Chapter 2: Getting Dirty

Natalie shook her head, observing the atrocious conditions as they approached the remains of the abandoned VCU West Hospital. "Damn, I expected the treatments to be messy, but I wasn't expecting this!" Overwhelmed after the city's minimal social services collapsed, the hospital staff had struggled on, simply dumping the dead outside in the hope they could bury them in the future. The huge mass of limbs and lifeless eyes stood in a silent testament to the horrors of those final weeks, ensuring no one would venture near.

"I know. I'm hardly enthused about it, but David had to do this himself, so I was expecting it." Debbie shivered as they skirted the pile of bodies. "That's how Monique and I first met him. She remained by the hospital in case anyone needed assistance and I come along with an injury. David arrived to recover the same things we're searching for."

"These guys managed to gather so many useful things; you'd think they'd have found this stuff on their own. Or maybe we could just do without," Natalie said, surveying the ghastly remains.

"No, the items we're looking for won't be available in a doctor's office and the fact everyone feels the same as you ensures they wouldn't have been disturbed since." Reaching the front door of the hospital, Debbie prepared herself, grasped the handle and pulled it open.

The smell assaulted them, striking their noses like a blow to the face. Most of the decay-promoting microbes were destroyed by the plagues before they accomplished much, but they achieved enough to produce a powerful stench. Both she and Natalie wore high-quality air masks, but they provided little protection against what they faced. There were dead everywhere. As the corpses accumulated, hospitals focused on warehousing the sick. As the staff started falling victim themselves, any attempts to clean up were abandoned. Monique, a nurse at a hospital near David, knew enough to get out before it was too late, so Debbie assumed the last staff here were mostly good Samaritans who couldn't bear the idea of everyone dying alone and unaided.

Natalie grasped her arm before they could enter. "Are you sure we're completely immune? I know David and Alice are, but if their treatment doesn't supply one-hundred percent immunity, we'll never survive this exposure."

Closing the door, Debbie took a cleansing breath before responding. "Yes, I'm sure. Monique and Mattie helped in the different treatments and never contracted the plague." Debbie took another look at her friend to be sure she was OK before continuing. "There's no sense taking unnecessary risks. Keep away from the dead and we'll get in and out quickly. You know what we need, so hopefully we can finish fast."

Natalie nodded, frowning about the task ahead. Taking a deep breath, Debbie reopened the door and led them in, moving quickly so the stench wouldn't overwhelm them. The lobby of the hospital wasn't the wide-open, welcoming antechamber of before. Now the large expansive space was filled with corpses. After the initial meteor shower shattered most of the windows and the lack of electricity disabled the elevators, hospitals moved the majority of their functions to the lower floors. When the patients grew too numerous, the remaining staff gave them blankets in the lobby to give them a little comfort where they could easily monitor them. What remained, instead of coffee and gift shops, were the dead spread across the floor, their features permanently frozen in the grimaces of their deaths.

Debbie took off at a run with Natalie rushing after her without examining anything, figuring her friend knew what she was doing. Debbie headed to the elevators, only to duck into the stairway behind them. Once there, both girls gasped for air. The stairway, though hot and sticky from the heat and stale air, was at least easier to manage than the rest of the building. There were still corpses scattered along their route, but there wasn't as much room for them. They died on their own, rather than having been parked here by the staff.

Ascending the stairs two at a time, Debbie avoided the first floor. "There will be more dead here," she explained as they passed, speaking over her shoulder. "Those too sick to function would be on the lower floors. Hopefully the equipment on the upper floors is uncontaminated." She stopped at the 2^nd floor door, turning to give Natalie last-minute instructions.

