Chapter Text
The security guard gave her a look of surprise as she walked in.
“Back so soon?” He asked, raising his eyebrows.
Samira flashed him a weak smile over her coffee. “You know me. I can’t stay away for too long.”
Despite the joke, the security guard’s surprise turned to a look of concern. Samira hurried her pace so she didn’t have to hear any more well-meaning advice. She got enough of that from her mother already.
It was just that Samira preferred arriving at the lab early in the morning so she could get things set up the way she liked them. Then, sometimes, she found herself craving the peace and quiet she got in the lab after everyone else had left for the evening. When it was just her and her cultures, the rest of the world faded into the background hiss of the oxygen flowing into her suit. Samira could forget about the sweat beading on her forehead, the ache behind her eyes from the lights reflecting off the eyeshield, the fact that she hadn’t had anything to drink since she entered the room—she was able to push it all aside. It was only Samira, the virus, and nothing else.
The elevator door closed behind her. Sipping her coffee, she grimaced at the taste of the powdered creamer she’d added to it. She kept meaning to buy actual cream the next time she was at the store, but her grocery store runs were always focused on the essentials, while more frivolous things like coffee cream were forgotten about. Samira didn’t like to waste her time.
The doors slid open and she made her way down the hall towards her office. Technically speaking, it wasn’t her office, it was the office meant to be used by everyone on her team, but as of right now that team was only made up of three people. But as the lab supervisor, Robby had his own separate office, and Abbot preferred to do his analysis on his laptop from anywhere but the office. So for the time being, the office space was hers and hers alone.
Except when Samira opened the door, she found herself face to face with two people, and quickly realized her time of having the office to herself was over.
“Ah, there she is. I knew she’d be early,” Robby said as she walked in. “Dr. Mohan, c’mere, I’d like you to meet the newest member of our team.”
There was an unfamiliar woman standing in front of Robby. She looked young, with rounded cheeks and bright eyes, her dark hair pulled back into a ponytail. For a moment, Samira could only frown at Robby. But then she remembered herself and flashed the woman a smile.
“Samira Mohan, pleasure to meet you,” she introduced herself.
“Trinity Santos.” After saying her name, the woman moved as if she was going to offer her hand to shake. But then she seemed to remember the kind of jobs they all held, and put her hand back down.
“Dr. Santos here is going to be joining our lab. It’ll be her first time working in BSL-4,” Robby explained.
“I’ll tell you now, It’s a pretty steep learning curve from BSL-3,” Samira warned. “It gets way hotter in the suits than you think it would.”
Santos didn’t seem put off by the warning. “I doubt it can be worse than summer in Manila. I think I’ll survive.”
Samira raised her eyebrows, both impressed and amused by Santos’ confidence. She shared a look with Robby and could tell they were both thinking the same thing: Santos was in for an unpleasant surprise.
Instead of saying this out loud though, Samira asked, “Manila? Are you from the Philippines?”
“No, but I have family there, so I’ve visited a lot. I also spent a summer helping out with a malaria program there,” Santos explained.
“Oh god, malaria, don’t remind me,” Robby groaned. “Awful month. Not as bad as the time I got typhoid, but definitely not an experience I want to repeat.”
“You’ve had typhoid?” Santos asked, brows furrowing.
“Field work in West Africa will do that to you. Especially when you’re fresh out of college in the nineties and think you’re invincible,” was Robby’s only explanation.
Santos flashed Samira a questioning look. Samira shrugged.
“Well then, Mohan,” Robby continued after a beat of silence, “Dr. Santos has had spacesuit training, but for her first time in the lab I want you guys to buddy up. Santos, once Mohan has given you the tour, if you’re feeling up to it then you guys can start analyzing some of the cultures Mohan was working on yesterday.”
At this, Santos’ eyes went wide. “Oh, I am so ready, Dr. Robby. I won’t have any problems, I’m sure of it. I never had any issues during my training-”
“Training and stepping into an actual hot zone are two different things, Dr. Santos,” Robby pointed out, cutting her off. “Wait to see how you react once you’re in there. There’s no shame in needing some time to get used to it.”
Santos nodded. “Sure, if I need to step out I’ll let Dr. Mohan know,” she said in a tone that told Samira she absolutely would not.
Robby and Samira shared that same look again. Although she was still annoyed that Robby had neglected to mention the new hire until she was standing right in front of Samira, she’d corner him about that later.
