Doctors and Friends, First Two Chapters

DOCTORS and FRIENDS

by

Kimmery Martin

*****PREORDER HERE *****

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Note to the reader:

The writing of this novel preceded COVID-19 and therefore there is no mention

of the real-life pandemic. In this fictional universe, it does not exist.

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To everything there is a season, A time for every purpose under heaven: A time to be born, And a time to die; A time to plant, And a time to pluck what is planted; A time to kill,

And a time to heal

—Ecclesiastes 3:1-3

BERKLEY An imprint of Penguin Random House LLC penguinrandomhouse.com Copyright © 2021 by Kimmery Martin

Penguin Random House supports copyright. Copyright fuels creativity, encourages diverse voices, promotes free speech, and creates a vibrant culture. Thank you for buying an authorized edition of this book and for complying with copyright laws by not reproducing, scanning, or distributing any part of it in any form without permission. You are supporting writers and allowing Penguin Random House to continue to publish books for every reader. BERKLEY and the BERKLEY & B colophon are registered trademarks of Penguin Random House LLC. Library of Congress Cataloging-in-Publication Data Names: Martin, Kimmery, author. Title: Doctors and friends / Kimmery Martin. Description: New York: Berkley, [2021] Identifiers: LCCN 2021010461 (print) | LCCN 2021010462 (ebook) | ISBN 9781984802866 (hardcover) | ISBN 9781984802880 (ebook) Subjects: LCSH: Physicians—Fiction. | Virus diseases—Fiction. Classification: LCC PS3613.A7822 D63 2021 (print) | LCC PS3613.A7822 (ebook) | DDC 813/.6—dc23 LC record available at https://lccn.loc.gov/2021010461 LC ebook record available at https://lccn.loc.gov/2021010462 Printed in the United States of America This is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously, and any resemblance to actual persons living or dead, business establishments, events, or locales is entirely coincidental.

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CONTENTS

PART ONE: AFTER ARTIOVIRUS

Chapter One: This Thing’s About to Blow

Chapter Two: The Trolley Problem

PART TWO: BEFORE ARTIOVIRUS

Chapter Three: Antigram

Chapter Four: The Nerd Version of the Green Berets

Chapter Five: A Homesteader’s Guide to Going Off the Grid

Chapter Six: Team Mother Saints

Chapter Seven: Respira Profundo

Chapter Eight: He Died the Hard Way

Chapter Nine: The Dumbest Crime in History

Chapter Ten: The Subcellular War

PART THREE: DURING ARTIOVIRUS

Chapter Eleven: You Go to War with the Army You Have

Chapter Twelve: The Shortest President in American History

Chapter Thirteen: Every Armchair Virologist in America

Chapter Fourteen: The Archaic Clock

Chapter Fifteen: Refrain from Embracing

Chapter Sixteen: A Redneck with a Snowplow

Chapter Seventeen: The Omnipotence Paradox

Chapter Eighteen: Fragile and Exquisite

Chapter Nineteen: The Grace of a Breathing Machine

Chapter Twenty: The Wilds of Connecticut

Chapter Twenty-One: Triage

PART FOUR: AFTER ARTIOVIRUS

Chapter Twenty-Two: I Feel Guilty for Not Feeling Guilty if You Feel Guilty

Chapter Twenty-Three: The Magic Bullet

Chapter Twenty-Four: There’s Always Another Crash Waiting in the Wings

Epilogue: Familiar Behavior Patterns

Author’s Note

Bibliography

Acknowledgments

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PART ONE: AFTER ARTIOVIRUS

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—Chapter One: This Thing’s About To Blow

KIRA: Atlanta, Georgia

Eighteen Months After Patient Zero

One balmy evening near the end of a balmy winter, a man sidled up to me in a corner of an Atlanta mansion.

He had a request.

Before I go into detail about the repellent nature of the man’s proposal, I should temper your expectations. I know very well how my voice comes across in person, let alone in the recounting of a history. I have a sense of humor but it’s sometimes mistaken for condescension. Similarly, to my dismay, my sense of compassion during tragedy has occasionally been misinterpreted as judgment. Throughout a mass calamity in which millions of people died, we were hobbled by fear and grief and hardship and isolation, yes; but at the same time, we learned humanity is resilient beyond all reckoning. We shared a mutual hope. Women still gave birth, nurturing tiny new humans first inside and then outside their bodies. We still created art and music and literature. Our scientists continued to innovate, our doctors to heal, our educators to teach.

On a lighter note, we still extracted comedy from tragedy, finding new ways to laugh at ourselves. We swapped pandemic jokes. We watched late-night comedy routines. We captured funny snapshots, wrote pithy quips about them, and flung them into cyberspace. If a society can’t meme itself out of a disaster, what hope is there?

But this is not our collective story as a society. This is my story—and also Compton’s story and Hannah’s story and a little bit of Georgia’s story—and it represents the most difficult circumstances of our lives. For my portion, you’re stuck with my voice, such as it is.

I hope you can forgive me.

#

For the last fifteen minutes, I’ve been hovering at this party clutching my drink—a Manhattan—trying to act as if I were interested in the beads of condensation crawling down its beveled-glass surface. Earlier, I’d attempted to infiltrate the nearest knot of people but found myself largely unable to secure any purchase in the smooth waterfall of words. Every syllable I uttered ended up the same: an aborted reach, followed by a slide back down the conversational slope.

