Wincing at Light

<– Chapter 8 / Chapter 10 –>

He seemed to rise up from a long distance, soaring skyward at enormous speed. Brett emerged from a veil of white cotton strangulation into darkness. Someone was humming as he floated nearer to consciousness, but it wasn’t a tune he could place. The sound of it was tinny and resonant. Too much volume pushed through busted speakers.

He opened his eyes and saw only the gray, featureless steel plates of the ceiling. He blinked, heard himself groan very distantly. A form bent over him.

The man was trim, but round, almost portly. His head was a perfect circle flushed the red of a light sunburn. His small eyes were pale and bright like wet stones, and he wore a white goatee that seemed to exist for the sole intention of mitigating his circularity of feature. It didn’t work. Doctor Brent Liston bore a remarkable resemblance to the actor who had played Dr. Fizing on the mid-forties space drama To the Stars!. Brett could never remember the actor’s name, though he had enjoyed the show immensely as a child. Fizing had always been running here and there about the interstellar exploration vessel announcing: We’ll not let it stop us, Captain! If I have to resurrect every jack man among us, we’ll prevail! That or some similar variation of it.

Brett had worked with Liston for five years now, and he anticipated the day when Liston said something even vaguely along those lines. He suspected the good doctor would sound as much like Fizing as he looked. Once, two or three years ago, when he’d had too much vodka at a station-holiday mixer, Brett had almost asked him to say the words. Just to see, just to let his curiosity get the best of him for once in a situation for which his impertinence might be forgiven, but at the last minute, his courage had failed him. It was probably for the best.

Liston squinted down at him, pleasant and thoughtful. “Welcome back, Commander.”

Brett said something in return that sounded like Ugh. This was waking up, then. He didn’t like it. Not at all.

“How are you?”

“Awful. My head hurts.”

“Disorientation. Dizziness. You took a bit of a fall, knocked your head.”

Brett began to remember. The bastard shot me! He clamped down on the thrill of hysteria that tried to uncoil in his stomach, made himself calm. A stone. “Ritter shot me.”

Liston rolled his shoulders like a shrug. Neither here nor there, it seemed to say. You want a criminal investigation, talk to Ashburn. I’m just the med specialist.

“How does the arm feel?”

He raised his arm, tenderly at first, prepared for a stab of pain. He lifted it all the way over his head and then lowered it again. Rotated the whole damned limb on its axis. “I don’t feel anything.”

Liston nodded, smiling. “That’s good! It means the medication is working. Just a topical anesthetic, Commander, it shouldn’t bother you much. If you experience anything like nausea, stomach irritation, bowel irregularity, you should let me know, of course, but I imagine you’ll be just fine.”

“Can I sit up?”

“Yes, yes. Certainly.”

Liston moved in to help him, but Brett waved him off. There really wasn’t any pain.

“I think I fainted,” he said.

“Shock. Pain. Adrenaline. It’s not particularly surprising.”

“It’s also not the sort of reaction to tense situations a station commander wants to be broadcasting to folks who depend on his level headedness for their survival.”

The doctor waved dismissively. “There’s nothing to be ashamed of. Vaso-vagel syncope is a common reaction to uncommon events. It happens to the best of us.”

“Really?”

“Of course.”

“Like who?”

“Doctor-patient confidentiality and everything I was ever taught about medical ethics prohibit me from answering that question. But I can tell you that there are individuals on this station who display quite a bit more than the typical adverse reaction to the sight of human blood.”

“You’re just trying to make me feel better.”

“And you’re allowing your misplaced Western machismo to inordinately cloud your judgment. More severe vaso-vagel reactions are accompanied with bladder evacuation. You should consider yourself fortunate.”

“Thanks for your vote of confidence.”

“I’m just telling you that it could have been worse. You were shot. I don’t want to minimize the seriousness of that fact, but it wasn’t serious, thank God. A roll of gauze, a bit of tape and a couple weeks of careful treatment will fix you up. You were very lucky.”

Brett lowered his eyes. It was just censure. “You’re right. Thank you.”

He ran his eyes around the medical bay. He sat on a padded slab of plastic mounted at the headboard by a series of terminals and data displays. The power indicators were all amber indicating sleep mode and the screens were dark. The hooks which would have held IV fluids were empty. The sensor cuffs and wraps and tentacled arrays were neatly piled on a table, their cords disappearing into the backs of the various monitoring machines. There wasn’t even a metal tray of medical apparatus sitting by the bed. Brett felt his face begin to flush.