“Alright then. Let’s head over to the decon room, Dr. Santos.”
After saying goodbye to Robby and leaving their bags in the office lockers, Samira and Santos made their way down to the lab.
Samira used her ID to get them into the west wing of the lab, making sure to note both their names in the logbook near the door. This first room was lined with generic lockers for them to leave their clothes in. When entering the lab with Robby or Abbot, they always let Samira go first so she could undress in private. But she’d brought Santos into the locker room without thinking about it, and only realized her mistake when she went to pull her shirt over her head and noticed Santos watching her with wide eyes.
“Oh, I’m sorry,” Samira said, dropping her arms. “Uh, I can step outside if you want to undress first, or I can go first and you wait outside-”
“No, it’s okay,” Santos quickly said, a faint flush painting her cheeks. “I mean, like, it’s stupid for one of us to go outside since we’re both in here now. I just won’t look behind me until you’re done.”
Despite Santos insisting she was fine with it, Samira silently cursed herself for putting her in that position in the first place. After medical school, Samira couldn’t be bothered to be shy about something as simple as changing her clothes, at least in front of other women. But when Collins still worked in Level 4 she’d always preferred to go into the locker room first to change by herself, with Samira waiting outside until she was done. Samira was an outlier in that regard. It was a fact she often forgot.
Still, Santos was an adult. If she said she was fine then Samira was going to take her word for it.
Samira undressed quickly. She left her clothes—underwear and all—in her locker, to change into a clean pair of scrubs. While she did her best to keep her gaze fixed on the locker in front of her, from the corner of her eye she could see Santos taking her earrings out. Samira had never gotten in the habit of wearing jewelry, and working in BSL-4 only gave her more reason to not bother with it. Every accessory or item of clothing she had to remove before entering the lab took more time away from her work.
As she was straightening out her scrub sleeves, she caught a glimpse of smooth, pale skin behind her, before she forced her eyes back to her pile of folded clothes. In the back of her mind, she couldn’t help but think about how Santos was surprisingly well-muscled, but shook the thought from her head before she could linger on it for too long.
“You decent, Dr. Mohan?” Santos asked after a moment.
“Yup,” Samira responded, wondering if it was her imagination or if her voice sounded strained. She shut her locker and tied her hair back into a low ponytail. When she looked back at Santos, she saw she was doing the same. “Are you ready to go in?”
Santos nodded. “Sure am.”
The next door hissed as the seals shrunk, and pressurized air was released. Samira entered first with Santos following close behind. Once the door shut again, Samira checked the pressure monitor to ensure the seals properly reinflated before moving on.
They walked past the decon showers and sat on a low bench in the middle of the room. Four plastic packages of clean socks waited in a pile on the ground, and Samira passed Santos a pair before taking one for herself. With her socks on, Samira then grabbed a nearby roll of duct tape and wrapped it around her ankles, taping the legs of her scrubs to her socks, before passing it to Santos so she could do the same.
As Santos taped her socks, Samira grabbed a pair of gloves and pulled them on. She examined the gloves under the fluorescent lights above her head, searching for any signs of tearing. When she deemed the gloves satisfactory, she took the tape back from Santos and wrapped it around her wrists to seal the sleeves of her scrubs to the gloves, making sure to wrap the tape multiple times.
While Robby often complained about how exhaustive entering the lab was, Samira found the entire process meditative. It forced her to go slowly. Rushing into the lab could mean life or death for her, so she took her time. The methodical steps gave Samira a chance to order her thoughts. A loop of tape around her wrist meant another worry from her real life left outside the lab. None of it mattered. Not in there.
Once Santos finished with the tape, Samira handed her a second pair of gloves. They both pulled the second pair of gloves over the pair taped to their scrubs. Luckily for their blood circulation, this second pair did not get taped. Then, Samira hooked the earpiece and microphone for her two-way radio receiver onto her ear. Santos did the same.
Samira led Santos into the suit room. The positive-pressure suits were hanging on a rack, with Samira’s, Robby’s, and Abbot’s all clearly labeled alongside the others. Towards the end of the rack was a new one, with the name, ‘SANTOS’ marked across the chest.
“There’s yours,” Samira pointed out.
“Holy shit,” Santos muttered, “I get my own suit. That’s so sick.”