Twenty minutes before, I’d been rolling along the streets of Buckhead as they became wider and posher and leafier, navigating past Hummers and Land Rovers and various other luxury vehicles until the huge home hosting tonight’s event floated into view like a glowing mothership at the top of a hill. Ten thousand watts of incandescent bulbs burned brightly against the night sky, illuminating a pair of cream-jacketed valets trying to wave me down. I ignored them. No one drives my truck except me.

My truck! My truck is really an economy hatchback from which I’ve removed half of the back seat. This vehicle, which I’ve named Herman, has been with me for twelve years over multiple continents so he doesn’t exactly boast the latest technology. He also looks like ass, having sputtered through monsoons and deserts and, in the worst of times, literal wars. I’ve replaced and rotated his tires, changed his brake pads and calipers, swapped out his filters, substituted his belts and hoses and batteries, and flushed his radiator and transmission. There are more than 200,000 miles on this sucker and there’s no way I’m getting rid of him until the tragic day when he finally and irredeemably croaks. As always, driving him makes me happy.

In the house, though, I’ve lost a bit of my composure. I can’t control my fidgeting; of its own accord, my body yearns toward the door. My foot taps, a relentless, skittish beat. My face, too, is a failure: I can feel it settling into the kind of gritted-teeth smile produced by young kids who are being forced to pose.

Part of this reaction is physical. Even though the room, a grand, high-ceilinged sweep of space, has been cleared of furniture, the air circulates poorly. Flames roar in a ten-foot-high fireplace anchoring one end of the room, its mantel heaped with drying pine boughs and berry-encrusted twigs. The beribboned garland is clearly meant to invoke a festive yuletide spirit but in me it produces a burning desire to figure out where the fire extinguishers are stored. Whoever decorated the mantel didn’t hold back elsewhere, either; even without furniture, the room appears to have been fluffed by a herd of manic elves. There’s red and green shit everywhere: glass stars, hunks of mistletoe, human-sized nutcrackers standing sentinel in the corners, all of it somewhat shimmery from the radiance of the fire.

But my discomfort stems not just from the ostentatious decoration, or from the oppressive warmth, or from the perfumed but acrid scent of other people surrounding me, shooting up my nose like a chemical weapons attack. It’s not only the sound, the chittering and cackling of too many voices straining to make themselves heard.

It’s the bodies.

Even if I close my eyes and block my ears, I can sense them. Mere feet from me, they span all directions, appropriating space, emitting sound waves and social urgency and, without a doubt, respiratory particles.

A party, it should be obvious, is not my thing. By now, you’ve gleaned a few more facts about me, or you think you have. Socially awkward, you’re thinking; oversensitive. Insecure. Or maybe this: too introspective.

I feel the need to defend myself from your assumptions, even though they are logical. Despite my earlier warning, I’m actually good with people. My people, anyway. I like my people. I’m not a hermit or overwhelmed by sensory stimuli either; I can state without any exaggeration that I’ve endured some of the harshest conditions the planet has to offer.

I’m just not great around a lot of people. Especially now.

To my left, a blond bejeweled woman in her fifties gazes with rapt attention at an older man at her side, her fingers stroking the green circular pin at the top left of her long, floaty dress. His suit sports a corresponding pin, also on the left, at his lapel. Next to him, another couple, a beefy white man and a rail-thin, much younger woman, display their respective pins in the same spots. I reach for my pin, securely attached to the right side of my blazer. There’s no mandate regarding pin placement—you can put it anywhere on your torso you like, as long as it’s easily visible—but to me it’s come to serve as a signal for handedness. Right-hand-dominant people tend to pin theirs on the left, and vice versa, making it easy to keep a running tally of the lefties.

I’ve spent little time in society over the last months, but still, I’m amazed at the ease with which these people have adapted to the fear that first gripped the world not even two years ago. The acute sickness caused by the artiovirus is rare now, vanquished by an army of public health servants, and, ultimately, a vaccine, but our world still bears the ghostly imprints of the lost: children who live with grandparents instead of parents, schools without qualified teachers, and above all, hospitals still in crisis mode because of a lack of doctors and nurses and cleaners and techs. There are, however, still plenty of hospital administrators.

Despite our losses, merriment shines on most of the faces here. Please understand; I don’t judge them, these people who are trying to return to the past. I understand the urge to repress the memories. Everyone lost someone. The particular hell of the artiovirus was its precise targeting of the otherwise young and healthy. It turned our immune systems against us, generating not a cytokine storm but a cytokine tsunami, sometimes felling people in a matter of hours. You could feel fine in the morning and be dead by evening.

But, as everyone in the country now knows, the virus harbored an even more terrible secret, one we would not suspect for months.

#

When a hand brushes my shoulder, I expect one of the three friends who are meeting me here tonight, or possibly somebody I know from the time when I worked at the CDC. Instead, I encounter a ferrety bald man who’s made the unfortunate decision to groom his mustache into a pencil-thin line. The effect is reminiscent of a cartoon villain or, perhaps, a weasel.

“Artie Smert,” he says, offering his hand in what appears to be a misguided reflex. Even before the pandemic I wasn’t big on shaking hands so I ignore his outstretched arm. Batting his eyes, the man attempts to execute a face-saving maneuver by raising the hand to smooth back his hair, which might seem a tad more natural if he weren’t bald. After a brief awkward slide along his scalp, the hand drifts back down to his side.