"If you find a useable gurney, just dump any bodies rather than trying to move them. We also need equipment—instruments and supplies—so grab whatever you can. We don't know how much electricity these folks have, but we'll require whatever monitoring or other electronic equipment you can find, even if they can't use it here." It was difficult for Natalie to hear her through the thick industrial facemask, but Debbie didn't slow down. "Check the patient rooms for useable equipment," Debbie suggested, sounding like a seasoned professional several decades older than she was. Natalie leaned on that experience, doing as instructed. "Pay attention to storage or medical closets. Use the crowbars we brought to break into anything you need. I'll check the upper floors for any useful medical supplies. Try to find the private rooms for less ... used gurneys. Don't be afraid to run outside if necessary. But if you do, remember you need to return and finish."

With that Debbie opened and held the door for Natalie, who ran through. She turned in time to see Debbie dashing up the stairs. Natalie no longer had her friend's experience to count on.

Running down the hall, Natalie couldn't help but glance at the bodies lining the halls. The only available gurneys had bodies piled on them and looked thoroughly contaminated. But the corpses she observed were odd. Despite being here for so long in the still warm summer weather, they didn't seem to rot. Despite their stench, the skin didn't appear mottled, peeling or decaying. Instead they seemed to mummify, even in the warm, humid air; something she hadn't thought possible. Without anything to decompose the flesh from within, it didn't seem to decay, meaning the smell had to come from something else. She assumed that was what Alice's dog, Lassie, smelled when it identified sources of infection. The disease itself, in these concentrations, had its own obnoxious smell.

Almost bumping into a cart, Natalie shook her head just as her foot caught on the outstretched hand of a long-deceased businessman. She took several stumbling steps before she recovered, almost landing face first in a pile of the undecaying dead. She decided she needed to focus. She could worry about what occurred later, once they were safely away. She might be immune, but she couldn't think of a more disgusting event than lying among these dead.

Skipping the first several doors, she chose a private room at random. Kicking the bodies leaning against it out of the way, she yanked the door open and rushed in. She closed it behind her to keep the stench of one room from breaching the others. She didn't expect much of a difference—semi-putrid air isn't much better. The room, though initially private, was stocked with bodies. There were between five and six bodies on each bed, lying in alternate directions on their sides to maximize space. Those not lucky enough to warrant such comfort during their dying moments lay sprawled against the walls. Even so, the air was easier to breathe than it had been in the hallway. With the windows shattered and the floor near the window heavily damaged, there was nothing blocking the flow of air. Corpses lay on planks of plywood. She guessed the patients pulled down the planks meant to protect them from the elements to protect them from the cold tile floors. She also shivered with the images of the plague's free access across the city.

The room itself held nothing of use. Any electronic equipment had been removed as pointless and the most she could do with the heavily laden and soiled gurneys was to push them out the open window for easier disposal later. Taking a last gulp of air, she dashed into the squalid hallway again.

Having a better idea of what to look for, Natalie searched for smaller doors, realizing the wider doors were designed for gurneys while the smaller ones were for storage or offices. Picking one, she found shelves of badly folded linens and wrinkled, disarranged hospital gowns. Slamming the door shut, she continued on, checking a door on the other side. That room was like the first, though there were fewer bodies stacked in it. Noticing a dead nurse crumpled by the door, she grabbed her stethoscope, figuring those would come in handy. She also checked for keys to restricted supply areas, but she had none. She assumed the gurneys were useless, considering the piles of accumulated feces lying under them. Suppressing her gag reflex, she again ran out into the hallway.

Trying another smaller door, she found it locked. Assuming that indicated it was locked earlier in the crisis, she pulled out her pry bar and made quick work of the flimsy lock, kicking the door open. No matter what happened, no one would ever attempt to use these facilities again, so there was no sense keeping them pristine. This room had no one in it, which she thanked the heavens for, but the private desk was covered in open books. Glancing at one she saw it was a medical text with various sections highlighted. She guessed the non-medically trained volunteers eventually turned to them to figure out how to treat the sick. Noticing a locked filing cabinet, she broke into it too. There she found a gold mine: a couple of boxes of hand sanitizer, new gloves, unused needles and surgical blades. Unfolding the plastic bag she'd stuck in her jeans, she dumped them in before exiting the room.

