Ouellette defocused on the gross ravages and zoomed down to the subtler ones: two melanomas visible on the left arm; tremors in the right; some dark tracery that looked like blood poisoning, creeping up the wrist from the injured palm. The usual symptoms of malnutrition. Half of the signs were consistent with ßehemoth; none were incontrovertible. Here was a woman suffering violence across several orders of magnitude.
Ouellette tried on a professional smile, although the fit had never been a good one. "Let's see if we can't get you fixed up."
"That's okay," said the woman, stargazing. Ouellette tried to guide her towards the van with one gloved hand (not that she needed the gloves, of course, but these days it wasn't wise to remind people of such things). The woman jerked away at her touch—
"That's okay. That's okay—"
— staggered against some invisible wall and stumbled off, locked on heaven, oblivious to earth.
"That's okay…"
Ouellette let her go.
The next patient wasn't conscious and wouldn't have been able to move if he had been. He arrived on a makeshift stretcher, an oozing jigsaw of lesions and twitches, short-circuiting nerves and organs that hadn't bothered waiting for the heart to give out before starting to rot. The sickly-sweet smell of fermented urine and feces hung around him like a shroud. His kidneys and his liver were in a race to kill him first. She couldn't lay odds on the winner.
A man and two children of indeterminate sex had dragged this breathing corpse before her. Their own faces and hands were uncovered, in oblivion or defiance of the half-assed protective measures promoted by endless public-service announcements.
She shook her head. "I'm sorry. It's end-stage."
They stared back at her, eyes filled with a pleading desperate hope that verged on insanity.
"I can kill him for you," she whispered. "I can cremate him. That's all I can do."
Still they didn't move.
Oh, Dave. Thank God you died before it came to this…
"Do you understand?" she said. "I can't save him."
That was nothing new. When it came to ßehemoth, she wasn't saving anybody.
She could have, of course. If she were suicidal.
Protection against ßehemoth came packaged in a painstaking and complex series of genetic retrofits, an assembly line that took days—but there was no technical reason why it couldn't be crammed into a portable rig and taken on the road. A few people had done that very thing, not so long ago. They'd been torn limb from limb by hordes too desperate to wait in line, who didn't trust that supply would exceed demand if they'd only be patient a little while longer.
By now, those places that offered a real cure were all fortresses built to withstand the desperation of mobs, built to enforce the necessary patience. Further from those epicenters Taka Ouellette and her kind could walk among the sick without fear of sickness; but it would have been be a death sentence to offer a cure so far from back-up. The most she could do here was bestow quick-and-dirty retrovirals, half-assed tweaks that might allow some to survive the wait for a real cure. All she could risk was to slow the process of dying.
She didn't complain. In more complacent times, she knew, she might not have been trusted to do even that much. That hardly made her unique: fifty percent of all medical personnel graduate in the bottom half of their class. It didn't matter nearly as much as it once had.
Even now, though, there was a hierarchy. The ivy-leaguers, the Nobel laureates, the Meatzarts—those had long since ascended into heaven on CSIRA's wings. There they worked in remote luxury, every cutting-edge resource within easy reach, intent on saving what remained of the world.
One tier down were the betas: the solid, reliable splice-and dicers, the gel-jocks, no award-winners here but no great backlog of malpractice suits either. They labored in the castles that had accreted around every source of front-line salvation. The assembly line wound through those fortifications like a perverse GI tract. The sick and the dying were swallowed at one end, passed through loops and coils of machinery that stabbed and sampled and doused them with the opposite of digestive enzymes: genes and chemicals that soaked the liquefying flesh to make it whole again.
The passage through salvation's bowels was an arduous one, eight days from ingestion to defecation. The line was long but not wide: economies of scale were hard to come by in the post-corporate landscape. Only a fraction of the afflicted would ever be immunized. But those lucky few owed their lives to the solid, unremarkable worker bees of the second tier.
And then there was Taka Ouellette, who could barely remember a time when she'd been a member of the hive. If it hadn't been for that one piece of decontamination protocol, carelessly applied, she might still be working the line in Boston. If not for that small slip Dave and Crys might still be alive. There was really no way of knowing for sure. There was only doubt, and what-if. And the fading memory of life as an endocrinologist, and a wife, and a mother.
Now she was just a foot soldier, patrolling the outlands with her hand-me-down mobile clinic and her cut-rate, stale-dated miracles. She hadn't been paid in months, but that was okay. The room and board was free, at least, and anyway she wouldn't be welcome back in Boston any time soon: she might be immune to ßehemoth but she could still carry it. That was okay too. This was enough to keep her busy. It was enough to keep her alive.
Finally, silently, the breathing corpse had been withdrawn from competition. Subsequent contenders hadn't rubbed her nose quite so deeply in her own ineffectuality. For the past few hours she'd been treating more tumors than plague victims. That was unusual, this far from a PMZ. Still, cancers could be excised. It was simple work, drone work. The kind of work she was good for.
So here she was, handing out raf-1 angiogenesis blockers and retrovirii in a blighted, wilting landscape where DNA itself was on the way out. There was some green out there, if you looked hard enough. It was springtime, after all. ßehemoth always died back a bit during the winter, gave the old tenants a chance to sprout and bloom each new year before coming back to throttle the competition. And Maine was about as far as you could get from the initial Pacific incursion without getting your feet wet. Go any further and you'd need a boat and a really good scrambler to keep the missiles off your back.
These days, of course, keeping to land was no longer any guarantee that the EurAfricans wouldn't be shooting at you. There'd been a time when they'd only shot at targets trying to cross the pond; but given a half-dozen landside missile attacks since Easter they were obviously itching for more effective containment. It was a wonder that the whole seaboard hadn't been slagged to glass by now. If the dispatches could be believed, N'Am's defenses were still keeping the worst of it back. Still. The defenses wouldn't hold forever.
Rossini surrendered to Handel. Ouellette's line-up was growing. Perhaps three people accumulated for every two she processed. Nothing to worry about, yet; there was a critical mass, some threshold of personal responsibility below which crowds almost never got ugly. These ones didn't look like they had the strength to go bad even if they'd been motivated to.
At least the pharms had stopped charging for the meds she dispensed. They hadn't wanted to, of course: hey, did anyone think the R&D for all these magic potions had been free? In the end, though, there hadn't been much choice. Even small crowds got really ugly when you demanded payment up front.
A forearm the size of a tree trunk, disfigured by the usual maladies: the leprous, silver tinge of stage-one ßehemoth, a smattering of melanomas, and—
Wait a second. That's odd. The swelling and redness was consistent with an infected insect bite, but the puncture marks…