I hadn’t intended to make this guy look stupid so I offer him an elbow to bump. Unfortunately this doesn’t go any better, as he’s grabbed a business card from his pocket and apparently mistakes my gesture as an invitation to deposit the card on my elbow. I retrieve it with my other hand and study it.

“You’re Dr. Kira Marchand,” says the man. “I’ve been wanting to meet you for some time.”

The voice rings a bell. I read the card again. “Artie Smart?”

“It’s Smert, actually, not Smart. Are you familiar with the Midwest? The Dakotas, maybe?”

I blink at the non sequitur. “I was raised in Kentucky. I bounced around the world for awhile and now I live here, but I’ve never lived in the Midwest. Why?”

“My friend in the Dakotas pronounces smart as smert.”

This line of conversation is of such confusing irrelevance I do not know how to respond. No wonder I always go mute at parties. “You left a bunch of messages with my office last year,” I say finally. “You’re a television producer.”

“That’s right!” says Smert jauntily, as if responding to even a modicum of positivity on my part. “We’d love to work with you on a show about female doctors during the pandemic. People recognize you from those press conferences where you explained what was happening…” Here, his eyes slide to the side. People don’t like to mention the worst outcome that can occur if you survive ART, or if they do, it’s usually in an undertone.

Some months into the pandemic certain unpleasant truths about the illness began to make themselves known. By then we knew the basics: who was most likely to contract it, who was most likely to die. Like a typical virus, ART targeted the very young, the very old, and the weak. But this particular mortality curve followed an unusual shape when it came to the age distribution of the dead. Like an ongoing M, it peaked and fell and peaked and fell and peaked again; it turned out the virus had a predilection for strapping adults in the prime of their lives. Like a food snob, it cultivated its tastes precisely. It preferred men to women, eastern seaboarders over southwesterners, people with type A blood over types O or B, and so on and so on through a range of attributes. But it would—and did—devour anyone who crossed it if the mood struck.

What we didn’t know then would turn out to be far worse than the immediate deaths. ART causes a delayed but catastrophic complication in a small but significant percentage of people, brought about by an autoantibody targeting certain proteins in the brain. As of today, we cannot predict who will suffer this effect, or when, although we believe it is likeliest to occur within a year or two of recovery from the initial illness. Now that we’ve conquered the virus, all of humanity is united in the fervent desire to find a cure for its most infamous sequela. Barring that, they want a predictive test. Everyone wants to know who will get the complication.

Artie Smert warms to his pitch. “That press conference you did with POTUS? You’re a natural-born speaker.”

I offer him a glance of considerable skepticism.

“It’d be a limited-run series,” he says, one finger unconsciously tracing the line of his mustache. “But not depressing. We'd allude broadly to the details of the pandemic—the deaths, the morbidity, the cratering and recovery of the financial sector—but there’s no appetite out there for another exposé of those circumstances. Everyone on earth’s already familiar with them. And you know: no need to go into detail about the … brain thing, either: this isn’t a horror film.”

“Then what?” I ask.

“This series,” he says, proudly, “will focus on the personal stories of those on the front lines, especially those with an unusual story to tell. In particular, the series would focus on you.”

If Smert considers this approach to be an enticement, he’s mistaken. I don’t watch television. While I have streamed a scientific documentary or two, I’ve never seen a reality show. I am ignorant of celebrity news. I barely even talk to regular people, unless I already know and like them.

Speaking of people I know and like, I spy my friends—Vani, Compton, and Hannah—perhaps twenty feet away, standing together but each of them speaking to people I don’t recognize. None of them lives in Atlanta; they’re here to support me when I give a speech later tonight. How had they managed to strike up such animated conversations with strangers?

Vani, my closest friend, catches my eye first, but then again Vani generally catches everyone’s eye first. She’s my age—early forties—and infinitely more alluring. Tonight, indifferent to the attention she draws, she’s dressed in an electric yellow silk concoction with an array of jeweled bracelets crawling up her arms. Even from this distance, I can read her expression, so characteristic of Vani, somehow combining an aura of peace with a ridiculous, endearing sense of humor. She’s like a human embodiment of both Xanax and one of those party drugs that make people giggly.

Compton flanks her, her cap of sleek dark hair set off by an equally sleek black dress. Compton is the Ritalin to Vani’s Xanax; she’s beaming an intense, skeptical look to two chatty blond men who appear to be in their forties. On her other side, Hannah, pink-cheeked and fair, with her shapeless dress and messy bun, might have registered as dowdy compared to the other two were it not for the warmth in her expression, which she’s aiming at an older gentleman who is apparently hard of hearing. He’s got a hand cupped round his ear and I’m fairly certain the entire room can hear him shouting delightedly in her direction.

Oblivious to my distraction, Artie’s still going strong. “We’d want to showcase your particular, ah, style in the show, of course. You were one of the first Americans to contract the illness. You were one of the few worldwide experts on this particular virus before the pandemic. People must wonder: why does a woman want to become an expert on germs?”

Why? I’ve considered viruses to be my mortal enemy ever since missing my own tenth birthday party after coming down with what my mother erroneously referred to as ‘the stomach flu.’ The stomach flu is not a flu at all but everyone on earth is familiar with its symptoms.