“Your suit is your responsibility,” Samira said, although she was sure Santos would’ve already been told this during her training. “You’re the one who has to change the gloves every seven days-”
“And apply zipper lubricant once a week, I know,” Santos finished, flashing Samira an annoyed look. “I don’t need the reminder.”
“I wouldn’t recommend ignoring helpful reminders, especially when you’re new to this,” Samira pointed out in as neutral of a tone as she could manage. “I’m not trying to insult your intelligence. There’s a lot to remember when you’re getting used to this procedure. And you know what the consequences can be if you miss any of these protocols.”
Samira watched as Santos visibly swallowed her annoyance and nodded. “You’re right. Sorry.”
“It’s okay, I get it. You’ve just been through training so I’m sure this has already been drilled into your head. But the real risk shows up when you get too used to the routine of it all. That’s when you make mistakes.”
Santos considered this for a moment. “How do you do it then?”
Samira flashed Santos a half-smile. “Every time I’m getting ready to walk into the lab, I imagine myself dying of Ebola. Or Nipah. Or Lassa. Anything we have in here that can cause horrific, painful death, which is most of this stuff.”
Blinking, Santos glanced back at her suit. She only looked a little green as she nodded.
“Power of imagination. Got it.”
Santos followed Samira’s lead as they laid their suits onto the ground. They covered the exhaust valves and zipped up the suits, before Samira handed Santos a spiraled oxygen tube hanging from the ceiling. As Santos began inflating her suit, Samira grabbed another oxygen line to connect to her own. They both watched their suits blow up without either of them inside, Samira keeping a close eye to make sure Santos didn’t over-inflate hers.
Samira told Santos when to disconnect the line. Then, they stood the empty suits up so they could perform their visual inspections. Samira had just replaced the gloves of her suit the day before, so as she expected, there weren’t any leaks present in her suit. She waited for Santos to finish her own inspection before speaking.
“Mine is good. Is yours, Dr. Santos?”
Santos nodded. “Yup. Looks good to me.”
“Great.” Samira moved in front of Santos’ suit so they were standing shoulder to shoulder. “Now you inspect mine and I’ll inspect yours.”
“I appreciate that, Dr. Mohan, but I know to do a visual inspection-”
“I’m sure you do. But this is just something I personally like to do whenever I’m entering the lab with someone else. A second set of eyes never hurts,” Samira told her.
Hearing Samira’s explanation seemed to make Santos more receptive to the idea. Although she hadn’t even known Santos for an entire hour, Samira was already getting the sense that she was used to having to assert herself and her intelligence. Samira would have to keep that in mind when giving her advice in the future.
Santos’ suit was free of leaks, and Santos reported the same for Samira’s. They moved back in front of their respective suits and Samira unzipped the front of hers, allowing the air to rush out as she took the covers off of the exhaust valves. They laid their suits out on the ground and stepped inside, zipping them up at the same time.
The suit closed over Samira’s head. The world around her became muffled, her vision blurred by the glass face plate in front of her eyes. She connected herself to the same oxygen line she’d used before, and listened to the sound of air rushing around her as her suit inflated.
A glance to her right told her Santos had done the same. With both their suits fully inflated, Samira stepped in front of Santos and focused on the face behind the glass.
While it was clear Santos wasn’t used to the suit, she didn’t seem uncomfortable inside of it. Her face was relaxed, her bright eyes clear and free of the panic that often consumed people the first time they put on a pressure suit. It was while looking into Santos’ eyes that Samira found herself wondering what color they were. They weren’t quite blue, closer to green but not completely. A sort of grey-green, almost.
“Dr. Mohan,” Santos said after a moment, practically having to shout to be heard over the sound of their oxygen, “I’m good. I’m not going to panic.”
Samira, having forgotten what she was doing for a moment, nodded and quickly took a step back. “Right, yeah. So you’re feeling alright?” She asked, forcing herself to look away from Santos’ confusing eyes.
“Good to go,” Santos confirmed, giving her a thumbs up.
Samira nodded. “Let’s get a move on then.”
They disconnected from the oxygen lines and each pulled on a pair of rubber boots over their suits. There was only one more room to pass through before they were in the lab. Samira let Santos go first into the chemical shower room before following, making sure the door was shut and sealed behind her.
The shower didn’t turn on, which was good since they didn’t need to use it until they were leaving the lab. Still, they both stayed out of range of the shower head, inching by until they were at the final door that led into the laboratory.