It could have been worse. Another way of saying, it wasn’t actually so bad at all. A flesh wound.

Christ. He would never live this down.

He studied the drawn curtain between his bed and the other eight that constituted the medical bay. Something clicked, his head starting to work again.

“I heard you had diverted all medical traffic to the dispensary.”

“Because of Tappen, yes,” Liston answered.

“On the other hand, it isn’t every day that the station commander takes a bullet,” Brett said slowly.

“I wanted the full range of equipment at my disposal.”

“Just in case?”

Liston grinned, winked. “As a precaution.”

“Can I have my shirt back?”

“The one you came in with is on its way to the laundry, but Miss Riley said she would bring you a new one when she returns.”

“How long have I been out?”

“A few minutes. Not long.”

“Of course not.”

“There was a good deal of blood on your shirt. It’s probably ruined. Quite the gory sight to the untrained eye.”

Brett sighed in disgust. “Anyone ever told you that you have a rotten bedside manner, Doctor?”

Liston suppressed another smile. “I wasn’t hired for my personal skills. Besides, you don’t hear Mr. Tappen complaining. Granted, he’s comatose.”

“But if anybody asks…”

“I’ll tell them that it was only my swift action and skilled surgical expertise that saved your range of movement from permanent damage, if not your life itself.”

Finally, Brett studied the bandage on his arm. It was cleanly wrapped in white gauze with a piece of surgical tape stuck on the outside of his arm. A small but ugly streak of crimson stained the middle.

“That’s it, then?”

“It was a small enough wound.”

“You could have lied to me, doc, just for tonight.”

“Medical ethics prohibit me from lying to patients, even for their own good.”

It was enough. If he had to take any more of Liston’s good humored mockery, he might just forget his own professional ethics long enough to slap him. Gingerly, Brett levered himself down from the bed. He tested his balance before releasing his grip on the rail. There seemed to be nothing awry. Nothing at all.

“If you’re done, I’ve got to go talk to Ashburn.”

Liston placed a restraining hand on Brett’s arm. “Actually, we’re not done.”

“No?”

“How far away was Ritter when he shot at you? Do you remember?”

“I don’t know. Five or ten meters. Too close for my comfort, thanks.”

“Not much a marksman is he? Five meters. You must have loomed as large as a barn door at that range. Just sitting there, as Djen said when they carried you in. No sudden moves. No particular attempts to evade.”

Brett could hear the thoughtfulness in Liston’s voice. Evidence. “Go on.”

“It’s just funny, don’t you think? I mean, during our pre-mission training, I remember the weapons instruction module clearly. I had some reservations about it, as you might imagine. I almost dropped out of the program, you remember? As a physician, I didn’t even have to bear arms when I was in the army.”

“I remember.”

“So they paired me with Ritter, because he had been something of a sportsman in his youth. Game hunting. Deer, squirrels, grouse. Have you ever tried to shoot a squirrel, Commander? Even at ten meters, a squirrel is small. The size of a playing card, and quick.”

Brett rubbed his chin. He’d forgotten about this, left the details of his crew’s personal lives scattered around the floor of his office with all the lab reports. “You don’t think he was trying to kill me?”

“I don’t know what he was thinking. Frankly, I don’t think Ritter knew what he was thinking.”

“Any time you want to clarify your point would be fine with me, doctor. I’m listening.”

Liston released his arm, satisfied that he had gained Brett’s full attention. “You were going to find Ashburn, I assume, to see what he’s done with Ritter. To ask him yourself exactly what he was trying to do.”

“Something like that.” It wasn’t a responsibility he was looking forward to. What would he do if Ritter had been trying to kill him?< Lock him in the brig? Persia Station didn’t have a brig, and even if it did, would Brett really want to keep him there for five years? Could he expect Ashburn to hold him for that long? A man they’d all worked with every day for the last five years? It was the sort of disaster that could destroy the functional efficiency of a deep space outpost. If there were protocols for dealing with attempted murder, Brett was unaware of them.

Probably the best he could hope for was short term incarceration until the next supply ship arrived, then Brett could happily ship him homeward. Let the slow wheels of Justice grind a bit more slowly than usual, as long as they did their job.

“It’s not something I relish,” he said, defensive. “I don’t have any interest in revenge.”

“Ritter is here. On the other side of the curtain, Commander.”

In spite of himself, Brett winced. A stab of pain deep in his belly, something primal. Something predatory and vicious. Ritter had tried to kill him, and he was here.

“Why?”

More cogently, where the fuck was Ashburn?

