We all fall down, p.18
We All Fall Down, page 18
“So far. I connected with the head of Public Health there. They’re tracing all passengers who were on his flight and placing them on home quarantine and antibiotic prophylaxis.”
“Good. And what’s the status of the ring prophylaxis campaign here in Genoa?”
“On schedule. Over a hundred local public health workers are fanning out this morning across the neighborhoods identified as hot spots. We have enough antibiotics to start ten thousand people on prophylaxis, if necessary.”
“It’s going to be necessary, Byron.”
Their eyes meet. “We could end up breeding a lot more antibiotic resistance,” he warns. “Especially if people don’t bother to finish their whole course of antibiotics.”
“You’re preaching to the choir.” Alana knows that doctors bear much of the blame for causing worldwide antibiotic resistance through overprescribing, but in mass prophylaxis campaigns like this one, it’s inevitable that some patients will fail to complete courses of prescription and thereby spare enough bacteria that could “learn” to acquire resistance.
Her eyes are drawn again to the patient whose arm is casted. “This guy doesn’t look like he’s suffering from the plague.”
“Apparently he was one of the kids who was beaten so badly yesterday.”
“Which kids?”
“You didn’t hear? Two Turkish teens were attacked outside their dad’s convenience store. This one got clubbed in the head with a brick.”
“Are they saying the attack was racially motivated?”
“A bunch of local thugs got all fired up after some anti-Muslim rally. He and his brother were just in the wrong place at the wrong time.”
“Jesus,” Alana mutters, but she stops herself before adding, it’s my fault.
Chapter
Thirty-Nine
Letizia Profumo sits beside her husband, Francesco, at the very same table where he proposed to her almost three years earlier. On that memorable day, the quaint family-run restaurant was packed, whereas tonight only one other table is occupied. Though it’s the night of their second anniversary, Letizia would still rather be at home. She’s exhausted. And her nausea is intractable.
Letizia pushes the cima ripiena, the restaurant’s signature dish, around on her plate. She has no appetite for the veal specialty that’s normally her favorite. The thought of another bite turns her stomach. She never expected to feel this sick or overheated so early in her pregnancy.
Francesco is too busy sopping up the white sauce from his penne dish to notice right away. But as soon as he does, he grips her wrist in his meaty hand. “What is it, Leti?”
“My stomach is not right.”
“Are you sick?”
“In a way, I suppose.”
His face crumples with concern.
Letizia smiles and then reaches for her handbag. She extracts the used home pregnancy test that reveals the pink plus sign, and flips it over to show him.
“Amore!” His eyes light with joy. “You really are?”
“Yes, I really am. Happy anniversary!” She throws her arms around his thick shoulders and hugs him tightly.
Letizia isn’t sure if it’s the hormones or just happiness, but a thick ball forms in her throat and tears spill down her cheeks. It takes her a few moments to realize that the constriction in her throat is not going away.
Choking, Letizia wriggles free of her husband’s grasp. She coughs hard, trying to clear the obstruction. She feels something give, but her hand doesn’t reach her mouth in time. The blood and phlegm spray across her husband’s plate, as if intending to turn his white sauce into a pink.
Chapter
Forty
Desperate for fresh air, Alana slips out of the hospital without telling Byron or Nico that she’s leaving.
The sun is high and a light breeze carries the scent of fresh blooms, but the perfect spring weather does little to quell her dark thoughts. As she walks along the relatively deserted sidewalk, Alana reminds herself that she has no connection to the assault on the Turkish teens. But that doesn’t prevent the guilt from gnawing. She forces the thought to the back of her mind and focuses instead on the recent developments in the outbreak: the accelerating death toll, the growing antibiotic resistance, and the discovery of healthy rat carriers. It feels as if events are conspiring to create the perfect epidemiological storm. She wonders if, hundreds of years before, similar bleak factors propelled the original Black Death to the point of critical mass.
She thinks again of Zanetti’s construction site, where Yasin died. She is more convinced than ever that the old monastery has to link the current outbreak to the medieval one. But if so, where could the plague have hidden all those years?
On a whim, she hails a cab. Ten minutes later, she is dropped off in front of Brother Silvio’s dreary apartment building. It takes the diminutive monk a minute or two to answer his door, but he does so with a big smile as he welcomes her inside his cramped apartment. The smell of old books seems even stronger today.
“I hope I’m not disturbing,” Alana says.
“Not at all. I am happy for the company. Many believe a monk’s life to be one of solitude. But for me, it was the opposite, living as I did among my brothers. I miss the humanity.”
She can’t help but return the cheerful monk’s grin. “Brother Silvio, I was hoping to learn a little more about the monastery.”
“Prego. What can I tell you?”
“Were there ever any unexplained illnesses among the brothers who lived there?”
“Unexplained?” He grimaces. “I lived at San Giovanni a long, long time. Over forty years. Long enough to see several of the brothers pass.”
“Of course. But were there any sudden illnesses? Fevers? Rashes? Bad chest infections? And so on.”
He frowns, deep in concentration. “Brother Simone, he died of pneumonia a few years ago. But he was almost as old as me, and he had the cancer. The doctors, they said it was a blessing.”
