The Wyrms of &alon

When the first strategy meeting of Ward E’s CMT finally came to an end, I staggered out of the room feeling as if I’d just crammed a textbook and a half’s worth of fungal biochemistry and antifungal pharmacology into my head, along with a couple seminars of clinical praxis for patients suffering from a contagious illness. It was… overwhelming, to say the least. In addition to being dazed and confused, by the time the meeting ended, I felt like I hadn’t meaningfully contributed to the discussion, and that left me with a fresh pound of guilt for me to haul around for the rest of the day.

“Don’t trouble yourself about that, Genneth,” Ani had told me, as we walked out of the meeting room, “I’m sure you’ll be front and center when we sit down to discuss our plans for managing the Type Two cases.”

With those simple words, Dr. Lokanok succeeded in banishing my guilt and replacing it with dread. For time’s sake, we’d agreed to reconvene tomorrow morning to formulate our policy for dealing with the Type Two cases. Our current priority was getting Ward E’s staff up to date with their much-needed protocols for dealing with the Type One cases. Apparently, the latter was, by far, the more common of the two. As Dr. Derric had explained, initial estimates suggested Type Two cases made up at most one out of every ten thousand NFP-20 infections. Fortunately, as nerve-wracking as our meeting had been, doling out briefings to Ward E’s staff turned out better than what I had expected. It had been smooth going, and the staff all seemed to be really good people. I was honored to be working beside them, and I’d told them as much.

Also, Nurse Kaylin was astonishingly loud for someone on the short-side—or, perhaps, I had swapped cause and effect for that one. She was rather… voluble, and, when you added that to the rest of her irascible demeanor, I could see how that would have gotten her in trouble with management and Human Resources.

Now to the negatives.

I was still dead. Other living-dead people, such as myself, were probably developing magic powers to move objects with their minds, and, disconcertingly—as if I had any room left for more disconcertion—Andalon appeared to be AWOL. So much for wanting my help, I guess.

The rest of the negatives, however, were much more mundane.

It really grinded my gears that, despite the mounting evidence that coughing, talking, or even merely breathing could potentially spread the Green Death, WeElMed management had yet to do what Dr. Horosha had suggested to Director Hobwell, pull out all the stops, and activate the infection containment measures built in to the hospital to respond to an outbreak of darkpox. Two well-placed videophone calls—one to the person who told me who to call, the other to the person I was told to call—led me to one of Hobwell’s underlings, who informed me that the reluctance to activate the darkpox measures had something to do with avoiding mass panic.

That explanation did not inspire much confidence.

In spite of that bit of sheer fudging insanity, management wanted to have their cake and eat it too, and to that end, all of the CMTs had been given a list of rules and regulations we had to follow with regard to PPE. Other than being dead and the adjacent problems, alongside the “being one of the people in charge of the team in charge of managing an entire Letter Ward during a pandemic” thing, there was no more tangible, distinctive, unnerving, or nettlesome a part of my new normal than having to wear PPE and abide by the positively catechistic regulations accompanying their use.

Our PPE would have looked appropriate if worn by a research chemist, a welder, or blacksmith—if welders and blacksmiths wore plastic while they worked. The PPE came in several parts, most of which were hot off the matter printers down in the basement levels. The PPE’s business end—the gown—consisted of a pale blue apron-robe hybrid which we wore atop our usual medical attire. The synthetic material had a kind of fuzzy texture to it, and it reached down well below our knees. As Dr. Derric kindly mansplained to me, the “fuzziness” was actually nanoscale engineering at work, with the material being designed that way so that it would lock in place any fluids that spilled upon it. While I kept my personal console in my coat pocket, I stored my work PortaCons in one of the pockets on either side of the gown.