“This is it,” Samira told Santos, “last chance to back out.”
Santos was struggling to suppress a smile. “I’m ready.”
So Samira opened the door and let Santos into the lab.
The first time Samira had stepped foot inside one of the Major Containment Lab’s hot zones, she thought the place reminded her of a labyrinth. The rows of freezers and incubators and the narrow corridors created by the counters made it difficult to navigate. Even though the layout wasn’t complicated, it gave the impression of stretching on for miles, and that you could get hopelessly lost if you weren’t careful.
Samira began showing Santos around the lab, pointing out incubators being used by their team or another. When she pointed out the first cryo-freezer—a large cylinder on the ground that was about the size of a side table—Santos’ eyes went wide.
“Shit, is that where we keep it?”
Samira frowned. “Keep what?”
“Smallpox!” Santos exclaimed, having to shout to be heard over the oxygen keeping their suits inflated.
“Oh, no, Smallpox isn’t just out in the open like this,” Samira told her. “I’ve never actually seen the freezer myself. But from what I’ve heard, they try to hide it, so that you’d have no idea what you were looking at even if you were standing right in front of it.”
Santos considered this for a moment. “Then how do you know this isn’t Smallpox?” She asked, pointing to the freezer.
“Because these are Ebola samples,” Samira explained. “I thawed one out yesterday.”
It’s worth saying that Santos didn’t flinch when she heard that the freezer had Ebola in it, but Samira could tell she wanted to. She was good at suppressing those knee-jerk reactions.
“Which strain?” Santos asked. Then, with only a little trepidation in her voice she added, “Zaire?”
“Sudan,” Samira told her. “Although we still do research to try and improve the Zaire vaccine and find more antiviral treatments, it’s not our main concern right now. We still don’t have a vaccine for Ebola Sudan, so that’s what I’m working on.” She paused and flashed Santos a smile. “Would you like to see it?”
“Ebola?”
“In the flesh,” Samira confirmed. “Or, well, I guess under the microscope. Same thing when it comes to viruses, you know.”
Santos nodded so Samira got to work setting it up. She showed Santos to the microscopes and their attached monitors. Taking out the samples she’d left in the incubator the day before, she smeared the cells onto a slide and pushed it under the microscope lens.
What Samira was hoping to find were healthy, stable human cells. But she knew that she was almost certainly going to find that her cells had imploded because of Ebola Sudan. Vaccine progress took a lot of trial and error, even with being able to use Ebola Zaire’s functional vaccine as a guideline.
Sure enough, when the images from the microscope popped up onto the monitor, Samira found herself face to face with images of the blown up insides of her cells.
“Didn’t work,” Samira muttered, although she knew Santos wouldn’t be able to hear her over the air.
“Jesus,” Santos breathed, staring at the images. “It’s like a grenade went off.”
“Have you ever seen the insides of monkeys infected with it?” Samira asked. “Look at those cells, and apply that level of damage to a living being’s entire organ system.”
“I know, I’ve seen pictures,” Santos told her, sounding more subdued than she had all morning.
Staring at the evidence of her failed experiment for another moment, Samira sighed before pushing out of the desk chair, her space suit rustling with the movement. “Well, I think I need to culture some more of this strain before I continue my tests. Would you like to help me?”
Santos perked up at the idea of culturing Ebola herself. “Yeah, for sure.”
Fighting the urge to smile at her eagerness, Samira moved towards the freezer again when a voice crackled to life in her ear.
“Mohan, Santos, are you in the lab right now?”
The voice on the radio belonged to Robby. Tugging her arm out of her space suit sleeve and bringing it up to her ear, Samira said, “Yeah, we’re here, Robby. Is something up?”
“Decon immediately. Something’s come up.”
In all the years she’d worked in Robby’s lab, she could count the amount of times he’d pulled her out of the lab without warning on one hand. Her heart began to beat faster.
“Are we following crash out procedure?”
The radio crackled again. “No, not crash out. But unless you’re in the middle of a necroscopy, put whatever you’re working on away and get out here as soon as you can.”
Robby knew as well as Samira did that she wasn’t in the midst of a necroscopy. With their progress on antivirals and vaccines at a standstill, they hadn’t done animal trials in nearly a year.
“We’ll be right out,” Samira confirmed.