A virus is one of the oddest entities in the universe. Neither living nor dead, it exists in a suspended netherworld, waiting to encounter a creature it can invade. Unlike normal life forms, a virus cannot replicate itself; it is dependent on hijacking the machinery of a living cell in order to reproduce. They do this fantastically well, attaching themselves to the surface of a cell before penetrating it. Whatever vital functions the cell was carrying out are forgotten as it transforms into a kind of zombie factory to create more virus. Eventually—such as in the case of influenza—the doomed cell explodes, spewing out up to a million little viral soldiers, many of which are deformed mutants. The functional ones attack new cells, churning out even more viral swarms. They are deeply creepy little fuckers.

Still, Artie Smert hadn’t asked me to describe the characteristics of a virus. He’d asked why a woman would want to study germs. This question once again strikes me mute, which is fortunate because if I’d had the wits to answer, everyone would have witnessed language incompatible with party manners. In my case, however, I’d taken a roundabout route to my expertise. I started my career as an internal medicine doctor with an aid organization and it wasn’t until after my husband died of a sudden undiagnosed illness that I returned to the States and completed a fellowship in infectious disease, followed by special training in battling pandemics. My mentor at the CDC, a man named Waliedine Katz, turned me on to the artiovirus.

“And, yes,” Mr. Smert goes on, oblivious to my mental detour, “you’d be the perfect person to explain the efforts to defeat the—” He breaks off, fluttering both hands at his temples to indicate the worst outcome of the virus.

“I can send you abstracts from some of the latest papers,” I say. I catch Hannah’s eye and wave, hoping she’ll interpret the gesture as a distress signal. It seems to work; she nudges Compton and Vani and points in my direction. Even from a distance, I sense their protectiveness; this is the first time I’ve been in public in a very long time .

“Sure,” says Smert. His beady eyes tighten, focusing on my face. “But what people would really want to hear about, I think, is your personal story during the pandemic.”

I take an involuntary step back. Could Smert possibly know the real reason I left the CDC?

Having alluded to the subject he’d like to broach, Mr. Smert inexplicably stalls out. To combat my escalating pulse I take in and blow out small measured dollops of air, waiting for him to bring down the hammer. Finally, I do it myself.

“You want to talk about why I’m no longer at the CDC, I’m guessing.”

“Certainly,” he says. “I realize the pandemic was difficult for you on a personal level as well as a professional one. The, ah, situation with your children…”

I wait, but there is no more. He must not know—or at least he must not know for sure—the details of what I did.

By some miracle, an account of my behavior at the tail end of the pandemic, known to only a handful of people, had not filtered through the medical community in Atlanta and out to the general public. Still, for ethical reasons, I’d disclosed my action to a few people at the hospital and at the CDC, hoping some greater good would come of my transgression. To my relief, the story of what happened behind the scenes never blew up. Or, to employ a bit of irony: it never went viral.

But if this man suspects what I did, how long before some legitimate news reporter catches wind of it? The thought sends an antsy ripple crawling up my spine. Somehow, somewhere along the line, Mr. Smert must have managed to connect with someone who knows the truth.

I recall those days in fragments, long unbroken streams of timeless waiting, my mind suspending itself in a protective haze where thoughts dissolved into nothingness before they could fully form. The blurred metallic edges of a hospital bed; the plinky little drip of IVs; slats of light cutting through parallel rows of blinds and falling in stripes across my forearms; exhaustion giving way to confusion. Sometimes this nightmarish haze sharpens into shards of distinct terror and I remember that final moment.

It haunts me still.

“I’m not interested in being on TV,” I say to Smert, as my friends wade through the mob to reach my side. Up close Vani, Hannah and Compton present dramatically different approaches to evening makeup; Vani’s glossy lips and curled eyelashes and vivid yellow—yellow?—eyeshadow contrasting with Hannah’s unadorned eyes and the slash of crimson outlining Compton’s smirky half-smile.

Smert switches tactics, pivoting to my friends. “Are you ladies co-workers of Dr. Marchand?”

Only Hannah smiles back at him. “We’re old medical school friends,” she says before anyone can stop her. “I’m Hannah—I’m an ob-gyn in San Diego. Vani practices internal medicine in Kentucky and Compton’s an ER doc—she was in New York City during the pandemic.”

Perking up at the words ER and New York City Smert swings his attention toward Compton but upon encountering her total absence of expression he swings right back to me. During our med school years if we needed to deflate some horny clown in a bar—metaphorically or literally—we deployed Compton, who even then possessed a brittle, ball-busting sophistication. I know her well enough to state a warm core of generosity lurks within her but you have to excavate a layer of straight-up ferocity to reach it. We love her for it.

Before Smert can regroup, a commotion across the way catches our attention.

A crowd forms around a couple of slim men in cream-colored jackets—servers or caterers, I think—who are attempting without success to lift an enormous glass urn.

The urn is one of a pair, around eight feet tall and quite wide. It resembles more of a massive fish tank than an urn, except instead of fish it contains thousands of solid green and red decorative balls floating in water. I have to admit I’m interested: there’s no way these two are going to be able to move this thing. I’m puzzled as to why they’d even want to attempt it but then I spy the problem: a crack in the glass, running along a fault line three or four feet up, just beginning to ooze water.

“There must be a thousand gallons of water in there,” someone says. “Or more.” As if our heads are on a crank everyone in the vicinity looks down at the floor, constructed of whitewashed wood and capped off by a finely knotted silk Persian rug.