The gloves were like a bag of chewy candies, in that they came in many different colors, each of which had a different fruit flavor: purple grape, red cherry, light green lime, yellow lemon, orange orange, dark green kiwi-watermelon, and so on and so forth. The gloves worked in concert with the gown. All it took was a simple wave of a heating wand over the wrist-ends of the gloves and the material melted into the hem of the gown’s sleeves, forming a perfect airtight seal. Once done, the gloves only came off when we removed the gown altogether. Our PPE packages came with plastic face-shields which we wore by way of an adjustable head to which the shields were attached. The face-shield consisted of plastic visors on three of its four sides—stretching back to behind our ears—supported by a sturdy white synthetic frame. They looked like the rectangular prism lamps one might catch outside an antique home, only sleeker. Whatever parts of our heads the face-shields couldn’t protect got covered by a soufflé-shaped head covering. From a distance, it made our heads look like plastic mushrooms.

We also got special plastic sleeves for our consoles, to prevent them from becoming fomites.

The guidelines for using the PPE were as detailed as the equipment itself. As the day progressed and more and more CMTs took charge of their Wards and put their plans into action, the hospital had begun to triage itself, with a wide swath of Letter Wards—including Ward E—getting prioritized for housing and treating NFP-20 patients. A handful of the other Letter Wards were assigned to deal with non-elective surgeries, other emergency conditions. Although the receptionists received orders to notify prospective and incoming patients that non-elective surgeries were no longer being offered, in truth, that was a lie. As long as you were sufficiently wealthy, powerful, or important, you could schedule any elective procedure you wanted and would be attended to by one of the non-NFP-20. It seemed not even a pandemic was enough to break down our socioeconomic class hierarchies. Either that, or the pandemic just wasn’t yet dire enough to merit such a breakdown.

The establishment of internal triage zones within WeElMed meant that you had to change your PPE whenever you moved in or out of a NFP Ward. The same happened at your shift’s beginning and your shift’s end, and whenever you needed to eat, drink, or answer nature’s call. Thankfully, the hospital had more than enough space for people to do all this. There were clusters of lounges, restrooms, vending machines, locker rooms, and waiting areas adjacent to each and any of the short corridors which separated the hospital’s different wards and wings. Even though darkpox protocols had yet to be invoked, all of the NFP Wards had activated their separation corridors’ airlock functionalities. Traffic flowed through them in discrete chunks, like food through a sphincter, and many folks used the airlocks to don or doff their PPE, though that did very little to make the constant donning and doffing and donning it again any less mind-numbing. Despite the massive nuisance this caused, I didn’t resent the guidelines in the least. You didn’t need to tell me twice why it was necessary, or about the good that it did. Also, through the behavior of a handful of troublemakers, revealed the surprisingly wide gap that separated malice and selfishness from bonafide stupidity.

In between all the donning and doffing, I took on my new duties and the fancy stethoscope that came with them. Just like everyone else on our team—research consultants like Brand notwithstanding—when we weren’t scheduled to convene and discuss our latest plans, I was tasked with helping in the fight against the Green Death. I spent over an hour informally examining folks in the Ward Lobby, and the waiting rooms, and the reception areas, checking for signs of infection. The most prominent—and frightening—signs to keep a lookout for were skin ulcers and dark, subcutaneous filaments. I kept my eyes peeled for signs of neurological dysfunction—Nalfar’s, seizures, ataxia—anything which might indicate a Type Two case, though I didn’t spot anything. With the help of a very patient nurse, I learned to how recognize what everyone was quickly coming to identify as the characteristic sound of lower respiratory involvement in Type One NFP-20 cases, and began using my stethoscope to listen to every gosh-darn person I crossed paths withs, even if they didn’t appear to be coughing.

After that, I began doing my rounds, something I hadn’t done since medical school. The vast majority of the patients I’d seen throughout my career came to me by appointment only, so doing rounds was a complete change of pace for me. As I scuttled from room to room, my primary duty was to function as a prescription-writing machine. These included painkillers, antifungals, expectorants (drugs that increased mucus secretion in the respiratory tract), mucolytics (drugs that reduced the viscosity of the mucus), mucokinetics (drugs that made it easier to cough out the mucus), antihistamines (to reduce inflammation and congestion, the latter often caused by mucus), along with many other drugs that I’d either never known, or had only previously experienced because I’d either administered it to my kids because they’d picked up some bug from school or because I’d administered it to myself after the bug my kids picked up at school had inevitably gotten me sick, too. Thank the Angel, the nurses were there to help ameliorate my difficulties and inexperience. But there was another factor that I hadn’t expected.

