The Wyrms of &alon

I turned toward the source—toward the doorway, and the figure who stood there. His PPE visor’s internal light was on, but, even if it hadn’t been, I still wouldn’t have had any trouble recognizing him.

Jonan.

That same light cast a wan glow upon his blond hair, which was still as perfectly combed as ever, despite the mushroom-shaped hairnet binding it.

Dr. Derric stepped toward me and pointed at one of the handful of idle machines at Jerrick’s bedside.

“I need to borrow that ventilator,” Jonan said.

“I’m pretty sure a room’s equipment is supposed to stay in its room,” I said.

Dr. Derric craned his head forward. His brow furrowed once he bothered to realize who he was talking to.

“Dr. Howle?” he said.

I nodded. “Guilty as charged.”

“What are you—”

—Jonan shook his head. “Know what? Never mind. What I need is help moving that ventilator. It’s urgent.”

“But—”

Angrily, Jonan pointed at Jerrick. “—This patient is still breathing on his own,” he said, “mine isn’t. So, come on; time is of the essence.”

Oh no…

Gulping, I rapidly nodded in agreement and immediately stepped out of the way. “Tell me what to do, then. How can I help?”

Jonan smiled in encouragement. “Stand on the other side of the ventilator and carefully roll it along with me. Carefully.”

“You don’t need to repeat yourself,” I said.

“Just follow my lead.”

And so I did. We wheeled the ventilator out of the room, down the hall, and around the corner. A turn after that brought us into a large room with six beds, separated from one another by slidable curtain dividers. An ECG trilled shrilly, like a hidden bomb about to detonate.

“Alright,” Jonan said, “you can let go now.”

I did. Grunting, Jonan pulled the ventilator over to one of the beds, pulling one of the curtains aside to make room. The screeching ECG got a little louder. Hooking patients up to the ventilator was frightful drudgery. Most of Jonan’s patients were already lost in fever dreams, but those that weren’t had to be sedated before they could be hooked up onto the ventilator. He cut into their necks with a scalpel and jammed a device down their throats—which I later learned was called a laryngoscope—to which he then attached the ventilator’s tubes.

“What do I do now?” I asked.

Jonan looked over his shoulder and glared at me.

“Stay on guard and leave me alone,” he said.

“You look like you could use some help,” I said.

Jonan kept having to change instruments. One moment he had a scalpel in his hand. The next moment, the scalpel clattered into a plastic tray as he set it down and picked up another laryngoscope, inserted it into the throat incision, and then picked up the scalpel and repeated the process all over again.

Jonan angrily flicked the ventilator’s power switch.

“There,” he said. The ventilator got to work.

I watched the ECG’s spastic signal settle back to a healthier rhythm. Jonan wasted no time. He flit from one patient to another like a hummingbird from flower to flower, checking their vitals one after another, muttering under his breath the whole time.

If Pel had been here, she would have pointed out the significance of the comparison. Hummingbirds were one of the most auspicious birds to encounter during an augury. They represented the Lass herself, the spark of true faith lived with love, vigor, and zeal. For the augur to spot a hummingbird in a church garden meant that the fortune’s recipient was on a fateful path, pleasing to the Godhead. Pel would have seen good portent in my comparison. As for me, I was unsure.

It would have been nice, though, if it was. But as I surveyed my surroundings, it quickly began apparent just how inapt the comparison was.

“Lass it tight…” I muttered, cursing the sight before me.

Jonan’s patients made Jerrick seem healthy in comparison.

I…

I’d never seen cases this bad before. In these patients, the splotches, bruise-like discolorations had progressed to full-blown necrosis. Bolts of dark lightning spidered their way up through the patients’ epidermis, along their limbs, necks, and faces. Flesh rotted into dark, ulcerated valleys that oozed black tar. Bright green dusted the black like a coat of powdered sugar, giving off a sickeningly sweet stench that not even the combined power of a plastic visor and F-99 face mask could fully block. Fleshy growths were just beginning to emerge from the valleys, coated in gobs of putrefaction.

These people were being digested from the inside out.

“This looks pretty serious,” I said, softly.

“I’m more than capable of handling it, thank you very much,” Jonan replied, exasperated.

I rolled my eyes and sighed. “Dr. Derric, I mean no offense but… I don’t think you can handle this on your own. In fact—”

Wait a minute.

I’d failed to ask the most obvious question of all.

“—Why are you here all by yourself?” I asked. “What’s going on?” I tried my best to sound authoritative, going so far as to walk up to Jonan by one of his patient’s bedsides, loudly clearing my throat to draw his attention.