The crowd surges, parting to reveal a slender woman in a floaty, frothy, long-sleeved dress—the de rigueur outfit for the evening, it seems—who hurries toward the beleaguered servers with pursed lips but an unwrinkled brow.

“We need to do something before this breaks,” she says sharply to the jacketed men, as if this were a novel thought. Her fingers drift to the green pin on her dress collar. “Can you tip it forward and collect the water in something?”

“Ma’am, tipping it forward might break the glass,” says the closest server, a red-faced blonde in his twenties. He swipes at his forehead. “Plus it’s too heavy.”

From a man in the crowd: “Maybe we can scoot it outside.”

The hostess glances down, dubious. “That would scratch the floors.”

By now a sharp rivulet of water is spraying down the side of the massive container, collecting in a pool that reaches the hostess’s feet. She lets out a small shriek directed at the other server. “Josh! There’s water on the floor.”

“Yes,” says Josh, heroically managing not to roll his eyes. “I’ll get a towel.”

“No! I mean, yes, get a towel, but hurry.”

“Maybe get lots of towels,” adds the man who’d suggested pushing the urn outside. “This thing’s about to blow.”

The crack widens, prompting a collective intake of breath. Chatter in the room intensifies as people offer one outrageous suggestion after another: get a bunch of bedsheets set up and crack the glass with a hammer (why?); lower down a child armed with a bailing bucket (too dangerous, plus this does not seem like the kind of household that comes equipped with a child); evacuate and let nature take its course (lame); let nature take its course but film the explosion for YouTube. I have to admit, that last one does hold some appeal.

Am I the only person here who recognizes the obvious solution?

I zip through the knot of people close to the urn, picking up speed as I reach the emptier section of the room. Nobody, it seems, wants to miss the show, even if they wind up getting drenched. I mime a series of actions to my friends: running to my vehicle, extracting my tool kit, and returning. Vani’s face scrunches up, confused.

Okay, maybe that was too much to try to mime.

Once I reach Herman, I rummage through the back until I find what I need. Probably I should hurry; by now there’s a decent chance those nitwits back at the fancy house have decided to get it over with by hammering at the glass with their Louboutin stilettos. Picking up the pace, I charge through the foyer of the house. Back in the big room, not much has changed. A conga line of middle-aged men, their shirtsleeves rolled, are preparing to heave the urn aside. They’ve managed to nudge it a couple of inches from its original spot but progress has stalled as the hostess paces in front of them, still dithering about the floors. Ignoring both the men and the hostess, I roll up alongside the urn and set down the small portable ladder I carry. From the worn canvas bag at my shoulder I extract a long length of rubber tubing and a roll of duct tape. Working quickly, I slap the duct tape over the crack in the glass, stemming the hemorrhage, and then hop a few steps up the ladder.

It’s as if I’ve marched in waving an Uzi; all conversation in the room ceases. The hostess in particular is dumbfounded; her mouth frozen open in the shape of whatever word she was last speaking. Taking advantage of her sudden muteness, I point to the window. “Can you open it?”

She springs to life, gamely tugging at the window sash, which doesn’t budge. “Zeke! Josh!” she hollers at the servers. “Josh, the window, hurry!”

Josh comes over and also pulls on the sash of the window, but at some point, someone’s painted it shut. I reach into my shoulder bag again and locate a putty knife, which I pass to Josh. Deftly, he slides it along the interior joints of the window sash, loosening the stuck paint, and manages to heave the window open. Nodding at him, I place one end of the rubber tubing inside the urn and suck for a moment on the other end—I make this quick, as people are already pointing cell phones in our direction and I don’t want to wind up all over the internet in some pornographic meme—and then cap the end of the tube with my thumb before passing it to Josh. He thrusts it out the window and uncaps it, where it begins spraying water into the garden beyond.

The partygoers break into applause.

“Oh mah goodness!” says the hostess, fanning her face. “Thank you so much. You’re marvelous—you saved the day! What do I owe you?”

“Nothing,” I say. “Happy to help.”

“Oh no, I insist. And you got here so quickly! You’re truly wonderful!”

It dawns on me that the hostess thinks I’m a plumber, dispatched to handle this party emergency. I’d be irritated at the misconception, but it’s hard to blame her. In contrast to all the floaty-dress women around me, I’ve dressed in black pants, formerly mud-encrusted black boots that I’ve hosed down, and, in a nod to the occasion, a velvety blazer, which I removed a few minutes ago to deal with the urn situation. Aside from my government-issued uniforms, these are the most formal clothes I own.

“You’re Dahlia, right?” Vani says to the hostess. “I’m Dr. Vani Darshana.” She turns to me. “This is Kira Marchand; she’s a doctor as well.”

To her credit, Dahlia assimilates this information with aplomb. “A doctor!” she says, every bit as enthusiastically as she had when she thought I was a plumber. Since the ostensible purpose of the event is to raise money for medical research the room is crawling with doctors, but you’d never know it from Dahlia’s reaction. “We love the CDC around here! That’s wonderful! Who are you with?”

“I’ve worked for everybody,” I say. “NGOs in the beginning; then the CDC, in the virology branch and as an instructor for the EIS. I’m temporarily offline right now but I do sometimes still collaborate with the WHO. I’ve interfaced with the NIH—NIAID—and even USAMRIID. Depending on, you know, the situation.”

Dahlia blinks, helpless against the onslaught of alphabet soup. Vani helps her out. “Kira’s an infectious disease specialist,” she says. “One of the world’s pre-eminent experts on artioviruses. You might have seen her on the news.”