Reaching an intersection, she was about to head down the main hall when she had a sudden intuition and went the other direction down the smaller corridor. Her way was blocked by a cardkey locked door. Taking that as a good sign, she forced the door and pushed it open. Inside she found a relatively pristine space with the doors and walls made of Plexiglas. She instantly recognized it as an isolation ward. Hoping anything they had was as dead as the patients, she continued on. She assumed it mostly held the usual drug-resistant staphylococcus (MRSA) patients most hospitals were plagued with. She hoped the MRSA strain hadn't survived exposure to the incredibly potent plague viruses.

Trying the next door, she found it locked to prevent accidental exposure. Using her pry bar to shatter the glass door, she dumped the last patient off the relatively pristine gurney. He seemed to have died before he succumbed to the plague, so the gurney's pads remained clean. Natalie hoped it wasn't coated in MRSA contaminations as she pulled it out the door. She also stopped to add a spare heart monitor and the nearby drip stand. Examining a smaller equipment closet, she discovered another steal, two portable defibrillators. She threw those on the gurney along with another couple boxes of sanitizers, gloves and hospital gowns. There wasn't much else of use, aside from the better quality filtered mask she removed from a nurse's corpse. It might be contaminated, but it should be reusable once they cleaned and sterilized it.

Having a full gurney, she rushed out through the crowded hallway as she grew dizzy from the stale air. She couldn't suppress the impressions of plague causing the dizziness. Despite knowing she was immune, she couldn't keep the paranoia of the Great Death's potency from her imagination.

Reaching the stairs, she stopped to consider her options. If she dumped the supplies, she could conceivably dismantle and collapse the gurney, but she wasn't fond of that idea. Instead she propped the door open, got in front of the gurney and pulled it down the stairs after her, using her strength to prevent it from tumbling down on her. The crowded stairway made her progress slow, and the stale air made her limited breathing even more difficult, especially sucking in the limited amount of fresh air through a thick mask, but she struggled on. The plastic bags she'd used to protect each item from cross-contamination allowed her to tie them onto the gurney, allowing her to concentrate on stabilizing the larger electronic devices.

Swearing to herself as she struggled, she wondered what Debbie was up to, knowing she was facing her own difficulties. If either of them had something collapse on her, there would be almost no way to locate her without knowing where she'd gone. She added a few curses for Alice for having Bogarted all the military headsets.

Opening the ground floor door, she again held her breath as she rushed through the crowded atrium. When she finally opened the outer door, pulling her gurney behind her, she sucked in a lungful of fresh air.

She made another three trips inside, only returning when she'd gathered a significant amount of supplies. She left them lying outside, not afraid of anyone stealing her stash. There was unlikely to be anyone about, and anyone stupid enough to risk stealing infected hospital supplies would only be asking for death anyway. Each trip was a little easier as the air inside the hospital was infused with fresher air from outside, and she now knew her way past the obstructions. She was tempted to mount a rescue mission for Debbie, when she suddenly appeared around the far end of the hospital, guiding two gurneys of her own.

"I came down the back staircase. I uncovered more supplies than I could carry, but I discovered a few things I couldn't find elsewhere: compressed air, magnification goggles and bottles of anesthetics. I also found the hospital pharmacy. They'd exhausted the antibiotics and painkillers, but I scooped up several bags of pills. We'll have to identify them later, but I figured they'd last where the rest won't."

It took some careful packing to get everything stored in their makeshift ambulance, but once they did, they drove back, never casting a glance back at the towering symbol of death and former magnanimity.

"OK, we're beginning the procedure now," Debbie finished inserting the needle and started the infusion, "so let's go over the final details. You won't be able to remain for long."

"How long will the process take?" Nate asked, biting his lip as he watched the two girls prepare their patients. The uninfected had been relegated to the far side of the room to prevent accidental contagions.

