Plague Ship (15 page)

“When you stop loving me,” Carolyn replied.

David brought a finger up to his lips, then reached out and touched Carolyn’s nose. “Then you’ll be perfect forever.”

A female patient appeared at the door of the sick bay. David rec
ognized her immediately. She was the librarian from Ohio who had the oculogyric reaction to Compazine. The poor woman had had
nothing but bad luck on the cruise, and now she was holding her left wrist with her right hand.

“I’ve fallen and hurt my wrist,” she said, grimacing with pain. “Can someone please help me?”

“I’ll get it,” Carolyn said and rushed over to the woman.

“If it’s a fracture, see if you can find us some casting material,” David called after her.

“Gotcha.”

David leaned against the wall as a sudden wave of fatigue swept through him. He hadn’t slept soundly since the outbreak began, except for a few hours here and there, and now he was feeling the full effect of it. He needed sleep or he would start making poor decisions and people would suffer because of it. And then there was Choi, who would be difficult to handle fully awake. If David remained sleepless, Choi would take him easily. Again David wished he had killed Choi when he had the chance. That was a big mistake. A mistake that could cost him his life.

Karen came up to his side and said quietly, “David, we have to talk.”

“About what?” he asked.

“Carolyn.”

“What about her?”

“I’m not accustomed to taking orders from nurses,” Karen hissed.

“Well, you’d better get used to it,” David said. “She’s more experienced at critical care than 99 percent of the doctors I know.”

“What makes her such an expert?”

“Her years in the ER, then as a MedEvac nurse before she began working on the Beaumont Pavilion.”

Karen nodded begrudgingly, “Yeah, I guess that would do it.”

“Damn right, it does!” David emphasized. “Just thank your lucky stars we’ve got her down here.”

Karen took his arm and pressed it against her body. “It’s you who we should be thanking our lucky stars over.”

Carolyn called out from the examining area, “I think she has a fractured wrist.”

“Give Steiner a buzz and tell him we need some x-rays.”

“He’s on his way down.”

David winked at Karen. “See what I mean?”

“And we don’t have the materials to cast it,” Carolyn added.

“Shit,” David grumbled. “What about splints?”

“Nada,” Carolyn answered.

“You’ve got to be kidding!” David groaned in disbelief.

“No splints,” Carolyn said again. “And if they do have any splints down here, they’ve hidden them so well I can’t find them.”

David disengaged from Karen and sighed heavily. “I’ll see if the ship’s carpenter can help us.”

“She’s small,” Carolyn reminded him. “The splints shouldn’t be longer than a foot or so.”

David trudged wearily out of the sick bay and into the passageway. He had his head down, shaking it and struggling to keep his eyes open. He didn’t see Choi following him.

twenty-two

A thousand miles away
in the Oval Office, all eyes were on the recently elected President. John Jefferson Tyler, the first African-American President, was reaching into a large bowl of M&M’s. A former two-pack-a-day smoker, Tyler had substituted the small pieces of candy for tobacco, and those closest to him knew they could measure his anxiety by how many M&M’s he consumed. He was currently gobbling them down by the handful.

“How many dozens are dead?” Tyler asked, wanting specifics.

“We can’t be certain, Mr. President,” said Lawrence Lindberg, a heavyset man with a neatly trimmed beard. “We estimate at least three dozen, but it’s no doubt many more by now.”

Tyler gave the CDC’s director of global quarantine a long look. “Why can’t they just count and give us a number?”

“It’s not that simple, sir. The patients are spread out over the entire ship. Some are in the sick bay, most in their cabins. And there are only a few doctors and nurses to care for all of them. Which means there could be a lot of unnoticed dead.”

“Did all the passengers take Tamiflu like they were supposed to?”

“As far as we know, Mr. President.”

“And that had no effect?”

“Apparently not.”

“And none of the other drugs work either, eh?”

“No, sir.”

Tyler reached for another handful of M&M’s. “In total, you say there are over a thousand people on board the
Grand Atlantic
. Correct?”

Lindberg nodded. “If you include the crew.”

“Will the virus infect all of them?”

“In all likelihood.”

“And kill most of them?”

“In all likelihood.”

The President rose from his chair and walked over to the window overlooking the Rose Garden. He stared out at the dwindling sunlight for ten full seconds before turning back to the group of national security and scientific advisors. As usual, his Sphinx-like face was totally expressionless. “Can we do anything?”

The scientific advisors shook their heads collectively.

The President directed his next question to Anthony Church, the short, wiry director of the National Institutes of Health. “What about a vaccine, Tony?”