Comprehension is dawning on Dahlia’s face; polite puzzlement giving way to startled recognition, followed by an expression of singular, devouring curiosity. Sometimes this happens; people recognize me from local news clips I’ve done to answer epidemiology questions or an interview in the Atlanta Journal-Constitution about virology or they remember me from one of the national press conferences in which I assisted the president. Vani, realizing her error, trails off as Dahlia’s mouth opens wider.

“You’re friends with the president, right? And you’re one of our speakers tonight!”

The second part of this statement is true; partly to atone for my actions a year and a half ago I’m one of several people who’d agreed to give a short talk emphasizing the need for research dollars. Regarding POTUS: I’ve met her and was once drafted into a live national press conference at her behest but describing us as friends is a stretch. That doesn’t stop people from peppering me with all manner of political and nonpolitical questions about her. Atlanta is almost as bad as D.C. when it comes to power trippers.

I attempt a deflection, gesturing to my outfit. “I’m dressed wrong. I didn’t know about the floaty dress thing. I thought it was going to be a room full of CDC nerds.”

“Oh, honey! That is no problem. You look lovely! So chic and … comfortable!”

The avidity on Dahlia’s face clearly signals she’s poised to fire off more questions so I pivot in an attempt to escape her, forgetting who is standing to my left. Shit: out of the frying pan and into the fire.

“Great save, Dr. Marchand! See what I mean? You’d be a natural on TV.”

Mr. Smert, I decide, is one of those people who respond only to bluntness. “Pardon the graphic image, Mr. Smert, but I would sooner jab a fork into my eyeball than appear on a reality television show.”

Remarkably, this does not faze him. “It’s not a reality show, Dr. Marchand; it’s a docudrama. Starring you and a few others. You’d be famous. I mean, not like before, when you’d be quoted in the newspaper or do a press conference. I’m talking about exceptional fame.”

“I don’t want to be exceptionally famous. Or any level of famous.”

Smert blinks, clearly unaccustomed to dealing with people who don’t wish to be exceptionally famous. “Ah. If you don’t want to be on-screen, we could use an actor to portray you. We’d welcome your input on the script, of course. You’d be influential in the development of your personal storyline.”

I try not to waste time wondering what it might mean to be ‘influential’ in the recounting of my own history. “I don’t want to share my personal story.”

With an expression of triumph, he plays his trump card. “The compensation would be significant. Very significant.”

“I don’t want money, Mr. Smert.”

Mr. Smert gapes, uncertain how to deal with the kind of individual who’d reject the holy trifecta of money, power, and fame. Vani seizes the opportunity to steer me past him before he can regroup. As we move toward an elegant arched doorway, I remember my manners. “Thank you, but no thank you,” I call over my shoulder. “Hope you find somebody else to make rich and famous.”

—Chapter Two: The Trolley Problem

KIRA: Atlanta, Georgia

Eighteen Months After Patient Zero

We stumble out into the night, an enormous respite after the heat and babble and stress of the party. I inhale, welcoming the sensation of fresh air. Removing the pin from the jacket lapel, I affix it to my T-shirt, where it will be visible to anyone I encounter.

Technically, appearing in public without a pin—green, yellow, or red—constitutes a crime. Penalties for noncompliance are rare, however. Forgetting your pin is a misdemeanor, and anyway, there are other ways of determining a person’s immunity status. By law, all cell phones in the United States use Bluetooth proximity technology to broadcast a signal related to the most recent IgG antibody tests of the owner, which everyone is supposed to update at a free center. If your cell phone comes within a twenty foot radius of the cell phone of a non-immune person—a yellow—you’ll both receive an anonymous notification. If your cell phone comes within a fifty foot radius of a known active infection—a red—you, and everyone around you, will hear an alarm. Both yellows and reds are rare these days, of course: the virus has already burned through a sizable minority of us, and most of those who escaped it long enough have now received the vaccine.

You can go off the grid, of course, and some people do, shunning testing and pins and the vaccine. They risk losing cell service and certain benefits, but pockets exist of disease-deniers and conspiracy theorists who care little for such things. There is also a sizable contingent of fierce nonconformists who prize independence above all else. Most people comply, or try to comply, with varying degrees of success.

Compton waits until we clear hearing distance from the house before she speaks. “Well, that was…eventful. Good save on that glass thing.”

“Thank you.”

“And way to dodge poor Mr. Smert.”

“Huh? Why’s he poor?”

“His name.” We reach a lighted stone fountain, embedded in a circular plaza of crushed white pebbles. “Art Smert? With apologies to Garfunkel, I predict zero babies named Art in the future. It’s going to fall out of fashion, like other notorious ‘A’ names. Adolf? Attila? Who wants a name that evokes images of genocide?”

“He can’t help what he’s named,” says Hannah.

“Smert,” I muse. “I’ve never met anyone with that name before.”

Compton consults her phone. “According to Urban Dictionary, the term smert refers to attempting to be smart, but failing terribly.”

“Aha,” I say. “The universe has spoken.”