“Don’t worry. I took the precaution of restraining him prior to tending to your wound. You’re in no danger.”

Brett took a deep breath, cleared his head. He spat his words like slivers of glass. “Why was he brought here instead of immediately being taken into custody?”

“After he shot you, Ritter collapsed. And despite what your security officer may have to say about it, it was not as a result of Mr. Valent’s more aggressive that was strictly warranted takedown maneuver.”

“Maybe it was vaso-vagel syncope,” Brett growled, “from the shock of realizing he had just tossed his fucking life in the toilet.”

Maybe Ritter pissed his pants. Maybe cosmic Justice moved with a bit more alacrity than secular justice.

Liston pursed his lips. Unhappiness folded the old frown lines that streaked his jowls into canyons. He looked like a man on the precipice of grief.

Brett felt himself shamed again. Just do your job, he thought. Be disciplined, like you would if he had shot Ilam or Jervis.

Grudgingly, he asked “How is he?”

“Sick. More than I care to think about, honestly.”

Brett frowned. “Sick like Tappen, you mean. Meningitis.”

“It’s a preliminary diagnosis. I’ve hardly had time to examine him. I didn’t want to say anything until I’ve performed the necessary labs, but you didn’t do me the courtesy of remaining unconscious for another couple of hours.”

Brett shook his head. “Damn it.”

“Damn it, indeed. Do you know how rare a bona fide case of spinal meningitis is, Markus? Six thousand cases a year in North America. North America, I tell you, where every day we have farmers poking their hands into animal rectums, drug users sharing needles infected with God only knows what disease of the week, Chicagoans breathing whatever shit and toxins happens to be roiling about in the atmosphere from the nearest set of smokestacks. Six thousand cases in a world filthy with potential biological and bacteriological pathogens.”

Liston drew a breath, taking advantage of the pause to weigh his words. “And in Persia Station where even the air we breathe is assembled on the nano-scale and redundantly scrubbed for infectious organisms, we have two. Not a promising ratio given the broader context.”

Contagion. Just the speculation could spark a wildfire of panic. The breath in his lungs suddenly felt gritty, dirty, suspect.

“You should have said something to me earlier, doctor. You should have told me about the danger as soon as you knew.”

Liston snorted. “What would I have said? That Mr. Tappen appears to have developed a serious case of spinal meningitis? That in most cases of meningitis with a bacteriological epidemiology, the patient has carried the organism inside themselves for months, if not years, before it crossed from whatever haven it had carved for itself into the spinal fluid? Or perhaps that our station atmospheric scrubbers have been calibrated to filter out all known harmful bacteria, so the theoretical risk of infection to other crewmen was so minimal as to be statistically absent? And that’s even before the bacterial agent had to deal with the body’s own defenses! Would you have listened to me then? And if you did, what sort of special precautions would you have instituted above and beyond the standard protocols we already observe?”

Brett settled him with a calming gesture. “All right. It wasn’t fair of me to start pointing fingers.”

Liston seemed less offended than just weary, however. Already tired of thinking about the future. He had probably anticipated Brett’s reaction from the moment Ritter had been brought into the medical bay. “You were frightened. I understand. That’s why I’m speaking to you now. Believe me, from my perspective, this is very early in the diagnostic process to be making such dire predictions. But my own confidence, or lack thereof, in my preliminary diagnosis isn’t going to matter to the folks outside this room. They’re not fools, and they’re not isolated by their own busy lives and personal trajectories like they would be Earthside. They gossip. What else are they going to do? Persia Station is a sealed biosphere. We all share the same space; we breathe the same air; we eat the same food. Worst of all, we can’t escape any of those things. By now, I’m certain that everyone on station already knows what happened to you. Everyone knows that Ritter collapsed. Before long, they’re going to start comparing Tappen’s fainting episode with that of our esteemed xenohydrologist, and they’re going to reach their own conclusions. You’re the one who’s going to have to keep them from experiencing that same surge of panic you just felt.”

Liston was right, and for an acid instant, Brett hated him for it. He sagged back onto the bed. He wanted to scrub at his eyes with his fists as though it could make him see more clearly what he needed to do. “Start from the beginning. Tell me what I need to know.”

Liston lowered himself into a chair he pulled up beside the bed. “I know you don’t feel up to this now.”

“Don’t worry about me. Tell me what we can do.”

“I can give you a list to post, Markus, but Jesus, the symptoms of early onset meningitis are just vague and ubiquitous enough that anyone harboring even a case of the sniffles if going to shit themselves. I’m talking about things like headache, stiff neck, sensitivity to light. The sorts of things you’d associate with the common flu.”