Decontamination was not a quick task. Samira made Santos go into the shower first, shifting her weight from foot to foot as she waited for the detergent spray to sterilize the outside of Santos’ suit. Samira followed shortly after, willing the shower to go faster even though she knew it was on an automated timer.
Once they’d climbed out of their space suits, they hurried to the shower stalls for their actual bodies and both took the most efficient showers they could. They dressed (out of view of each other this time) and soon enough were hurrying out of MCL West and towards the office.
“What’s going on?” Santos asked as they hurried down the hall.
“I have no idea,” Samira confessed.
“This isn’t, like, some hazing thing for the newbie, right?” Santos asked, furrowing her brows. “You’re not testing me?”
Samira shook her head. “No. Robby wouldn’t pull us out of the lab like this if it wasn’t something serious.”
Santos grimaced. “Shit.”
“Yeah,” Samira said, “shit.”
When they got back to the office, Robby wasn’t alone. Abbot was there, arms folded over his chest and a deep frown on his face. He and Robby were in the midst of a tense discussion, only for Robby to stop the moment he spotted them.
“There you guys are,” Robby said, clearly relieved. “I’m sorry to pull you both out like that, but I needed Mohan. Santos, I would’ve had you stay in, but it’s your first day and I didn’t want to leave you to fend for yourself in there.”
“It’s fine,” Santos said, although Samira could practically feel her disappointment, “I’ll be back in there soon enough, right?”
“Very soon,” Robby confirmed before he and Abbot both focused on Samira. “Mohan, we have a situation at Emory.”
Emory Hospital? Samira frowned. “What’s going on?”
“They got a transfer patient in from one of the smaller hospitals just outside Atlanta,” Abbot jumped in to explain. “Young woman in her twenties. She’s going downhill, fast. But the team there can’t seem to figure out what she’s got.”
Samira already had an idea of where this was going. There was a reason it was their team that was being alerted, and not a team from BSL-2 or BSL-3.
“It’s a hemorrhagic fever, isn’t it?” Samira asked.
Abbot grimaced. “I can’t confirm because I haven’t seen her myself yet, but from the descriptions we were given… yeah. It sounds like that’s a possibility.”
“What kind of pathogen here in Atlanta could cause a hemorrhagic fever?” Santos asked.
”That’s the problem. You almost never see those here,” Robby answered. “If we’re lucky, it won’t be a hemorrhagic fever at all. If we’re less lucky, it’ll be a hemorrhagic fever but it’ll be something we’ve at least seen outbreaks of in the country before, like Dengue.”
“And if we’re unlucky?” Santos pressed.
“It’ll be Ebola, or something new entirely,” Abbot told her.
Santos sucked in a sharp breath. Robby and Abbot both looked back to Mohan.
“You’re going with Abbot to Emory to check the patient out,” Robby said. “Santos, you’re with me. I’ll finish showing you around the lab, then when they get back you can help prepare the sample so we can run a PCR on it.”
Mohan nodded, unsure if the fluttering in her chest was nervousness or excitement. “Understood.”
“And remember, that sample could be hot, so be careful.” Robby gave Abbot a pointed look as he said this.
“What he means is that he wants you there so I don’t do anything stupid,” Abbot translated for Samira. “He thinks I like taking my life into my own hands for shits and giggles. But I would argue I do the exact opposite.”
“I do not. I just think it’d be a good… learning experience, for Mohan.”
Samira, Abbot, and Santos all gave Robby a look that told him his attempt at lying was more pathetic than anything else. Robby sighed.
“Just get the damn blood sample so I can sleep easy tonight.”
Abbot nodded. “Sure thing.”
“We’ll be careful, Dr. Robby,” Samira reassured him.
Robby waved them both away. Santos spared Samira a hesitant look before turning to follow Robby down the hall, leaving Samira with Abbot.
“We should take your car,” Abbot said as soon as Robby was out of earshot. “I want to handle the sample, so you’ll be the one driving us back.”
Grabbing her purse, Samira nodded at Abbot and let him lead the way out of the office.
Although Emory was close enough to the CDC to walk, given the nature of their visit Samira understood why Abbot wanted to drive. It wasn’t her first time driving to Emory to obtain samples, although in the past, the tests they ran had always been deemed as a precaution. She’d never seen Robby—or Abbot for that matter—look so worried about one of these requests. The realization made the hair on the back of her neck stand up.