"It generally takes around five days, though we can't be any more precise than that. It varies with the health of each individual," Natalie explained. "A few cases have lasted as few as four to as long as six days. Recovery takes a while longer."

"What's that you're setting up?" Betsy asked, looking nervous about the antiseptic nature of the process.

"It's a defibrillator. It's common for people's heart to stop several times during the treatment, so it helps having one fully charged when we begin. That way we won't need to search for it when we need it.

"Their hearts stop?" Wilber asked.

"Calm down," Debbie cautioned. "You need to keep your blood pressure, breathing and heart rate as controlled as possible. But yeah, we told you this is serious. You'll be lucky if all that happens is your heart stops. The reason the rest of you can't stay is because there will be bodily fluids everywhere and it's highly contagious."

"More contagious than walking through an infected hospital?" Rufus asked.

"Much," Debbie assured him. "The air in the hospital is stale and heavy, but most of the humidity has dried. Here, they'll be fresh and the contaminants are only dangerous when they're damp. It's how the viruses transfer mechanism works."

"It doesn't sound pretty," Betsy remarked, making a face.

"Believe me, it's not," Natalie answered, checking her supplies once again.

"What are the odds we won't survive?" Wilber asked, visibly swallowing.

Natalie stopped, realizing that while this was a serious concern, she needed to get them off this pessimistic track.

"Considering any single plague is well over seventy percent fatal and that all the plagues together are one hundred percent fatal, your odds are damn good. But the issue isn't how likely you are to die. You've got to remember why we're doing this. You aren't doing this for yourselves. Believe me, if you're only thinking of yourself, you wouldn't survive. When I went through it myself, I prayed hundreds of times for the sweet release of death. No, you're undertaking this for everyone within a hundred miles of here, their kids, your kids and the continued survival of the human race. No matter how hard it might be, you've got to continue, because if you don't, you're condemning everyone you know to a certain death."

"But two volunteers take the pressure off, doesn't it?" Emanuel protested.

"Hardly," Debbie scoffed. "While we planned on handling two to account for any unexpected deaths, your continued existence depends on sufficient genetic diversity to survive as a distinct community and on your representing a large enough disparity in blood types to treat everyone else. Even if you were a universal donor, if there's only one of you, a simple accident or random heart attack could endanger the entire community."

Natalie glanced up from her equipment. "We don't mean to overwhelm you, but it's important to remember that this is bigger than just the five of you. We're trying to save the whole human race. While we've saved a handful of people, there's no way we have enough survivors to continue for long, and if this winter is as bad as we fear, there will be another wave of deaths soon. While we know how difficult and painful this is, that information doesn't help you. What does is knowing how much everyone relies on you. Your friends, neighbors, those survivors you haven't even met yet and those hiding in damp basements fearing exposure too much to reveal themselves. That's what will get you through this. Surviving the next couple of days with be the most significant event of your lives. How many people do you think will remember Bill Gates, Steve Jobs or Beyonce in another ten years? Not a damn person. Instead they'll all thank you for what you're about to undergo, because what you pay for with your own sweat and blood will buy the survival of everyone else across the globe. Someone in Phoenix might never know you, but everyone living here will."

"And you'll be here if anything happens?" Betsy asked, looking directly at the two girls, each much younger than anyone else in the room.

"We'll only leave if we need something, in which case only if you're being taken care of, and then we'll return right away," Natalie assured her. "We're in this for the long haul. This is our priority. This isn't like the hospitals where someone tosses a body out of a speeding car hoping someone will warehouse them until they die. No, we plan on sitting here, cleaning you off, forcing you to drink and talking to you to keep you active."

Betsy looked relieved at the simple assurance, although Wilber still looked disturbed.

"What about us? What can we do while we wait?" Rufus asked.

"Yeah, can we help somehow? Bring you snacks, give you a break?" Nate asked. "I'm not sure we can stand waiting around not knowing what's happening."

