The Plague
AN: With apologies to Camus.
The unusual events of this chronicle occurred in the early twenty-first century in Princeton, New Jersey. New Jersey, while known as the Garden State, is actually a series of turnpike off ramps between the actual cities of Philadelphia and New York. Our town is rather nicer than those two cities, and significantly smaller and insignificant in comparison.
Princeton is a nice enough town, for a place that exists merely as the location of a university. In this it is no different from any other northeastern town with a university. I'm not telling tales out of school, ask New Haven or Hanover, they'll tell you. In fact, if you told me that all of these cities were manufactured in a factory outside of Pittsburgh, I'd be in no position to deny it. Ivy covered buildings, rolling green lawns and daffodils in the spring. So let's take that as read.
It's interesting how one's priorities are ordered before a catastrophe. If you are not big on contemplating your mortality you probably fixate on money. Filthy lucre. We wake in the morning thinking about working for money, we go home at night thinking about how we'll spend the money. In between we spend our time distracting ourselves with emotions. Generally, life is boring. Our days, hours and minutes waste away with the idiotic ways that we entertain ourselves. I'm no different. And so the years go by with only bills paid, games played and girls laid to show for any of it.
I think it says something about our society in the way that we work and that we love. Just as we dispose of our income, we dispose of our lovers. We couple and release with alarming frequency; pausing only long enough to collect the baggage that we'll take to our next heartbreak or romantic disappointment. Rarely do we ever find a true love, one that suffers and exalts with us as we plod from day to day. At best what we find is someone who doesn't get in our way too much as we selfishly pursue our interests.
In ordinary times we go from moment to moment searching for what is missing from our lives. If we are discontented it is because something is absent, therefore we must fill that emptiness. Some fill it with work, others with love, others with vices that promise pleasure but ultimately deliver pain. It has been observed that, "you'll never have enough of what you don't really need." And so we search faster and faster and become emptier and emptier.
In the dark ages, it started with black rats. A disease has to get around somehow and this one likes to commute to work on the black rat. A ship would dock and as the cargo was unloaded, the rats too, would step off for a breath of fresh air. With the rats, their parasites, and the next thing you'd know, the continent would be awash in fever, rash and death. We all fall down.
It might take months for the ships to go from port to port; today we can move a disease in hours. Progress.
The greatest fraud in modern medicine is that we have a diagnosis and cure for disease. If you watch enough television you believe that if all the symptoms are listed, that the brilliant doctor will figure it out and in the nick of time, fabricate the serum that will save you.
Doctors are people who have made their peace with the absolute fallibility of modern medicine. For example, there is no cure for the Ebola Virus or for its cousin Marburg Hemorrhagic Fever, yet they are survivable with 'supportive care.' For some illness the cure really is bed rest, fluids and aspirin. There's something both terrifying and comforting in that.
Americans also have a notion of entitlement about disease. We do such a good job with public health in the United States (barring the fact that a significant number of Americans don't have access to routine healthcare) that we expect that when a unique sickness invades our borders that we can track it, identify it and neutralize it.
In fact the frontline of our defense against invading disease are airline personnel. If they are traveling from 'questionable' parts of the world, they are to be on the lookout for passengers with disease. Interestingly enough the initial stages of disease look an awful lot like airsickness. But no matter. The next time you think about giving a stewardess a hard time about the selection of juice in the beverage cart you would do well to remember that she has the power to quarantine not only you, but the entire plane.
Microbes. The problem with them is that they're so small. Easy to overlook, easy to pick up. Successful at replicating themselves in a short period of time. Most of us live our whole lives materially unaffected by them. Yet it's the small things, when piled up, that can be so devastating.
Just last year, at a swim meet, one person with meningitis threw us into chaos for two days. The halls filled with people some infected, most not, all afraid that they might be the next one to be felled by the disease.
You might think that they would have grown introspective, but most, once they had been given a clean bill of health, simply returned to their routine, their habits. Our lives are our habits.
Over three years ago we were on the alert for Anthrax or even Smallpox. Those of us of a certain age have the remnants of that inoculation on our upper arm. For all the good it does us after all these years. It turns out that it's not a lifetime inoculation. Of course I knew that, but there were those who walked around smugly thinking that at least in that one respect that they were safe. As if there weren't hundreds of thousands of other horrifying diseases lying in wait.
It started with a man I saw in the clinic. Typical of most men, he had to be feeling really terrible to rate a visit to the doctor. I'll not pass judgment, I'm the same way. He said that he suffered with fever, chills, cough and other flu-like symptoms. He soon went into respiratory arrest and we put him in ICU.
My team assembled and we went through our usual exercises, listing symptoms, listing possible causations. Ruling out diseases by what the patient didn't have. Medicine is an art, as much as it is a science.
Within my lifetime I am reminded of a time when we didn't understand AIDS or HIV. People fell sick and then died. We treated the sicknesses and had no understanding of the virus that caused them. To an extent, we still don't. Not enough to have a cure.
Disease lies dormant all over the world. Endemic. Pandemic. As the world gets smaller disease gets bigger. If it weren't enough that nature provides all manner of sickness, men also work to invent ways of using disease as a weapon.
There are other weapons we use as well. One of my staff, Dr. Cameron, has the need to love me. I find this awkward in that I am her employer. I also find this awkward because Cameron has an imperfect understanding of love. Truthfully, love is individual. How I feel for one whom I love and what they feel for me are not the same thing at all. Each of our experiences is encumbered by loves in our past. Both Cameron and I have unhappy experiences with love. I do not think that either of us has the means to be very good to each other.
I found her staring out the window of my office in the midst of her usual duty of sorting my mail. I've never asked her to do this; I think she finds the activity to be a small connection to me. Intimate and administrative.
"What are you looking at?" I asked.
"It's a very big world out there. I'm so small." She said staring at some point in the distance.
"We're all small compared to the world," I replied. There exists in Cameron a disquieting depth of unhappiness.
She continued to gaze; filling her emptiness full of places she had never been and things she would never see. "I'm small and alone." She said quietly.
"You're not alone. You have family. You have friends here at the hospital." I offered, genuinely wishing to comfort her.
"A person needs more than an acquaintance to prevent loneliness. My family is distant and cold, like other people that I love. I think that I need to be somewhere else. A warmer climate perhaps." She sighed, "I'm thinking about relocating to California. Foreman has agreed to help me. It's nothing definite yet, I just thought you should know."
"If you're looking for warmth, California is a poor choice." I offered, trying to lighten the mood.
She smiled wanly, "You're right of course. You're always right. You'll let me go?" It wasn't my permission she wanted.
I considered her. She had tried before to leave and I had tried to be without her. We had both failed.
"No." I said simply. For all the complications of our relationship I was not prepared for her to go. "I will do better." I promised her. I wasn't sure exactly what I was promising.
"A cold response." She nodded.
"The response I can manage. I do value you." What could I say that would be enough to satisfy while being far short of what she wanted to hear?
"I need more. You know that." She never cried, not with me.
"I am giving what I'm able."
"You are taking more than you deserve." She accused. It stung with truth.
"Be generous." I said in a low voice. "Please."
At that point the rest of the team entered with the latest data on our patient, and the discussion was pushed to the side. Cameron turned again to the world, large and uncertain. Then she turned to join the discussion of the small and isolated.