“There is no vaccine available, Mr. President,” Church replied.

“How long would it take to produce one?”

“At least a year, if everything went smoothly.”

“No good,” the President said, more to himself than to the others. He went over to the bowl of M&M’s and absently picked up another handful. “So we’re left with treating the sick using only supportive measures?”

Church nodded.

“Then we have to get them ashore, don’t we?”

His proposal got no response from the group. They looked at him in silence.

“Don’t we?” the President repeated.

“That presents a huge problem for us, Mr. President,” Church said carefully. “We’re talking about hundreds and hundreds of very sick patients who would require strict isolation in intensive care units. Most ICUs are routinely filled to capacity, with very few empty beds. So if you suddenly have hundreds and hundreds of terribly ill individuals that need prompt admission and constant monitoring, they would overwhelm all the ICUs in a dozen of our largest metropolitan areas.”

“And, Mr. President,” Lindberg added, “those metropolitan areas don’t have enough specialists and nurses to care for all those critically ill patients.”

The President began walking in a circle around the Oval Office, his shadow silhouetted by the sinking sun. He was a lanky, tall man at 6'4", with the easy stride of an athlete who had lettered in two sports at Harvard. He continued circling because he thought better on the move. Abruptly he stopped and gazed over at Lindberg. “Couldn’t we distribute the sick people to hospitals all across the country?”

“That raises another set of problems, Mr. President,” Lindberg said. “How do we transport these patients? How do we keep them isolated along the way so they don’t spread the avian flu virus? And once they arrive at the various medical centers, there is always the very real possibility that the virus will be passed on to others. Remember, this virus is highly contagious and travels via invisible droplets through the air. One unguarded cough in a crowded room, and you’d end up with dozens of infected people. What I’m saying, Mr. President, is that moving these patients ashore would almost surely start a pandemic.”

“Are we talking on the order of the 1918 flu pandemic?’

“Worse,” Lindberg said. “With modern-day plane travel to every corner of the world, we could easily see a billion infected and hundreds of million dead.”

The numbers were stunning to the President. His jaw tightened noticeably. “So you’re saying that taking them off the ship is not an option?”

“Yes, sir. That’s precisely what I’m saying,” Lindberg told him. “That ship is like a floating reservoir containing untold trillions of this killer virus, and it will remain so for the foreseeable future.”

The President let the new information sink in before asking, “Are you telling me they’ll have to stay at sea indefinitely?”

“I’m afraid so,” Lindberg said. “There is no way we can let that ship dock anywhere without the gravest of consequences.”

“Well, they can’t just stay out there forever,” the President thought aloud. “Their families won’t stand for that.”

The members of the President’s advisory committee shifted around in their seats uncomfortably. All were thinking the same dreadful ending.
The passengers on the
Grand Atlantic
would never reach land. They would never see their families again. They were all destined to die at sea.

Finally Lindberg spoke, breaking the silence. “Mr. President, the families have not yet been told about the true nature of the outbreak. We decided it was best to initiate a blackout on every aspect of this dilemma, much to the consternation of the cruise line. As you might imagine, they’ve been bombarded with calls from anxious relatives.”

The President waved a hand dismissively. “The passengers know, and they’re going to somehow contact their relatives ashore, if they haven’t already. You can’t stop the news from getting out.”

“We
have
stopped it, Mr. President,” Lindberg went on. “The executive order you signed empowered us to establish a federal quarantine on the
Grand Atlantic
. To this end, we have EA-18 Growlers continually circling above the ship. These planes can block out virtually all electronic transmissions, including those made on cell phones. The latter is particularly important, since some of the passengers have very influential relatives who will demand the ship be brought into port.”

The President asked quickly, “How influential are these families?”

“One of the passengers is Marilyn Wyman, who is the sister of Senator Evans.”

The President groaned inwardly. Albert Evans, the Senate Majority Leader, was a close friend and a powerful ally. The President made a mental note to personally call the senator. “How does this blackout help the situation?”

“Sir, if these influential people knew about this pending catastrophe, they’d demand their relatives be brought ashore. Or worse, they’d try to come up with ways to get their relatives to land.”

“How? How could they get these people ashore?”

“By helicopters or yachts or by every other possible means they could devise. People do desperate acts in desperate times. And keep in mind, sir, all that’s required for a pandemic to start is for a few of these passengers to secretly reach shore. In essence, Mr. President, the blackout reinforces the federal quarantine and makes sure that no one foolishly tries a rescue mission.”

The President nodded slowly. “And with a blackout, the position of the ship can’t be revealed.”