They parked in Emory’s staff parking garage after showing the security guard their CDC badges and explaining they were there to collect a blood sample. Abbot was out of the car before she’d even finished parking, and by the time she’d locked her car he was holding the elevator door open for her.
As the elevator carried them up the floors, Abbot turned to Samira and said,
“I don’t want you entering the patient’s room. From what I was told, the doctors haven’t set up Level 4 quarantine procedures since they don’t know what the patient has yet. So I don’t want you taking a risk.”
Samira raised an eyebrow. “How are we going to get the sample then?”
Abbot looked away. “I’ll go in there.”
“This is exactly the kind of thing I promised Robby I wouldn’t let you do,” Samira reminded him.
“Well, Robby’s not here,” Abbot began, “but besides that, while you have experience with these pathogens in a lab setting, it’s a very different thing to actually face them in a person. I’ve seen these things out in the field. I know how to minimize exposure while treating a patient when you’re not sure if they’re contagious or not. So if this patient is actually infected with something we need to be concerned about, I think we’ll all be better off if I’m the one taking her blood.”
A part of Samira wanted to argue. No, she’d never seen these pathogens in a human host before, but that was the point. She wanted that experience. There was no telling when the next outbreak would be, and even if it was soon, the CDC likely wouldn’t even send her into the field to help out. This might be the only chance she got to see with her own eyes what the pathogens she’d dedicated her career to studying actually did to a human being.
But the voice of reason in Samira’s head was louder than the part that wanted to argue. Because if exposure to this patient made her sick, she wouldn’t be able to continue her research. At the very least, she’d be in quarantine for nearly a month. Not to mention, she wasn’t particularly fond of the idea of dying.
“You don’t have a space suit to wear here,” Samira pointed out.
“I’ve had to make my own PPE out of trash bags before,” Abbot countered. “I think I can make do with a medical supply closet.”
The elevator dinged as it reached their floor. Samira and Abbot stepped out and looked around for a moment, unsure of which direction to go. Luckily for them, a nurse noticed their confusion and asked where they were heading.
A few minutes later they were standing outside the patient’s room. While Emory had a Special Clinical Isolation Unit—which had been used back in 2014 to treat American Ebola patients—this patient was being kept in a standard room. A warning had been placed on her door alerting staff to wear PPE when entering the room, but if this really was a Level 4 pathogen, those precautions wouldn’t do much in the long run.
There was a window looking into the patient’s room. Through it, Samira could see a young woman laying on the hospital bed, with dried blood crusted around her nose. Even from a distance, Samira noticed the whites of her eyes had turned bright red as well. Her gaze was unfocused as she stared at the ceiling, and Samira wondered how aware of her surroundings she was.
“Excuse me, who called the CDC here?” a familiar voice suddenly asked.
Samira and Abbot both turned to see Emery Walsh, a physician at Emory Hospital, walking towards them. Although Samira had only had limited interactions with her before, she’d heard plenty about her from Abbot, who knew her from his time with Doctors Without Borders.
“You have a potential hemorrhagic fever caused by an unknown pathogen. Of course we got called,” Abbot retorted.
Walsh scoffed. “Don’t be ridiculous. It’s dengue fever. Not contagious.”
“You tested her blood?” Abbot asked, raising his eyebrows.
“I don’t need to. I saw Dengue plenty of times during my MSF tour in the Congo. I know what it looks like.”
“You can’t know that for certain, especially if you don’t know her recent travel history,” Samira cut in.
“We’ve spoken to the family. No recent travel outside the country, but she was in Texas last week to visit a friend and it’s peak mosquito season over there,” Walsh explained.
“Texas has Dengue?” Samira asked Abbot.
“It’s rare, but it does happen there,” Abbot confirmed, although he still looked troubled as he focused back on Walsh. “You can’t be sure without a blood test though.”
“Look, I just got some scans back and I’ve confirmed she’s got internal bleeding. I’m not going to wait around for some tests to tell me what I already know while she bleeds out into her stomach,” Walsh snapped, narrowing her eyes at Abbot. “I’m ordering a transfusion ASAP.”
Samira’s eyes went wide. If the patient didn’t have Dengue and instead had something that was actually transmittable from person to person, performing a transfusion posed a huge risk.
“I don’t think that’s a good idea,” Samira said.
“Same. Walsh, you know damn well you shouldn’t have sharps anywhere near someone with hemorrhagic fever until you know for certain what you’re dealing with,” Abbot agreed.