"No, we don't want any of you coming anywhere near this room," Debbie insisted. "If you want, you can remain in the outer room and we'll let you know how things are going, but everyone in here will be highly contagious until their fevers pass and we can scrub down every inch of this office."

"We've got plenty of food and water," Natalie said. "You can do other things though. Even though you're the only ones here, word of this is likely to spread. Don't ask me how, but anyone passing by will notice what's happening and be curious about it. You'll need to keep an eye out. If you see signs of anyone, leave them gifts of water, food and some of those charged phones we left you. Beyond that, you need to continue collecting resources. Discovering caches of stored food is good, but collecting water, identifying places you can grow gardens and gathering enough tools to maintain a source of electricity are all going to be necessary."

"Don't worry, I'll make sure everyone keeps busy," Emanuel announced with a meaningful glance at the others. "We realize how vital this is and we won't waste the opportunity. Until now, we were merely waiting for the inevitability of a painful death, but you're granting us the benefit of hope. Hope for the future, for a community, friends, family and a way forward. We're each committed to this and none of us are going to go quietly, no matter how attractive death may be."

"Here," Natalie said, handing out two mobile phones. "While we're occupied, you should listen to these just so you'll know what's going on. You'll need to be familiar with the process when it's your turn. These contain recordings of David treating someone. The strange thing is, while the blood transfusion allows them to survive the plagues, it's his specific technique which allows the patients to survive the treatment."

"You'll notice David sings throughout the procedure, detailing the lives and deaths of people the patients never knew, but it's a necessary part of the treatment." Debbie leaned against a gurney, taking the time to focus on everyone. As this was a vital part of the process, she continued training these individuals about the treatment so they could do it themselves. "It seems odd singing to people who are unresponsive, but the nursery rhyme approach is calculated. The logical left hand side of the brain shuts down because of the pain. By singing, we connect to the more emotional right hemisphere, which remains awake focusing on the pain. The story about everyone who came before gives enough information to force the logical part of the brain to remain both awake and alert, while reminding the patients what they are fighting for. The stories of how everyone fought up to this point, stresses how important the entire process is. The story is captivating and it's what gives each of us the strength to pull through the process."

"And you're confident they'll both survive this treatment?" Rufus asked, glancing nervously at Betsy.

"No, we're not," Debbie admitted. "We've lost several people to the treatment, but the survival rate is much better than you'd have if you caught any single plague. Those were also complicated by other issues like the age of the participants and how they were infected. So we're confident they stand a good chance of surviving. But again, their attitudes are a necessary component. This is a much tougher fight than any soldier has ever fought. This is a short internment in the larger scheme, but it will seem like ages. Having survived this, it will define the rest of your lives. Nothing will ever seem the same again, just as life now is utterly different than it was before the Great Death started."

"All right." Betsy awkwardly tried to make a dismissive motion without getting tangled up in the drip lines. "You've made it clear how important this is. What else do we need to know?"

"You basically know everything required," Debbie assured her. "The best thing for you now is to simply marshal your strength and make any goodbyes you want."

"Gee, thanks for the pep talk," she replied, rolling her eyes, giving Debbie hope she had the right attitude.

"How safe will we be outside?" Nate asked.

"You should be fine," Natalie assured him. "We set up a battery operated dehumidifier to keep the risk of cross contamination down, but I wouldn't lurk outside the door. What's more, we'll be moving in and out, so I wouldn't come any closer than the outer office."

"We also supplied you with high-qualify masks, though they're in very limited supply," Natalie added.

"Don't waste your supplies. We managed to find a delivery truck outside one of the medical centers which had a lot of necessary equipment like gloves, masks, gowns and bandages, so we're set. In fact, we can set you up when you move on."

"OK, I hate to rush this, but we don't want to risk exposing you beyond this. We're going to chase you out while we focus on these two," Debbie added, doing just that.