“And its course can’t be tracked,” Lindberg added.

The President started pacing again, back and forth in front of his desk. “The families have to be told something.”

“They have to be told the truth,” Lindberg said without inflection. “Namely, that there is an outbreak of a highly contagious bird flu virus aboard the
Grand Atlantic
, and that the ship will remain quarantined and held incommunicado until the outbreak is brought under control with drugs and other—”

“But you just told me that the drugs don’t work,” the President interrupted.

“We’ll tell them we’re trying newer, experimental drugs.”

“Is there any chance these experimental drugs will work?”

“Almost none,” Lindberg said honestly. “But we’ll keep trying.”

The President rubbed at his forehead, like he was attempting to soothe a headache. “There’s going to be a public outcry when the news media gets hold of this story.”

“The outcry will be limited and primarily from family members,” Lindberg predicted. “The general public may sympathize with the passengers, but deep down they’ll want that ship to remain at sea for obvious reasons.”

“Particularly when they realize their own survival may be at stake,” Church chimed in.

“But that doesn’t solve our problem, does it?” the President asked, his tone sharper now.

“No, sir,” Lindberg and Church answered simultaneously.

The President knitted his brow, concentrating, all the while pacing the floor of the Oval Office. He mumbled something to himself that sounded like
nightmare
. The others in the room strained to catch his words. Suddenly he stopped and snapped his fingers, as if he had the answer to the problem. “Why not send a bunch of doctors and nurses, and all the equipment they need, out to the ship?”

“We considered that option too,” Church told the President. “But we’d require hundreds of doctors and hundreds of nurses to provide around-the-clock critical care. Keep in mind, these highly contagious patients would be in four hundred separate cabins. Then there’s the matter of protecting all the doctors and nurses from the virus. They’d all have to wear space suits with external oxygen supplies. And even then, there’d be no guarantee they’d be protected. In all candor, Mr. President, I don’t think we could find nearly enough volunteers to go aboard that death ship.”

“What about military doctors and nurses?” the President queried. “They could be ordered to go on board.”

Church shook his head. “We need ICU doctors and nurses who are specialists in critical care. The military doesn’t have enough qualified people to fill the bill.”

The President gave Church a prolonged stare. “So we’re just going to let those people die?”

“The vast majority will die regardless of what we do,” Church said bluntly.

“Couldn’t some be saved by sending out medical personnel?” the President pressed.

“A small percentage perhaps,” Church replied in a clinical tone. “But we’d be risking the lives of a lot of doctors and nurses to do it. It’s not a very good trade-off, Mr. President.”

“So we’re damned if we send help, and we’re damned if we don’t?”

“I’m afraid so, sir.”

The President started circling the Oval Office again, searching for an answer to the dilemma. He moved past his desk and by the door to the Rose Garden before stopping in his tracks. Abruptly he narrowed his eyes and turned back to the group. “Is there any way to decontaminate the
Grand Atlantic
?”

“Not without destroying the people aboard,” Lindberg answered.

The President stepped in closer to the director for global quarantine before saying, “Spell that out for me.”

“Well, sir, if you incinerate the ship with all its passengers, the decontamination would be absolute and complete.”

“Incinerate!” the President’s voice went up an octave. “Like a nuclear explosion? Is that what the hell you’re saying?”

“It was never a serious consideration, Mr. President.”

“I hope not.”

But it was a serious consideration and had been discussed at length. Scientifically it was a viable option. Politically it was not. None of the advisors thought it wise to mention this.

“I need answers,” the President commanded. “Workable answers.”

“I’m not sure there are any,” Lindberg said candidly. “Despite our best efforts, we seem to find ourselves between a rock and a hard place.”

“That’s a place I don’t like to be in,” the President said.

“Yes, sir.”

The room went silent. All the advisors were concentrating on the insoluble problem, a few pausing to thank God they weren’t aboard the
Grand Atlantic
.

The President straightened his tie and buttoned his coat. It was a signal the meeting was over.

The advisors stood.

“Should—should we meet again, sir?” Church asked hesitantly.

The President nodded. “As soon as you come up with a way to save those people and decontaminate the ship.”

“But, Mr. President,” Church blurted out. “You’re asking for the impossible.”

“Yes,” the President said, “I am. So you gather all the resources you need and do the impossible.”

“But, Mr. President—”

The President ended the discussion with a wave and stepped into his small, private study next to the Oval Office. Closing the door behind him, he reached into his desk for a cigarette and lit it.

Screw the M&M’s
, he thought and, inhaling deeply, concentrated on the terrible dilemma he was facing.