Jonan squeezed the edge of the bed, like it was a giant stress-relief ball. “Making up for my mistakes,” he said, quietly.

Penitence? From Jonan Derric? Well color me surprised.

I repeated my previous request. “Is there anything I can do to help?”

Jonan beat his fist into the mattress. “No.” He spoke without making eye-contact with me. “These are my patients. It’s my responsibility to help them. I don’t expect you or anyone else to help me clean up my messes, and you shouldn’t expect me to clean up yours, either.”

“I see…” I said. Understanding blossomed in my mind.

With a snort, Jonan turned and glared at me. “What?” he said, plainly irritated.

“You’re trying to maintain your sense of control,” I explained. “Psychologically speaking,” I looked around the room, “this is your lair, and your reluctance to ask for help here is a manifestation of your desire to refrain from acknowledging your helplessness in this situation.”

Jonan pulled off his gloves, tossed them in the medical waste-bin and, closing his eyes, rubbed his fingers on his temples. “This is why I don’t like psychiatrists,” he grumbled.

I lowered my head. “I’m sorry, it’s just force of habit,” I said.

Jonan sighed as he donned a fresh pair of gloves from a dispenser on the wall. Ignoring me and the awkward silence around us, Jonan returned to his patients. This time, he went around scrutinizing the bags atop the IV drip.

Eventually, Jonan broke the silence with a groan. He turned to me. “You wanna know what happened?” His eyes narrowed. “Fine. Earlier today, I conscripted a handful of nurses and charged them with assisting me in testing out various combinations of the therapeutics I brought up during the CMT meeting.”

He gestured to his patients with a wide sweep of his arms.

“Everyone you see here received one or more versions of granulocyte colony stimulating factors.”

Ordinarily, with the day I had, I wouldn’t have remembered much of what Dr. Derric had said in his rather technical presentation from this morning. But, strangely, I remembered everything.

“You’re talking about G-CSF and GM-CSF. The ones that stimulate the growth of certain kinds of white blood cells.”

Jonan raised his eyebrows. “I’m kinda surprised you remembered,” he said.

I nodded. “You’re not the only one.” I looked him in the eyes. “So… what happened?”

Jonan glowered at me. “I’m going to give you the benefit of the doubt and assume that was a stupid joke. See for yourself.” He gestured at his patients. “The colony-stimulating factor treatments didn’t help. They made things worse. Hell,” he threw up his hands, “as far as I can tell, they accelerated the disease progression.”

“What?”

“It’s not unheard of. For most microbes, getting swallowed by a macrophage is the end of the road. But some microbes have learned to turn this disadvantage into an opportunity, having evolved the antigens and proteins needed to survive inside the macrophage. It’s basically evolutionarily sanctioned vorarephilia.” Sighing, Jonan lowered his gaze and shook his head. “Ugh, I should have anticipated it.”

“Don’t beat yourself up,” I said, “you couldn’t have known.”

“Like hell I couldn’t!” Jonan snapped. “Fucking tuberculosis does it, as does kala-azar in Dalus and Araka. Some microbes even use the macrophages to spread through the body. The immune system can’t fight pathogens that are already inside our white blood cells.” He shook his head again. “I should have anticipated that NFP-20 would exploit our immune systems to further its spread. Fuck.”

“Are they still on it now?”

“Hell no,” Jonan said, “they haven’t been, for hours.” Only half of his gaze was on me. “Ani and I took them off not long after we started administering them. The initial reactions were not good.”

There was an awkward pause.

“You can’t prove anything with the scientific method, you know,” he said, “you only disprove things, jettisoning ignorance and idiotic assumptions—like my immunostimulant therapy plan.” Dr. Derric shook his head. “The patients have been deteriorating all day. Putting them on the immunosuppressants needed to reverse the CSF’s effects only made things worse. It’s just hastened their decline.”

“You said you had nurses working under you. Why not ask them for help?” I suggested,

Jonan raised his eyebrows. “And give the minions something to laugh at? No thanks.” He shook his head. “When it comes to career advancement, prestige is everything.”

An ECG panicked and went wild.

“Dammit!” Jonan swore.

We rushed toward the alarm.

The man in the bed—

—Holy Angel…

He looked like a piece of meat that had fallen off a grill and into a cesspit. He was a shivering mummy—without the bandages—dipped in rot, filaments, and sprouts of bulbous fungal bodies. He was covered with massive, filament-threaded ulcers, and there wasn’t the slightest trace of healthy pink tissue in any of them. Nausea flipped my stomach upside-down, and I had to gag and burp to keep myself from puking up my dinner.

