Cold Silence Read online

  As a boy I’d believed in this trash. But I knew better now. I knew this after what had happened to Karen. I believed in guns, germs, and laboratories now. Not in hope, prayer, or friendly gods.

  Wilderness Medicine 101. Get splints on the injured, but the very flesh seemed to be melting off these people. Administer appropriate antibiotics, but we did not know if a microorganism was involved, or whether it would respond. Call for medevac, but that was impossible. What we knew here was even less than in most extreme emergency cases. We knew nothing. Only bits of truth, of possible analysis. To prematurely choose a cause could be fatal. But to do nothing seemed like it would produce the same result.

  My earpiece whispered out the low voice of Hassan, the militia leader, over our shared comm-system.

  “My brother is in there. He helped your people find special places, the special rocks,” Hassan said.

  “Special how?”

  “They are old.”

  “Old how?”

  “They were the rocks near the ruins.”

  “What ruins?”

  “Roman.”

  “Hassan, I don’t know what’s happened, but we’ll do our best to find out.”

  “My brother was a wrestler. A powerful man! Look at him now! I have never seen a disease like this!”

  “Have any people outside the compound fallen ill?”

  “Not yet. I wish to keep it this way.”

  Eddie and I shuffled into the compound. Our air filters allowed in some odors now: rot, grease, shit, Lysol.

  Hassan’s voice hardened. “You will take tissue samples. You will give the medicines. When you are done, you will strip off all clothes and leave them on the ground. You will be naked. You will not take anyone out with you.”

  Uh-oh. “I thought you wanted these people evacuated.”

  “We will discuss that later.”

  The fighters behind us were spreading out, the Technicals moving right and left as vehicles took up new positions. This adjustment placed the entire compound at the intersecting trajectory of at least fifty pointing guns.

  “Hassan, there are too many sick here for just two doctors. I need more.”

  “No tricks. Just you.”

  “We don’t have enough medication for all these people.”

  “Ah! You do know what this sickness is, then? The proper way to treat it! Tell me what they have!”

  “We don’t know yet. Hassan, one of these people is your own brother. Don’t you want him to have the best care?”

  He cut me off angrily. “Go to work.”

  We closed the last few feet. I have to admit, as a doctor I’ve seen many horrible things, but this, the sheer number of people, the mass of deformity, produced in me the greatest revulsion. I wanted to turn away. I was eight years old, with my parents, watching an old wide-screen rereleased 1959 Technicolor movie at the multiplex in Pittsfield, one Easter. The leprosy scene. The sick women coming out of caves in a Mideastern valley, in Ben Hur. Shunned. In rags. Hiding their faces.

  As a boy, I had squeezed my eyes shut, not wanting to see those horrible Hollywood special effects. I had asked my mother, when the film was over, Can that happen in Pittsfield? And she had said, No, it’s an old disease. It doesn’t harm people here anymore. It’s from Bible times, Joe.

  Bible times.

  Well, in Ben Hur the sick did not wear short-sleeved shirts that read TORONTO MAPLE LEAFS and khaki slacks from Costco. They wore clothing from the time when Jesus walked the earth and Roman armies conquered Jerusalem, a time when the existence of bacteria was unknown and the greatest doctors believed illness came from witchcraft or vapors or punishment from gods.

  Eddie’s eyes sought mine over our masks. Hassan would hear everything we said. Eddie’s expression contained the message: Hassan’s lying about something.

  I nodded. I know. But we do our job.

  —

  The first man in line was a white guy who looked about sixty, his back bent, his face swollen, breathing raspy, hair patchy like mange on a dog, mouth eaten away on the left side so severely that I saw white teeth, red gums.

  “Colonel?” the old guy rasped. “It’s me.”

  I hope I hid my shock. Wilderness Medicine 101. Make them comfortable as possible. And calm as possible. Get information as fast as you can, once they’re calmed.

  I managed to keep my voice light. “Hey, who ever figured I’d run into you here, Lionel.”

  “Yeah,” he rasped. He tried to smile, looking more like a skeleton. “Big surprise.”