“Better to be proactive, doctor.”

“Agreed. Just as long as you’re prepared for the headaches. Not literally, of course. Professionally.” Liston ran his hand over his skull, thinking out loud. “Maybe a general educational effort after that. Alert the crew that those who might have had more than casual contact are at greater risk. Those infernal card players, for instance. Shift partners over the last month or so, after the etiological agent ceased to be dormant.”

Liston was leaping ahead of the game, churning through medical protocols and disease containment procedures drilled into him by years of practice. Brett pulled him up short with a wave of his hand.

“I have no intention of casting doubt on your expertise here, Brent. I want you to understand that. As far as I’m concerned, the health of the people manning this station falls completely within your purview. But I’m the one who writes the checks that the administration is going to cash. Ultimately, this is my responsibility. I need to know that you’re confident in this diagnosis. I need to know that this is illness is what you say it is.”

Liston blinked at him for a moment, at the sudden shift in thinking. “Of course. Yes.”

“Ashburn told me that you’ve had him scanning the environment for pathogens. He said that the results were coming back negative.”

“Yes. I haven’t been able to identify the precise etiological agent, certainly. Ashburn’s contribution was a sort of scatter plot, to see if Cassandra could identify the source of the infection more rapidly than traditional lab techniques. Before tonight, I thought I had time, a few more days.”

Brett couldn’t fault him. Wouldn’t fault him. Liston had never shown himself to be anything but competent in his work.

“That’s okay. I want to know what you’ve got right now.”

“Without examining Ritter?”

“Yes.”

“Tappen presented two days ago with no recent history of complaints. He came looking for acetaminophen, complained of headache, photophobia, muscle aches and malaise. His assumption was that he’d stayed up too late, been working too hard, drinking too much. I saw no reason to disagree with him.” Liston smiled grimly. “I questioned him generally, and he admitted to some back pain over the last few days, elevated levels of fatigue, some diaphoresis. I thought he might be coming down with the flu, but didn’t give him much attention. I gave him some pills and sent him on his way. He passed out while on duty some two hours later and was brought back to me unconscious. That was really my first indication that this might be something more troublesome.”

“But not meningitis. Not yet.”

“It crossed my mind. Any first year resident carries around a mental list of potential diagnostic matches for a set of general symptoms like that. Meningitis is on the list, but relatively far down. Despite laymen’s perceptions, as a profession, we don’t automatically choose to assume the worst, even in medical emergencies. Nevertheless, I took the standard samples, performed the requisite tests. What came back was textbook evidence of infection. Elevated white blood count, increased fever, decreased glucose. I still wasn’t thinking actively about meningitis until the first episode of seizure. It was mild, thank God, and I’d taken the precaution of restraining him beforehand. I proceeded to administer a lumbar puncture to obtain cerebro-spinal fluid for additional tests. I looked for Streptococcus pneumoniae, Neisseria meningitides, Listeria monocytogenes, all the usual suspects. There was nothing. I advanced to CSF-serum glucose ratio tests, Gram stains, protein levels. Nothing!

“And yet I’m certain, still, of this diagnosis. The etiology eludes me, yes, but there are so many of the standard signposts. His CAT scan indicates a dangerous level of meningeal swelling and intracranial pressure. He has a rash indicative of septicemia which only accompanies bacteriological meningitis. I’ve given him intravenous cefotaxime, vancoycin, ampicillin—the entire arsenal in other words, Commander.”

“And?”

Liston dropped his head, exhausted, defeated. “He is not responding. Not to any of the accepted treatments. And that means he’s going to die. Unless I can identify the antigen and find a way to combat it, Mr. Tappen will not last the week. I have never encountered an infectious agent so well hidden, so determined to resist detection.”

“Is it an issue of resources? What can I do for you?” Brett understood instinctively the bitter tenacity with which Liston approached this problem. Tappen was one of them, an integral part of their community. His death would be deeply felt, devastating, made all that much worse by the amorphous nature of a shadow infection that refused classification. It was a loss they couldn’t afford.

“Micah down in bio has been lending support where he can, going over some of my results, duplicating my lab work. It isn’t a matter of manpower, just a matter of time. The tests take time, analysis of the results takes time and understanding which tests need to be done next takes time. After the standard causals are exhausted, it becomes a process of exploration.”

“All right, then. I’ll stipulate for the record that this is bacterial meningitis, as you say.”

“Bacterial meningitis of unknown etiology,” Liston corrected him. “I believe Ritter is all the confirmation I need for that particular conjecture.”