Debbie and Natalie tried to keep Betsy and Wilber's spirits up, discussing what the procedures entailed in order not to scare them too much. But the unspoken threat was clear to everyone. As their symptoms began to appear they kept pressing their patients to continue drinking and remain positive. They'd avoided singing too soon for fear they wouldn't have the strength to continue. But as words began to fail Betsy and Wilber and the silences grew, they knew they couldn't put it off any longer.

Debbie began singing softly, forcing the two tossing and turning on their gurneys to stop and pay attention, which was part of the process. But as she sang the now familiar song of David and Alice's history, her voice rose with pride. She didn't want to sully all they'd accomplished by mumbling their praise.

And the story was captivating even for two who'd never known the participants. Both patients grew quiet as they listened intently, marveling in the personal details and travails of those who'd gone on before. They hoped each one would pull through, or would at least help the others survive. They grew to love each person from the sung description of what they'd experienced. They marveled at how courageously they'd struggled while others either hid or attempted to inflict further damage on those around them. They silently cheered Ellen, who outwitted David, encouraging him to take on more survivors, even when he tried to keep them at arms' distance. They smiled as the two girls described Alice's manipulations of everyone, appreciating the underhanded tactics of a devoted mind in one so young. They compared her to those currently treating them; realizing age had no bearing on personal strength or commitment.

They felt the familiar sting of loss over Flora's family, pain they'd each experienced themselves, and appreciated how quickly she'd found a new home where she not only fit in but was welcomed as a full member. They grinned weakly at the enthusiasm of Alice's classmates, and felt comforted when they accepted the offered olive branch, hoping they'd have similar successes in the future. They also suffered the disappointment at how some people turned on each other, as those David tried to help turned against him, forcing David to kill those few who survived, gaining no ground for themselves in the process.

They were too dehydrated to cry over Linda's death, though it hurt them no less. They realized how necessary the strength of fellow survivors was, and David's pain seemed almost stronger than what they were suffering. But they rallied when he turned his suffering into action, setting out to stop the widespread criminal behavior, reveling in the very public displays he made of the miscreants he caught.

As the song revealed the fate of each beloved character, they lamented the loss of another potential leader, each willing to help others survive. But the songs made clear what they offered to the continued struggle and how the struggle carried on after their deaths. They struggled to hold their breaths during the final passages as Debbie related how the few survivors died, one after the other in their lonely shared cabin. They agonizing over the apparent death of both Ellen and Alice, even though they knew Alice had survived—the pain she represented was no less real.

When Debbie sang about David finally closing his eyes, losing his desperate bid to remain awake for his daughter, they experienced the frustration over the power of inevitability, and it reinforced their resolve to fight its amazing pull. But when she reached that stage, Debbie finally fell silent, her voice failing as tears streamed down her cheeks with the emotions of the scene.

Then, as they struggled with the all-encompassing silence, Natalie began softly singing of David opening his eyes again. She sang of his struggles to pull himself together and of how his first thoughts at realizing he was still alive was to seek out those closest to him. Even though they knew how dangerous exposure to an infected individual was, they marveled at the personal commitment needed to cradle your companion's dead body. And when she sang of Alice's miraculous recovery their hearts sang, just as Natalie's voice grew stronger to reflect the emotions coursing through both those in the tale and those in the room. They were sad to hear of David's anguish over losing his devoted Ellen, but that loss represented the acceptance they'd all had to deal with. David's bravely putting that aside to encourage his daughter filled them with hope that the future was as bright as he imagined it, even if it also promised to be as dark as what had already occurred.

As Natalie carried on the song, Debbie checked on their patients. They'd been lying with them so they could hold them steady and monitor their progress. Natalie held the smaller Betsy while Debbie cradled the shivering Wilber. They'd clean them up every time they soiled themselves, checking their vitals, examining their eyes, monitoring their fevers and wiping them down as Natalie's song continued. When she returned, comforting Wilber in her arms once more, Natalie continued as she recounted how David and Alice discovered Mattie.