“Both of you can relax. She’s already got an IV line in, courtesy of the last hospital she was at before she got transferred.”
A glance back at the window told Samira that Walsh was right. There was a saline bag hanging off an IV pole, leading directly into the woman’s arm.
“Fine,” Abbot sighed. “I need a blood sample anyway, so I’ll set up the transfusion bag while I’m in there.”
Walsh rolled her eyes. “If you want to then be my guest. I don’t care who does it as long as she starts getting some O neg in her.”
Once Walsh was out of earshot, Samira asked, “Are you sure about this?”
Abbot nodded. “I worked in an Ebola ward in Liberia back in 2014. I know how to handle myself in there.”
“Alright,” Samira relented, “tell me what you need.”
Together, Samira and Abbot raided a nearby medical supply closet to put together Abbot’s PPE set. He doubled up his gloves and taped them to the sleeves of his double-layered PPE gown, found a HEPA mask and goggles for him to wear, and even pulled a surgical cap over his hair. Samira found a bottle of bleach and poured it into a plastic tub, which Abbot would drop the sample tube into to sterilize the outside of it. She also made sure to have a garbage bag ready for Abbot to throw his PPE into once he was out of the room.
Samira watched from the window as Abbot entered the room. The patient didn’t seem to notice his presence, her glassy eyes still fixed on the ceiling. Abbot moved slowly as he took out the needle for the blood draw, watching the patient for any sign of movement. Samira didn’t even realize she was holding her breath as Abbot took her blood from the IV, only letting it out once he’d detached the last tube and capped it. Then, he swapped the saline bag on her IV out for a blood bag and waited for the transfusion to begin.
Samira made sure to stand back as he exited the room. He dropped the vials of her blood in their makeshift bleach bath, before going through the process of removing all of his PPE. The only time Samira caught even the slightest whiff of concern from Abbot was when they were making their way back towards the elevators, and Abbot let out a long, slow breath.
As he promised, Abbot held onto the samples in a styrofoam cooler during the short drive back to the CDC. When they got back to the MCL, Abbot carried it up to the transfer window for the lab to pass it through. Samira could see Robby and Santos on the other side, both of their faces distorted by the head bubble of their PPPS suits.
After that, Samira had some unexpected downtime. Through the radio, Robby had told her to wait in the cold lab, that way she could run the PCR on the samples once he and Santos had purified them. Abbot didn’t stick around, instead saying that he wanted to contact the EIS to see if they were aware of what Emory was dealing with. So that left Samira alone in the office, feeling at odds with being the person outside the hot zone.
In retrospect, it probably took too long for the idea of eating lunch to occur to her. But soon enough, she had a sandwich she bought from a vending machine in front of her, and was taking small bites of it as she thought over what she’d seen at the hospital.
The woman had been quiet. More quiet than she thought someone suffering from a hemorrhagic fever would be. She hadn’t even seemed aware of Abbot’s presence, and Samira wondered what must’ve been going on inside her body.
When she told Santos that she often imagined herself dying of Ebola as a way to keep herself safe in the lab, she wasn’t lying. Her mind often drifted to a scenario where something had gone wrong during her work. A hole in her glove, a dropped needle, broken glass—she had failed in some crucial way, and now she was paying the price for it. She would picture herself lying on a hospital bed, feeling her organs shut down as her immune system tried anything and everything to kill the virus raging inside her. It was terrifying to think about, but at the same time, it was also… thrilling. The urge was always there, even when her imaginary self was on her death bed, to get a sample of her own blood and view it under a microscope. To watch the virus take over her own cells, one by one.
Once, she went to a therapist at her mother’s request. Her office was painted an overly pleasant shade of pale blue, like it was trying too hard to be reminiscent of a summer sky. The therapist was a middle-aged white woman who wore beaded earrings and had let her grays grow through her long, brunette hair. She smiled when Samira entered, when she sat down, when she introduced herself and what she did for a living. She didn’t stop smiling until Samira told her about her daydream. Then, she told Samira that she worked too much. That she needed to find other things outside of her job that could fulfill her, like a hobby, or friends, or even a dating life.
Samira didn’t end up going back to that therapist.
“Mohan? You there?” The radio earpiece Samira was wearing crackled to life with Robby’s voice.
“Yes, I’m here. Have the samples been purified?” Samira asked as she pushed to her feet.