“It also confirms that the rest of the station is at risk. What do we do next?”

“Instruct all staff to report directly and immediately to medical if they experience anything on the list of probable symptoms. Tell them that an early diagnosis increases their chances of avoiding the worst. It may or may not be true, but it will make them feel better.” Liston paused, chewed his lip. “Anyone who has been in close contact, shared utensils or hygiene products. Anyone who has had sexual relations with him in the last month. I need to see all of them. Sievers, Jervis and Ilam should report at once for a battery of intensive antibiotic treatments. The rest of the station should undergo a lighter regimen just to be safe. That should put everyone at ease as well as circumventing any additional cases.”

“Except the antibiotics didn’t work for Tappen,” Brett reminded him.

“But in all likelihood, they will work on less advanced cases.” Liston sounded more hopeful than certain.

“You’re not sick, and you’ve been with Tappen since he became ill.”

But Liston shook his head. “I take precautions. I work in a sanitized environment. I never touch him flesh to flesh. And he’s only been here about three days. He may have been actively infectious for two or three weeks. But remember, he may have carried the bacteria in his system a long time before it passed into the spinal fluid.”

“And what about the rest of us? What’s the probability that we’re already infected?”

Liston only frowned. “Until I can identify the antigen, I can’t answer that question. We should assume the worst.”

Brett allowed the words to linger in the air, feeling their weight, their gravity. The horror of possibility tugged at him like a singularity, beckoning him to panic, but he resisted.

“What about Ritter?”

“What about him?”

“Does this explain his actions tonight?”

“It could. I’ve read reports of untreated meningitis advancing into encephalitis. The difference being that meningitis attacks the covering of the brain, whereas encephalitis attacks the brain itself. With enough damage, enough disconnection from consciousness, anything is within the realm of reason.” Liston looked up, his expression sheepish. “Not that I’m trying to alarm you, Markus. I don’t want you to assume that you’re going to have a station full of homicidal lunatics on your hands. Ritter’s manifestation is a highly irregular occurrence, a perilously advanced case. Most of our potential victims will go like Tappen. Today they’re feeling unwell; tomorrow they’re here, comatose, docile as lambs. In some ways, the typical course is almost more terrifying than the alternative.”

“Jesus Christ.”

Liston crossed his arms over his chest and grinned bleakly at Brett. “It’s a good thing you had already put away thoughts of vengeance, eh? Have you thought about how you’ll handle the disciplinary aspect? You can’t really punish him for medically induced hallucinations.”

“No.” Damn it. “But that doesn’t mean he’s completely off the hook yet. At the very least, it makes me suspect that he doesn’t like me very much. I should probably do something about that.”

“Beware the disgruntled xenohydrologists.”

“Exactly. It wouldn’t be the worst idea to take advantage of his condition to look through his personal effects. See what made him pick me out as a target.”

“The problem with administrators is that most of them can’t stand the thought of being disliked.”

Brett didn’t rise to the doctor’s taunt. “It’s a long haul. Private issues have a way of festering if left in the dark for too long, and I don’t mean just in terms of pitched gun battles in the arboretum.”

Liston might have said more, but the automatic door hummed open behind them and Djen entered carrying one of Brett’s t-shirts. She tossed it at him and frowned.

“I’ve had worse rejections to dinner offers,” she said.

Brett arched an eyebrow. “I find that hard to believe.”

“What a delightfully interesting dating life you must have had, Miss Riley,” Liston added, laughing. “Tell us more.”

“Play nice, Doctor, and someday I might, just to see your toes curl. How’s Ritter?”

Brett pulled on his shirt. “Hey, I’m fine, by the way. Just a flesh wound. Nothing to worry about.”

Djen rolled her eyes. “Don’t get blood on that shirt. You’ve ruined enough for one day.”

“I have him in a biocontainment tent,” Liston answered. “It appears he’s contracted a less developed case of Tappen’s meningitis. I gave him a significant dosage of Phelactix and started an IV. He’s still unconscious, but that isn’t necessarily bad. It will allow him to conserve energy while we fight the infection for him. I’ll keep the both of you apprised as the situation changes.”

“Let me know if he wakes up,” Brett said. “And Ashburn as well. He’d never forgive me if I bypassed him on a legitimate security incident.”

Djen took hold of his arm below the elbow to avoid the wound. “Come on, Commander. You’ve had enough excitement for one day. Let’s get you into bed.”

“That,” he said, “is the best offer I’ve had all day.”

<– Chapter 8 / Chapter 10 –>