  “Lie down.” I indicated a picnic bench. He struggled to do it and I helped. I said, “How long have you been a scientist?”

  His words came out slowly, forced. Vocal cords affected. “I went back to school after the Marines. Got my Ph.D. Dumb to come here, huh? But piracy off Somalia ended research here for twenty years, until now. Climate projects. Ocean. Super important work.”

  “What’s so important about it?” I asked, looking into the throat. Oh God. Maggots in there.

  “Sediment samples help date early man.”

  He was as calm as he was going to get. I said, “Well, I’m here to help. Lionel, what’s going on?”

  Eddie was lining the others up at the mess tent picnic table, our makeshift exam room. Wilderness Medicine 101. Triage them into groups: the doomed, savable, and healthy. Do it whether you’re working an avalanche, cyclone, or cholera outbreak. Do it and you’ll save the most lives.

  “Lionel, can you tell me how this thing started?”

  The twisted figure broke out coughing. He raised his left hand to cover his mouth. My horror intensified. The little finger was half gone. The stump of his index finger oozed blood.

  But his brain was working, and the words he squeezed out came from an observant scientist who was fighting to maintain self-control, and save his own life. “Two weeks ago everyone was fine. Then Miriam—a grad student—said her fingers tingled. And then Dr. Ross cut his leg with an ax, but he felt nothing. Our faces. My toe. I woke up three days ago and it was half gone.”

  I shone light in his eyes, used a tongue depressor on the rotting pink thing in the cave of his mouth. Heartbeat normal. I maneuvered a thermometer in his mouth, but his lips were eaten away so I had to hold it in place.

  “Very helpful, Lionel. Miriam was the first to get sick, you say?”

  “I think so. But everyone seemed to get it at the same time. Mike Dellman died.” The watery eyes shifted to the body draped over the thorn bushes. “They shot him. He tried to run. I don’t know where he thought he could go.”

  “Tingling, you said? Miriam felt tingling. Tingling was the first symptom? What happened next?”

  The eaten-away face before me seemed to consider, but it lacked animation. The nerve endings were probably shot. Flies landed on lumps and open sores.

  “Next? The patches, skin patches, like cancer my uncle Fred had in Arizona . . . My nose got thick. I can hardly see.” His panic suddenly crested. “Hard to walk!”

  “Very observant, Lionel. Keep it up,” I said, talking to him as if he were still a nineteen-year-old Marine, not an accomplished professor of geology. “Tell me about that rash a bit, will you? Where exactly did that start? Fingers and toes? Or in the central part of your body?”

  “It’s hard to think! My face! Yes! My lips.” His voice sped up. “And then the rashes came and my feet lost feeling!”

  “Turn over. Good. Any fever? Chills?”

  “It gets cold at night. But I stopped eating so I don’t know if I’m cold because I’m sick, or not eating.”

  In my earpiece I tried to ignore the sound of clan fighters arguing behind us, the babble of enraged voices back there, in the circle of guns. I said, trying to find possible sources of infection, “Where do you get your water?”

  “It’s bottled. Donated. S
eparate bottles for each person. We thought of that already.”

  “Any odd smells? Or tastes when you ate?”

  “No.”

  “The sediments you work with. Is everyone here exposed to them? Did everyone go to these Roman ruins?”

  “No. Some people stayed in camp, and never got near the work. They’re helpers. But they got sick, too.”

  I was finished with the prelim exam. But not the questions. Lionel was giving me baseline information. I’d need to ask every patient the same things. “Anybody you’re aware of with hostility to this group?”

  He let out a croaking laugh. “Hostility? That’s good! We’re in a war zone!”

  “Almost done, Lionel. It’s important to eliminate possible causes. Are you aware of any chemicals used here, by one of the warring groups? Have you been in any areas where you saw dead animals? Dead vegetation?”

  “Only us. Can I help you now, to help the others?”

  I gazed into the ravaged face and my chest swelled with pride for my former soldier. “Your answers are already helping, Lionel. The trouble you’re having speaking—is that because you’re experiencing difficulty thinking of words? Or is it physically hard for you to produce the words?”

  “Produce . . . the . . . words . . .”

