”
“It started two weeks ago,” he replied automatically, shoving aside his personal concerns. There would be time enough to chat later, once he’d hopefully figured out how to broach the subject. “The first two patients presented on the same day, a few hours apart.”
“Can you tell me about their symptoms?”
“Low-grade fever, congestion, mild cough. Typical upper respiratory stuff. It’s the kind of thing that cycles through here on a regular basis, so I gave them the usual treatment and sent them on their way.”
“And then what happened?” Her pen flew across the paper as he talked, taking notes on everything he said.
“The rest of the patients presented in the same way over the next two days. I put out a notice, reminding everyone to focus on hand-washing, cover coughs and sneezes, that kind of thing. But I didn’t realize anything was wrong until the third day.”
Avery pulled another piece of paper from her bag and consulted it. “That’s when Patient Zero came back?” she asked, referring to the first patient.
“Yes,” Grant confirmed. “And he looked like death warmed over.”
One of Avery’s eyebrows lifted. “Is that your official clinical opinion, Doctor?” There was the slightest hint of amusement in her voice—not enough for a stranger to register, but Grant picked up on it. He gave her a little smile of acknowledgment and was gratified to see her own mouth curve up slightly in response.
“Indeed,” he replied solemnly. “Fever of one hundred and five degrees, productive cough, bloody mucus. Not to mention, his eyes were bloodshot—he’d ruptured the capillaries from coughing so hard.”
Avery grimaced. “Poor guy.”
“Yeah.” Grant shook his head, remembering that sick feeling in his gut he’d gotten when the man had stumbled back in. “And to top it off, he said his pain was an eight on a scale of one to ten.”
“What did you do?”
“Started him on a febrifuge and pain meds. His chest sounded crackly, so I ordered a chest X-ray. Came back almost entirely whited out.”
Avery’s eyebrows lifted. “There was that much fluid in his lungs?”
“Oh, yeah. I’ll get you the medical records for all the patients so you can see the results for yourself. But essentially he was drowning in what I later learned was blood.”
It was a sight he’d never forget, a scene from a horror movie burned into his brain, made all the more terrifying because it had really happened. The man’s cough had grown steadily worse, and two hours after his admission, he’d begun to gag. They’d rushed to clear his airway only to find a rising swell of blood trying to escape. As he suffocated before their eyes, the team had flipped him onto his side. A torrent of blood had gushed out in a wet splatter on the floor, and a hot, metallic stench had filled the air.
Grant swallowed, clearing the memory of the smell from his tongue. “He died a few hours later,” he said softly. It always rankled to lose a patient, but it was doubly hard here. There was a finite number of people on the base, and Grant had made it a point to introduce himself to everyone. Even though he hadn’t known the man well, he did remember exchanging pleasantries with him whenever their paths had crossed.
Avery was silent for a moment. “It sounds like a very difficult case,” she said, a note of sympathy in her voice.
Grant nodded. She understood. Even though Avery didn’t practice medicine anymore, she was still a doctor and would have lost patients in med school. There were some cases that stuck with you, and Grant knew the death of the four men in this outbreak would haunt him for years to come.
“After he died, I tracked down the other patients who had presented with the same initial symptoms. I hoped this was just a one-off, but unfortunately, three others progressed too rapidly for us to save. I wanted to send the other six to South America for treatment, but my request was denied.” He shoved a hand through his hair and tried to keep the bitterness from his tone. “As soon as people heard what this thing does, they refused to take them. Didn’t want to risk it spreading.”
If he looked at the situation dispassionately, Grant understood the decision. Better to contain the pathogen here, where there were a finite number of potential victims. If this thing spread into the wider world, it could be a species-ending infection. But Grant hadn’t had the benefit of detachment. He’d touched those people, held their hands, comforted them as best he could. It was personal for him, and he was still angry his patients had been left to the mercy of a medical center that wasn’t equipped to handle this kind of disease.
Could the four victims have been saved if they’d made it to a larger hospital? It was a question that would undoubtedly dog him for a long time...
“I heard,” Avery said, a note of sympathy in her voice. “For what it’s worth, I think it was a crappy thing to do.”
He jerked one shoulder up. “Fortunately, we caught the other six before they bled out into their lungs. They got pretty sick, but at least they’re not dead.”
“What kind of drugs did you use on the ones who survived?”
Grant leaned back and ran a hand through his hair again, exhaling through pursed lips. “What didn’t we try is the better question. I pumped them full of anything I thought might help—steroids, antivirals, antibiotics, epinephrine, versed, Plasma-Lyte, albumin—you name it, I tried it.”
“Do you have any idea if one of the drugs was responsible for saving the other patients?”
He shook his head. “At that point, I was just trying to keep them alive. I don’t know if it was the combination of the medication, the supportive care or the fact that we caught them early enough that allowed them to survive.”
“Probably all three factors,” Avery said. She laid her notebook on his desk and set her pen down, then leaned back and met his