“No one else you can think of?”
He squints at her. “You believe this plague comes from San Giovanni?”
“You have to wonder,” she admits. “The first two known victims worked at the construction site. They died of the very same infection that almost wiped out the monastery during the Middle Ages.”
Silvio taps his veiny nose but says nothing.
Alana nods toward the bookshelf. “You told me last time that you had historical records of the Black Death in Genoa.”
“I do.”
“Could you show me?”
He spreads his palms in front of him. “Do you read Latin?”
“No, but I can get them translated if necessary.”
“Of course.” Silvio ambles over to the bookshelf and thumbs through the volumes on the shelf. He extracts a leather-bound volume and waves it in the air. “This one. Written by the fifteenth-century Genovese historian Ugo Cavotti. He tells how almost half of Genoa died from the plague.”
“Fifteenth century? So he would have been born after the time of the Black Death?”
“Yes.”
“You mentioned eyewitness accounts?”
Silvio wavers a moment, then he slips the book back into its slot and reaches above him for another volume. It is slimmer and appears even older than the previous one. “This is the diary of a Genovese doctor. Rafael Pasqua.”
She reaches for it. “May I?”
He hands it to her gingerly, as if passing her a robin’s egg.
She accepts it with both hands. The plain brown cover is scratched and stiff as she turns to the first page, which is written in Latin script.
“It is special, this one,” he says. “The other historians like Cavotti wrote about the big details and the tragedies. But Doctor Pasqua, he writes of his own experience. It is very . . . moving.”
“Do you think I could borrow it?”
He seems to hesitate again, but then says, “Yes, of course.” He takes the volume back from her and carefully replaces it on the shelf, and then hurries over to the laptop on the desk that is almost hidden by a stack of papers.
When Alana views him in surprise, he laughs. “Even we monks have had to accept the modern age. We do not transcribe with quill and parchment anymore, Dr. Vaughn. I have scanned a copy of the text into a PDF document. This, I will email you.”
Alana provides her email address and thanks Silvio, then heads downstairs. She flags a passing cab and takes it back to the hospital. Once there, she gowns up and heads straight for Claudio Dora’s private room in the isolation ward.
Claudio sits on the side of the bed. Though his cheeks are still hollow, he is no longer wearing any kind of oxygen tubing. His navy robe makes him look more like a guest at a spa than a plague victim.
“You look much better, Claudio,” she says. “Less pale.”
He motions to her protective garb. “And you still look like a glamorous beekeeper.”
“They say it’s all the rage in Milan this season.”
“Certainly in Genoa, at any rate. It’s all I ever see these days.”
“How are you, Claudio?”
“Better. I still tire easily, though. This Black Death can really wear a person out.”
She musters a smile. “Nico told you?”
“About the Black Death? Yes.” Claudio pauses. “Other things, too.”
“Like what?”
He looks skyward. “He struggles, our friend Nico. More so since you have arrived.”
“He drinks too much, Claudio.” She feels slightly sheepish voicing the concern in light of her previous evening, but it has been weighing on her mind.
“True. Even by Italian standards.” Claudio’s expression turns serious. “He was doing better. Much better. For years. And then Isabella . . . and the affair . . . It’s been hard on him.”
“That’s just an excuse, Claudio.”
“Sometimes we need those, though, Alana.” He falls silent for a moment, and then exhales heavily. “It’s amazing.”
“What is?”
“One unlucky construction worker shovels into the wrong pile of dirt, and presto, he drops dead from the plague. If his coworkers had reported Yasin’s death instead of trying to cover it up . . .” He shakes his head. “Then perhaps he would have been the only case instead of the tip of the iceberg.”
“Yeah, maybe,” she mutters, but her mind is elsewhere. “Unless . . .”
“Unless what?”
“That explains the second cluster.”
“What are you talking about, Alana?”
“The other hot spot, in Parco Serra Gropallo. We couldn’t figure out how the plague traveled from the old monastery all the way across the city to infect the rats in that park.”
“Do rats not travel?”
“Not that far in such a short period of time. Not even a healthy carrier.”
“So how does what I said explain anything?”
“The cover-up at the site. We already know they hid Yasin’s body. And then later they cleared away all the rats to make it seem as if the plague had never begun there.”
“Yes? So?”
“What if they took it a step further? What if they relocated the rats somewhere else to deflect suspicion away from the site?”
“Would someone do such a thing?”
She thinks of the explosives piled on the table in the extremists’ apartment. “You’d be amazed what lengths people will go to.”
He reaches for the book at his bedside with the grim reaper on the cover and raises it to show her. “During the time of the Black Death—the last go-around, anyway—they went to extreme measures, too.”
“So I’ve heard.”
“It’s ironic, isn’t it?”
“What is?”
He wiggles the book. “That the Black Death has come back home. To Genoa. After all, it was Genovese sailors who brought it to Europe from Asia in the first place.”
Alana takes the book from him and studies the cover. “I have my own text on the Black Death in Genoa. An eyewitness account.” She tells him of the medieval doctor’s diary Silvio emailed her, and then adds, “It’s written in Latin, of course. I will have them translate it into English for me in Brussels, but that could take a while.” She bites her lip. “Didn’t you once brag to me that you knew Latin?”