On a few of his knuckles, the flesh had been eroded all the way to the bone. Fungal threads spread over the fibrous white, staining it blackish green.

Again, I felt I was going to hurl, but then a piece of information from basic applied neurology came screaming into my head like a runaway train.

I’d been so focused on the flesh wounds that I’d lost the forest in the trees. The patient’s posture explained everything. His legs were as stiff as lampposts. His bone-bearing hands were balled into fists and bent inward, while his arms were crossed at his chest.

“He’s posturing!” I said.

Beneath the body horror was a textbook case of decorticate posturing. This put brain damage on the table. Severe brain damage.

And if it came on suddenly…

“He’s probably got an intercranial hemorrhage, an aneurysm, or a brain hernia.” I said. “We need to get this man to a tom scanner ASAP.”

The man’s chest rose and buckled. His head tilted back as his arms splayed out to his sides. His legs rolled inward, knee-cap against knee-cap.

He’d gone from decorticate to decerebrate in a matter of seconds.

“We need… uh,” I stammered. My thoughts raced. “We need—“

“His O2 levels are crashing!” Jonan yelled, rushing to fetch a laryngoscope. “I need to intubate!”

The man’s ECG fluttered like a fly.

“Jonan!”

Dr. Derric was running back with a scalpel and laryngoscope in his hands when all the tension suddenly fled from the patient’s body. The man fell onto his bed, perfectly still, his limbs splayed out somewhere in between the bed sheets and the long, keening tone of a flatlining ECG. His heart sputtered in irregular leaps as his biochemistry began its gradual shutdown.

Equipment clattered to the floor beside me.

I turned to see Jonan staring back and forth between his hands and the patient’s corpse.

“No…”

First came the calm.

He kicked the cabinet door.

Then came the storm.

“Fuck!” Jonan yelled. He flung out an arm. The curtains rattled in the ceiling’s tracks.

Pulling his console out from the pocket in his PPE gown, Jonan turned away from me, and leaned against a nearby countertop, propping himself up with his elbow.

“Turn the damn ECG off,” he said, breathlessly.

I flicked the switch to mute the ECG.

“What’s the time of death?” Jonan asked.

I looked over at the monitor. “Frank Isafobe. 9:23 pm.”

Jonan entered the information into the patient’s case file on the console.

“I’m sorry, Frank,” he muttered, “I guess you won’t be going to your daughter’s birthday parties after all…”

I blinked in surprise. “You knew him?”

Jonan shook his head. “We talked briefly. I suggested granulocyte stimulation therapy to him, and he agreed to it. It wasn’t long after administering it to him that he had a massive seizure. He’s been unconscious ever since.”

“Dr. Der—… Jonan,” I walked up to Jonan. “You acted in good faith. It’s not your fault for trying what you could to help.” I tried my best to sound convincing, even though I only half-believed what I was saying.

What right did I have trying to argue that intent was all that mattered when the Church used that very same argument to dismiss accusations of wrongdoing in its oppression, forced conversion, and systematic extermination of pagans, heretics, and apostates?

Had Jonan’s experimental treatment killed Frank? Most likely. Would Frank have survived without Jonan’s intervention? Maybe, maybe not.

Saying intention was all that mattered was just a softer way of telling somebody that the ends justifies the means.

The Godhead was the very essence of goodness, just as goodness was the very essence of the Godhead. That was where I was taught morality came from. But if that was true, why was morality so difficult, in practice? Why was it so hard to do good? And why did it so often cause us misery? I knew the Church said it was because of the ancestral stain man had accrued for defying the Godhead’ will, but, even so, why would goodness have to hurt?

I’d been asking myself these kinds of questions all my life, and I doubted they’d give Jonan any consolation.

“Well, look at the others,” I said, trying to find the bright side. “At least they all seem to be stable.”

Jonan’s head drooped. “Frank wasn’t the first,” he muttered.

“Fudge…” I swore, choking up, “that’s…”

“—Not good,” Jonan said. “Very not good.”

Jonan’s back bent as he took in a deep breath. Closing his eyes, he rested his hands on the countertop for a moment before regaining his composure and turning back to face me. He gestured at the room and the patients.

“And this has been Jonan Derric’s House of Horrors,” Jonan said.

I don’t think it was humanly possible to be more sardonic than that.

Jonan swung his arm. “Well, what are you doing at this hour, Dr. Howle?” he asked, in mock cheer, and with the phoniest smile I’d ever seen.

While I was trying to figure out how to respond, something fell in the hallway with a loud, unexpected thud that made both of us flinch.