Beyond the fountain, trimmed boxwoods and yuletide camellias flank a couple of cast-iron benches; behind them a wide expanse of lawn angles away into infinity. We sit, Vani and I on one bench, Hannah and Compton on the other. “Kira.” Compton tucks an errant strand of glossy hair back into formation. “Obviously you aren’t going to work with Artie Smert. But do you ever think about sharing your perspective?”[DK2]

“Of course not,” I say. “I see no reason to relive the most devastating thing I’ll ever experience just to provide fleeting entertainment for a bunch of ghouls. I know how it works: every little facet of my life would be sensationalized and contorted to look controversial. Conflict sells. Drama sells. What doesn’t sell are the anguished inner reflections of an introvert.”

Even in the dim light, I can see Compton’s eyes narrow. “Maybe your inner reflections wouldn’t work on television but you know where they would?”

“Com, wherever you’re going with this, I don—”

She holds out a slim-fingered hand. “Hear me out, Kiki. Other people want to capitalize on your life and, as you say, they would contort what happened to reflect their own priorities. You don’t need to do it to be famous; you need to do it to control the narrative.”

“No. Never. I’d hate people knowing about my circumstances, whether it came from me or someone else. Even if you set aside the consequences of my decision, I committed a serious breach of the ethics of my profession. It cost me my job.”

“Not exactly,” Compton points out. “You could explain. People would be sympathetic. You could write a book.”

“I could write nonfiction in the field of infectious disease, sure,” I say. I keep my voice light. “I have written nonfiction in the field of infectious disease and somehow that failed to interest more than five people until the pandemic. But a memoir would be by definition my personal story.”

Compton’s face takes on a mulish cast I recognize as a precursor to more arguing but before she can speak again, Hannah bails me out. “Of course you’re entitled to privacy, Kiki. All of us are.”

This shuts Compton up. Possibly the thought of her own experience during the pandemic—or if not hers, Hannah’s—is enough to deter her; in any case, she remains quiet as Vani picks up the conversational slack.

For December, the night is mild, the air breezy and rich with the scent of mulch and pine and winter camellias. I rest my back against the bench and bob in a tide of the lulling, familiar sound of my friends’ voices—Hannah’s clear sweet murmur, Compton’s clipped vowels, Vani’s singular blend of the American South and the south of India—as they chat about the party.

I hadn’t been entirely honest with Compton. In truth I have been recording my recollections, curating my memories into a semi-fictionalized narrative. I don’t have literary aspirations for my journaling, once finished—it’s more likely the whole thing will fester for decades in a drawer--but it’s unsettling to think of my private project unearthed by an opportunist. Still, somewhere in my mind, I’ve been picturing how a reader might respond to what I have to say.

Unlike the addictive, empty-calorie content of reality television, a work of literature—even a journal—allows for a more meticulous and insightful interpretation of events. You can present in shades of gray; you can offer and evaluate evidence.

You can justify.

I bat away that last thought before it can take root. In about an hour I’ve committed to standing up before the wealthy crowd in the house to present a short fundraising speech, geared toward extracting money from people who consider themselves philanthropists and pillars of the community, and, as such, receive non-stop requests for donations from one worthy cause or another.

Kicking at a tangle of old, dead leaves clotted in a heap at the edge of the bench, I try to order my thoughts, but the public-speaking area of my brain remains stubbornly disengaged.

It doesn’t seem likely I can finish writing a book if I can’t even come up with a ten minute speech on a subject I know well. I wait for a break in the conversation and direct a question to Compton.

“Hey. If you don’t mind my asking, what makes you think I could write a memoir? Vani’s the only one of us who can write.”

“Because,” she says, with the air of someone delivering the final word, “you’re the most brilliant person ever.”

I’m not the most brilliant person ever but I stifle an impulse to correct her. “If I wrote a memoir that other people read, you’d all be in it. How would you feel about exposing our warts to the world?”

I expect Compton to bristle at the concept of a public display of warts but instead she issues a tinkly laugh. “It’d be hard to portray Hannah or Vani as warty. You’ll have to invent something for them.” She pauses to consider her next words. “And now that I think better of it, you should probably leave my story out of it.”

I’ve already created neat literary slots in which to file our gang of seven from medical school. Hannah’s easy; she’s always represented the archetypal mother figure to us. She’s the organizer and the soother and the one who reins in the rest of us when we start to spiral. Hannah rarely demands attention but she nonetheless directs the tides that pull the rest of us.

In Shakespearean terms, Vani, an internist, would be cast as the foil: studious and sensible and calm, she provides an oasis of peaceful good humor in the midst of the ruckus constantly kicked up by everyone except Hannah. She possesses that rare gift of dialing down drama without ever descending into bossiness and something about her—her smooth rich voice, her radiant cheer—draws you in so subtly you’re hooked on her before you realize what’s happened. Vani is my person; ever since we shared an apartment in med school, she’s the one I call when I have a funny story or a need to vent, but she’s also the person I call during those times when life seems unbearable.

Compton issues a little snort. As if she were aware of my unspoken analysis, she angles her face in my direction and cocks an eyebrow—the Compton equivalent of a smile. Birdlike and brittle, Compton’s always looked as if she’d be most at home in the blue-black light of an underground speakeasy, clutching a cigarette holder and a martini, blowing a caustic stream of smoke through the rosebud of her red lips. Her elegant bitchiness masks a keen and genuine concern for others, which is an element of her personality she likes to keep submerged from view, for whatever reason. Unlike the rest of us she’s a born and bred Yankee, although she wound up at our medical school in Kentucky because her grandmother on her father’s side lived in a small town outside Louisville. Suffice it to say none of the southern charm rubbed off on her during the four years we all spent together.