“I am far too accomplished to brag about anything,” he says with a fleeting grin. “But yes, I can read Latin.”
“Would you mind . . .”
“Email it to me.”
“Are you certain?”
“I am bored out of my mind, Alana. And I’ve got at least two more days until I will be released from quarantine. My parole cannot come soon enough.”
Somehow, he already seems like an old friend. “I’m really glad you beat this thing, Claudio.”
“I am relatively pleased myself.” His smile falters. “How many others won’t?”
She has no answer for him. Instead, she pats his shoulder and says, “Listen, Claudio, I have to run. I’ve got another meeting to get to.”
“Of course, you do, Miss Bond. Probably in an abandoned gondola on some treacherous mountain peak.”
“Something like that.” She grins as she turns for the door. “See you soon, Claudio. And thanks.”
Alana leaves the hospital and heads straight to the biology building of the University of Genoa, where she has arranged to meet Justine. The rodentologist is already garbed in PPE gear and waiting for her in the basement hallway. She passes Alana a matching set.
“So?” Justine views her expectantly. “Got another Tinder date tonight?”
“Byron and I weren’t on a date!” Alana snaps, immediately regretting her defensiveness.
“If you say so.”
Biting back her annoyance, Alana shakes open the folded gown, raises it over her head, and jabs her hand into the sleeve. Her shoulder pops, and she gasps in pain.
“What’s the matter?”
Alana forces her arm outward and feels the instant relief of her shoulder slipping back into place. “An old injury,” she says as she carefully slips the rest of the gown on.
“From Afghanistan, right?”
“Yeah, a wall collapsed on me after our hospital was bombed. My arm was trapped. Ripped all the tendons in the rotator cuff. My shoulder has been unstable ever since.”
“Ouch. They couldn’t fix it, huh?” Justine asks with what sounds like genuine concern.
“I’ve had enough surgeries.”
“If you say so,” Justine says. “He’s not so bad, you know?”
“Who?”
“Byron. Nothing wrong with him that a couple martinis and maybe a baseball bat couldn’t fix. You could do a helluva lot worse.” She laughs. “So could he, come to think of it.”
Alana only sighs. “What about you, Justine? Are you married?”
“Unfortunately. I got a husband back in Atlanta. A real lab geek, too. He’s a royal pain in my ass.”
Alana picks up on the affection behind her flippant words. “Any kids?”
“No. Not yet. I like the fieldwork too much.”
“Yeah, well, don’t wait too long.”
Justine eyes her with a knowing smile but says nothing. Instead, she opens the door beside her with a gloved hand.
Alana follows Justine into the sterile-looking lab. In the center of the room stands a high table surrounded by wooden stools. On top of it, a grayish rat lies belly-up on a green towel, surrounded by an array of surgical instruments.
Justine picks up a scalpel and taps the animal’s hind leg with its blunt end. “This is the largest of the rats we found in Parco Serra Gropallo. I call him Vin Diesel.”
“Why?”
“I name all my animals, alive or dead. And this one kind of reminds me of the action movie actor. You know? A buff alpha-male type. Bet he was a real lady-killer in his day!”
“Oh, God.” Alana can’t help but chuckle.
Justine flips the scalpel over and reaches for a pair of forceps. “Okay, Vin, let’s see what’s under the hood!”
She pinches the skin at the base of the rat’s abdomen with the forceps’ teeth, lifts it up, and incises it with the scalpel. Once she’s created a small cut in the lower center, she runs a pair of pointed scissors upward, opening the flaps of skin and fur on either side like unzipping a jacket, exposing the shiny lining of tissue, known as the peritoneum, beneath. She slices through the peritoneum using a similar technique, and the intestines and liver spill out of the opening. Finally, she uses the scissors to chew through the animal’s breastbone, revealing the heart and lungs underneath.
Justine says nothing as she leans forward and examines the organs using two slim metal probes, occasionally exploring with her fingertip. Finally, she drops the probe on top of the stack of used tools. “Nada,” she says.
“Meaning?”
“No lung involvement. No lymph nodes. No skin buboes. Nothing. This animal was never sick with the plague.”
“But you’re certain he was infested with the same fleas that carried the plague.”
“Positive.”
“Perfect.” Even though it only confirms what they already suspected, Alana’s heart still sinks. “How do you stop an outbreak when the carriers are the only ones immune to it?”
Justine doesn’t reply. Instead, she folds the abdominal skin flaps back into place. She motions to the overlying brindle markings and white patches. “A very unusual pattern.”
“How so?”
“I’ve never seen these kinds of markings on a black rat. And look.” She flips the rat over and pries opens his mouth, exposing two long yellowish teeth above and below. “You see the size of his upper two incisors relative to his lower ones?”
“They look about the same to me.”
“Exactly! Usually a rat’s lower incisors are twice as long as his upper ones.”
“Wait, Justine, are you suggesting that this rat isn’t native to Parco Serra Gropallo?”
“Forget the park. I’m saying I don’t know of another black rat anywhere that matches this particular sub-breed.”
Chapter
Forty-One