  “Headache?”

  “No.”

  “Chest pain? Shortness of breath?”

  “I’m scared, sir. So yes. But is it related?”

  “Maybe. Numbness?”

  “In my feet.”

  “Night sweats?”

  “It’s hot here. You always sweat.”

  “What percentage of the people here are sick?”

  “Some people have it bad and some a little. Maybe seventy percent caught it. Half of those got better. Half, worse.”

  I heard two male voices coming from one of the other tents, high above the hubbub, singing. I couldn’t make out the words.

  I snapped a photo, but I had more questions than time to ask them. I said, “Last one for now. The healthy people. Is there anything common about them that you’re aware of? Maybe they came from the same place? Sleep in the same tent? Eat special foods? Anything?”

  “I wish those guys in tent four would just shut up!”

  I never forgot that Hassan was listening, so I kept my voice calm, which I wasn’t, as I asked person after person the same questions, and got the same answers. Lionel limped up and down the line, and I heard him telling others in that strangled voice, “Dr. Rush saved my life once.”

  Lionel saying, “He saved my buddies and he’ll save us. You’ll see.”

  —

  We snapped photos. We wrote down names and home addresses and next of kin information. We took temperatures and skin samples. We administered broad-spectrum antibiotics, after asking about allergies. The samples would be analyzed in our tent lab back at the base, but not for many hours.

  If Hassan lets us go.

  “Ma’am? Lay down,” I addressed a skinny, bespectacled black girl in a UPenn T-shirt and jeans who I guessed was about twenty-four years old, a grad student, she said. The disfigurement added years. The cauliflower ears ballooned out, making it hard for her glasses to stay on. Her arms were a mass of lesions. “How much time passed between the first sore appearing and now?” I asked.

  “Six days.”

  “Did you notice anything wrong before the rash?”

  “I spilled coffee on my hand. But I felt nothing.”

  “Have you ever had a skin problem before?”

  “No, Doctor.”

  “Hassan? Are you listening to all this out there?”

  “I am listening, Rush.”

  “Dr. Nakamura and I can’t handle this alone. We need help. Let me call the base and get another plane here. I don’t understand why you’re stopping us.”

  “If you call, the drones will come.”

  The clouds thickened and the sky darkened and a light rain began. Lionel and a couple of healthy people helped two more sick grad students into the tent and helped others back to their cots. Wait there, out of the storm, and we’ll visit you, we said. In the mess tent, I used a picnic bench exam table. Rice sacks were chairs. The tent drummed with rain. Rivulets ran in through a hole up top to puddle on the ground. The man lying on the table smelled like decaying meat.

  I glanced outside. The circle of militia had not moved. I was sure that the steady rain intensified their rage.

  —

  “Where are you from, Tom?”

  The assistant professor’s dark red British passport shot showed a handsome face, twenty-eight years old, a neat blond beard, vivid blue eyes, a shock of boyish hair, a cocky smile. But now the hair was the only recognizable part. The features had swollen; the beard was mange. He looked like a practical joker had stuck a million-dollar hairpiece on a chimpanzee.

  “You’re British, Tom?”

  “John Bull, that’s me.”

  “Have you ever experienced anything like this before?”

  “Never sick a day of my life till now.”

  “Tilt your head back. Can you swallow?”

  Some of his sores had opened, become runny and smelly. The brow had furrowed so much, it almost folded in on itself.

  “I’m giving you aspirin,” I said.

  The gargoyle face stared fixedly but that was because his muscles were damaged, producing a single expression. He whispered, trying for humor, “That’s the best you can do, Doc? Aspirin?”

  “Are you allergic to any medicines?”

  “I never needed any. Can I have some water? Most of it runs out this damn hole in my mouth. Better oxygen flow, though.”

  “You have a good sense of humor, Tom. Anyone ever tell you that?”

  “I’m a regular Jason Manford, Doc. That’s what Mum used to say.”

  —

  “Hassan?”

  No answer.

  “Hassan?”

  No answer.

  “Hassan, I need to know if you can hear me. If you can hear me, answer!”

  “What do you want?”