The other three friends from our gang aren’t here tonight: Georgia, a urologist, resided in Charleston before moving to Southern California; she’d represent the feisty, funny, iconoclast among us. Zadie, a pediatric cardiologist, is goofy and charming, Emma, a trauma surgeon, is introverted and introspective; they both live in Charlotte and are intertwined in our minds as the yin and yang of long-term friendship. And me?

I guess I’d cast myself as the villain. Or, no: not the villain. That’s not fair. I’m not motivated by evil or even self-gain. But at the very least I’m the troubled protagonist; the character most warped from the presentation of an unsolvable dilemma. Of the seven of us, I’m the one who seems most tormented by what happened to us collectively and to me personally.

From the nearby sunporch a woman carries on; a loud, long grating shriek of a laugh, followed by “You didn’t! You did not! Chas, tell her!” A low mumble, presumably from Chas, and more laughter.

Vani elbows me in the ribs. “What are you wearing, Kiki? Do you even own a dress?”

“Of course I own a dress.” This is both true and a lie; I do have a voluminous red dress-like garment that I wore to African funerals during my WHO days but it’s nothing like whatever Vani has in mind with the word ‘dress’. My outfit tonight is what I like. I don’t wear dresses in America and I certainly didn’t wear them when I lived in Chad. I picture showing up in my red tent to a Buckhead soiree and can’t repress a grin. Vani, no stranger to the way my mind works, elbows me again. “You can’t ever wear that.”

“You don’t even know what I’m thinking about.”

“Whatever it is, it is not right. I think I overestimated your ability to assimilate here. Maybe we can get you into a Cotillion class or something.”

“Bah,” I say, my smile widening at the image of me waltzing with a pimply Buckhead teenager, a tennis ball between our foreheads, as an officious blond lady in her fifties claps out ‘ONE-two-three, ONE-two-three’. But my smile vanishes as the word ‘teenager’ reverberates through my brain and it’s all I can do to repress the wild sob rising in my throat.

Vani senses the shift in my mood and reaches for my hand. Across from us, Hannah and Compton lean toward us, Hannah nearly rising off the bench. “Don’t think about it, Kira.”

But I’m thinking about it: there’s no stopping this train. It comes at me like it always does; out of nowhere, full-throttle screaming engines, ten thousand metric tons of carnage barreling down, allowing me only an instant to process my obliteration before it happens. One second I’m adapting, I’m fine, and the next second I’m doubled over, gutted from the impact.

I lean forward, allowing my head to fall onto my crossed arms. Vani sinks too, rubbing my back, whispering stupid little nothings of encouragement until embarrassment at my neediness eclipses my distress, providing the impetus for me to rise to my feet. “I’m a nightmare,” I say.

Vani is nothing if not loyal. “Yup,” she agrees. “Total.”

It’s dumb but it makes me laugh.

“Look,” she says, switching gears. The moon has come out and it illuminates the curve of her cheek, threading patches of glistening silver through her dark hair. “You’ve been through hell. It’s like…do you know what it’s like? That famous psychological experiment, what is it called? The one with the train?”

At first I think she’s somehow tapped into my internal train/shame metaphor but then it comes to me in a flash: I know the experiment to which she’s referring.

“The trolley problem,” I say.

She snaps her fingers. “That’s it.”

The trolley problem is indeed a well-known series of theoretical moral dilemmas, which psychologists use to gauge how consistently people use logic and ethics in their decision-making. Depending on how you answer, they’ll throw in enough permutations to keep it interesting.

One of the better-known variants goes like this: you’re the switchman of an old-school railway. A runaway trolley comes careening down the tracks toward five people who are lying, incapacitated, on the tracks. You, the railman, can pull an emergency lever that will divert the trolley to a side track in order to save the lives of the five people, but there’s a catch. A single person is tied to the side track and if you shift the trolley it will kill her instantly. Your choice must be made in an instant: do you do nothing and allow the deaths of five people—an act of omission—or pull the lever and divert the trolley to the side track, thereby directly killing one person?

Most people, when faced with this calamitous choice, do not hesitate: they opt to divert the train. Psychologists, though, are perverse bastards, so they upped the ante. This time, you are standing on a bridge above the trolley, an onlooker with no official responsibility. You observe the five people—still in mortal peril from the runaway trolley—and as you do, you see there is someone else on the bridge with you. It’s a tall man, craning to peer onto the tracks below. In an instant you recognize the implication: if you nudge the man over the rail, he will land in precisely the right location to stop the train. (Please note: I did not invent this ridiculous scenario. Blame the ethicists.)

Now your choice is even starker: do you shove one man onto the tracks in order to spare five people? The outcome, you’ll note, is the same as in the previous scenario: one person dies in order to save five, but this time the results are skewed the other way. Almost no one would actively sacrifice the big man to save the others.

Hmm, okay, said the psychologists, noting these results. Maybe this is still too easy. How could we make this a truly excruciating choice?

Scenario number three: there is a child tied to the track. Again, you can save him by diverting the train using the switch, which will kill whoever is tied to the other track. But this time it doesn’t matter because you look more closely and realize, with a sensation that defies description, that it’s your child. You know—you know—that no matter how many people are threatened on the other side, there is no choice. This is the point where biology overwhelms logic. You’ll do whatever you have to do to save your son.

Until you see who is tethered, terrified, to the other track.

Your daughter.

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