“The tubes are soaking in a bleach bath as we speak. Are the PCR machines ready to go?”
Samira hurried out of the cold lab and down the hall. “Yup. Do you want me to run a few of them simultaneously? Abbot drew it from the IV line so the samples might’ve been diluted.”
“Run three for each assay. I don’t want to end up with two different results and have to wait to find out which one is right. I want certainty, and I want it as soon as possible,” Robby instructed.
“Understood. I’ll have all six up and running.”
Samira made it back to the transfer window where the sample tubes were waiting, submerged in bleach. Through the window, she couldn’t see where Robby had gone, but Santos was pipetting something into a flask. She and Samira locked eyes through the glass, and Samira gave her a small wave. Santos lifted her hand holding the pipette and waved back.
Using a glove, Samira then picked the tubes out of the bleach and set them in a box, whatever virus they once held now rendered harmless. With one last glance at Santos, Samira hurried back out to the other lab so she could start the tests.
Samira had to use three PCR machines for each viral assay she was using. One assay tested for all primary viruses known to cause hemorrhagic fevers, including Ebola Zaire, Ebola Sudan, and Lassa. The other assay tested for Zika, Dengue, and Chikungunya.
Once the machines were running, there wasn’t much for Samira to do but wait again. She tapped her fingers along the table, watching dots appear across the screen and wondering what Robby and Santos were doing now in the lab. Was Robby teaching Santos how to culture Ebola Sudan like Samira had promised she’d do? For some reason, the idea annoyed her. Robby had pushed the newbie onto Samira, only to take her back as soon as something else came up for Samira to do. Even though she thought Santos was a bit overconfident, she liked her enthusiasm and had been looking forward to teaching her.
The PCR machines hummed in the background as Samira thought back to that moment when she and Santos locked eyes, right after Santos had zipped up her pressure suit. There had been no panic in Santos’ bright, greenish grey eyes. No sense of discomfort. Only her determination to get to work. She wanted to be there. Samira liked that about her.
As the machines neared the end of their cycles, Samira’s phone began to buzz. She was surprised to see Abbot’s name across the screen.
“Dr. Abbot, what’s up?”
“Mohan, I just got a call from Emory. The patient has started coughing up blood and they want to intubate,” Abbot told her, his voice strained. “Do you have those results yet?”
Samira tensed. “Almost. I think the results are coming in now…” she trailed off as the results began to display on the screens. Her eyes skimmed the rows as a pit opened up in her stomach.
“What is it?” Abbot asked on the other end of the call. “You went quiet. Is it Ebola?”
“No,” Samira whispered, staring at the result under the columns for all the different Ebola strains. “It’s negative for everything.”
“What? Say that again, I don’t think I heard you right.”
“No, you heard right,” Samira said, louder this time. “It’s all negative. Dengue, Ebola, Lassa, CCHF-”
“No, that’s impossible. Did you run it twice?”
“Three times for each assay. I’m getting the same results for all of them.”
Abbot went quiet for a moment. Then he said, “The way she was breathing in there- I knew there was something off about it. It didn’t sound like the breathing you usually hear with hemorrhagic Dengue cases, or even with Ebola.”
“You don’t think it could be yellow fever, do you?” Samira asked, grasping for anything she could think of. “Or typhoid?”
“Look, I think you should run the tests, but I’ve seen all that before. I don’t think that’s what this is,” Abbot admitted to her. “Also, I talked to EIS. They’re still digging, but they found out the patient’s brother was hospitalized this morning at another small hospital outside the city. And he’s got all the same symptoms she does.”
Samira sucked in a sharp breath. Whatever this was, it was infectious.
“It’s something new. Isn’t it?”
She heard Abbot sigh on the other end of the call. “I think you need to let Robby know the results. I gotta give the update. Then I’m going to head back over to Emory.”
“What for?”
“To let them know they have to lock that room down until we figure out how this thing spreads.”
“But if it’s airborne then it’s already too late. It’ll be in the vents,” Samira pointed out, her voice catching.
“Let’s hope it’s not airborne then,” Abbot said before hanging up.
Samira stared at the black screen of her phone, mind reeling as she tried to comprehend the reality she was now faced with. Instead of having any coherent thoughts though, the woman’s red eyes just kept flashing in her mind.
“Fuck,” Samira whispered under her breath. “Fuck.”
Then, after taking a deep breath to brace herself, Samira prepared to radio Robby.