  “Let me bring in copters. I’ll get the sick out. Surely you want them gone.”

  “We’ll talk later.”

  “In my experience,” Eddie said, not caring if Hassan heard or not, “later means never.”

  Another hour went by.

  We took more photos. We could not send them to anyone yet. The rain stopped and started again.

  —

  Two voices—two men—started singing religious songs again. One by one six prophets, the sixth the last to come. What the voices lacked in quality they made up in volume. The men in tent four were driving everyone crazy.

  “They stay in their tent,” Lionel said.

  “So! You two didn’t get sick,” I said, pushing in the tent flap. I saw the men sitting on two neatly made cots. A milk crate table. Field notebooks. Duffel bags. A once-happy group shot of grad students, khakis on, thumbs up, all smiles. Here we are in Africa!

  They both looked to be in their twenties, burned by the sun, a thin tall man and a pale chubby one. The blond tall one, clean shaven as a Mormon missionary, wore a short-sleeved cotton shirt fielding a SAVE THE PLANET motif, Merrill desert boots, and aviator-style silver-framed glasses. The second man was older, curly haired but balding, and dressed in ragged denim cutoffs, flip-flops, and a summerweight hoodie with a Breckinridge, Colorado, logo, a downhill skier etched in dark blue against white.

  “I’d like to take blood samples from you, if that’s okay.”

  “Sure thing, Doc, if it helps the others.”

  “You both seem unaffected physically.”

  The older one, Ned Ludlum, rapped his knuckles on a wooden tent pole, superstitiously. “Knock wood. But every day we check each other over, inch by inch.”


  “Any idea why you stayed healthy?”

  “Luck,” said Ned.

  “Prayer,” said Brad Colbert, the other guy.

  “Have you eaten anything the others haven’t . . . Got different vaccinations before you came to Africa? Different medicines you’re taking? Maybe you’re on antibiotics for something else?”

  “I’m taking Cipro, sir, for a cold I caught in Nairobi,” Brad told me, holding up the pill vial.

  “Nothing for me,” said Ned.

  “How about before you came? Do you have your immunization form? Special shots? Preventative medicines?”

  I checked the stamps and notations on their yellow immunization forms. They’d received standard prep for Americans visiting East Africa. Antimalarials. Yellow fever shots. Anticholera. Tetanus. Gamma globulin against hepatitis.

  I noted that both their cots were protected by pink mosquito netting. But many of the sick people had netting over their cots as well. Neither man showed sores anywhere on their bodies. Temperatures normal. Mouths unremarkable. Movement natural. Sleep irregular, they said, but it was hard to sleep regularly when your friends and neighbors were sick all night.

  Ned said somewhat apprehensively, “Are we going to be okay?”

  “I hope so.”

  “Can you cure our friends?”

  “I’ll do my best.”

  I left them in their tent, and they started singing again. Hope worked for them as well as preventative medicines, I guess. I just wished they weren’t so off-pitch. Those voices would drive anyone crazy after a while. They were grating on me, too.

  —

  I hoped nobody would say something over my radio to set off Hassan or his militia. If shooting started, we had no place to run.

  “I started this,” the girl sobbed. “It’s my fault! My God! I started this and now I’m better and they’re worse.”

  Kate Detrich lay in tent seven, alone, because her tent mate had died. The face of the twenty-four-year-old grad student was slightly red and scaly, but the symptoms were fading, she said. Her speech was clear. If I hadn’t seen the others, I’d think she had a bad skin condition. Her agitation was so extreme that she was shaking, from emotion, not disease.

  “I caused this sickness! Me!”

  She was someone who liked to fix up living quarters, no matter how temporary. The cot had a colorful woven blanket over it, and I saw watercolor sketches of African plants hung up: a fat baobab tree, a myrrh tree, a phoenix cactus, with purplish flowers. The milk crate night table had a Coleman lamp on it, and a photo of smiling parents with a happier Kate. Strawberry blond in the shot. About five foot three. Pageboy-cut hair. Pretty green eyes in a plain, intelligent face. The photo had been taken at Sea World. Behind the vacationing family, a leaping killer whale.