My memory.

Normally, it would have taken a while for me to memorize the names, effects, and dosage schemes for all the unfamiliar drugs I was now prescribing. Now, though, I only needed to hear or see that information once. At one point, I had to excuse myself and step out of the room to try to keep myself from freaking out that I had just recited from memory several pages’ worth of detailed drug information that I’d only briefly skimmed from documentation I’d read off my console. And it wasn’t just that I knew what words and numbers to say. I could see it in my mind’s eye. I could read off the information as if I was in a dream and the pages were right in front of me.

I honestly expected to have a panic attack right then and there, but—to my astonishment—I didn’t. All the physical symptoms of an oncoming panic attack were there: my undead breathing quickened as my corpse-heartbeat raced; icy hot blood throbbed through my veins, putrid and purulent. But the actual attack never came. I didn’t feel death’s hand crush the life in my chest. There was no moment of collapse. The stress passed over me like a wave.

I guess dead people like me don’t get panic attacks.

I went back into the patient room. While I was apologizing to the nurse for stepping out on her, my work console pinged. It vibrated like an old-fashioned egg-timer going off in my gown’s pocket.

Waking it from sleep mode brought a text blurb into view:

Dr. Howle: report to Room 212. Patient Kurt Clawless exhibiting extreme polyphagia.

“Polyphagia?” I grimaced.

It meant he was eating an unhealthy amount of food—a dangerous amount. An all-consuming hunger like that was either the result of insufficient impulse control (whether temperamental in origin, or the cause of some specific underlying condition), or the result of the body’s signaling systems gone awry: endocrine problems, the thyroid, diabetes. A couple years back, I’d consulted on a case that had left Dr. Rathpalla stumped: polyphagia, except with none of the above. I’d suggested he get the patient a CT scan around the vagus nerve, and my hunch proved to be right on target. The polyphagia of unknown origin turned out to be caused by a (benign) ganglioneuroma. The tumor put excessive pressure on the vagus nerve, and thereby interfered with the patient’s body’s ability to register their stomach as being full.

Here, though, I doubted something so obscure was to blame. The polyphagia had to be a symptom of Kurt’s Type Two NFP-20 infection. The question was: how?

“Again,” I said, nodding to the nurse, “I’m sorry about rushing out like that.”

“It’s no pr—”

“—And I apologize again for having to go right now. It’s one of my patients.”

Rushing out of the room, I turned down the hallway and walked over and up the nearest stairwell. Kurt’s room was just one floor up from ground level, adjacent to Ward E. Even so, I still had to change PPE before I could step out of the newer facilities into the older Number Ward where Kurt’s room was located.

The changing stations in the Ward-to-Ward transition corridors were fully automated—one of the many useful details DAISHU’s designers had dreamt up for our darkpox containment infrastructure. The most satisfying step of the doffing procedure was ripping off my console’s sleeve along with my PPE gown and the attached gloves and tossing it through a hole in a niche in the wall, where it fell down a chute into a shiny chrome digestion vat awaiting below. As Brand told me, once the several-feet-deep cylindrical container was sufficiently full, the vat’s contents would be dissolved by a special synthetic enzyme cocktail depolymerized the garments and then distilled the mixture into its raw contents which were then loaded into the matter printers down in the basements. Reduce, reuse, recycle.

A simple scan of my hand-chip over the sensor on the niche opposite the disposal niche caused a case to slide out from the wall, bearing a gown, gloves, and a new PortaCon sleeve. The heating rod in the wall activated as the wall slid open. Sealing the gloves to my PPE’s sleeves was just a matter of rubbing my wrists against the rod. I had to admit, the whole procedure was kinda neat… until the third or fourth time, and then it was just another part of my new chores.

I headed straight to Kurt’s room as soon as I was out of the airlock.

I couldn’t have anticipated what I found.