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Back At the End of Everything Save as PDF
Contents ( 46)
  3. Contents
  4. One
  5. Two
  6. Three
  7. Four
  8. Five
  9. Six
  10. Seven
  11. Eight
  12. Nine
  13. Ten
  14. Eleven
  15. Twelve
  16. Thirteen
  17. Fourteen
  18. Fifteen
  19. Sixteen
  20. Seventeen
  21. Eighteen
  22. Nineteen
  23. Twenty
  24. Twenty-one
  25. Twenty-two
  26. Twenty-three
  27. Twenty-four
  29. Twenty-five
  30. Twenty-six
  31. Twenty-seven
  33. Twenty-eight
  34. Twenty-nine
  35. Thirty
  36. Thirty-one
  37. Thirty-two
  38. Thirty-three
  39. Thirty-four
  40. Epilogue
  41. Author’s Note
  42. Acknowledgments
  43. About the Author

SAPPHIRE: I’m not. I’m just desperately clinging to the idea that one day, the things that make life worth living will balance out the things that are too hard to bear.

RILEY: I’ll see it before I believe it.

SAPPHIRE: As long as you stick around until you do.

RILEY: Is it enough if I promise to try?

SAPPHIRE: Honey.

SAPPHIRE: Of course it is. It’s everything.

This phone call has been disconnected.

Phone call from Sofia to her brother

Attempt #1

SOFIA: Luca? The phones have been spotty here, but—

We’re sorry, you have reached a number that has been disconnected or is no longer in service. If you feel you have reached this recording in error, please check the number and try your call again.

Attempt #2

SOFIA: Come on, pick up—

We’re sorry, you have reached a number that has been disconnected or is no longer in service. If you feel you have reached this recording in error, please check the number and try your call again.

Attempt #3

SOFIA: …

We’re sorry, you have reached a number that has been disconnected or is no longer in service…

WHAT IS PLAGUE MENINGITIS?

• Neurologists are reporting a complication in the treatment of plague patients: the occurrence of plague meningitis.

• While incidence of plague meningitis is low, it adds complex and ethical questions for hospitals that are already struggling with offering the care needed.

• Plague meningitis predominantly shows up in younger patients who have survived the initial few days of infection, with clinical signs and symptoms developing between 7 to 14 days after the onset of illness.

• With limited treatment options, it is currently unclear how well this type of inflammation responds to antibiotics or what its long-term effects may be.

Exact numbers aren’t available yet, but it’s becoming increasingly clear that this continued outbreak of Y. pestis is a health danger on multiple levels. A growing number of patients—predominately teens and young adults—who have survived their first days of infection are showing signs of plague meningitis, an inflammation of the meninges (the protective membranes covering the brain and spinal cord).

Signs and symptoms cover an array of possibilities, from neck stiffness and photophobia to high fever and loss of consciousness. Where standard treatment consists of a high dosage of antibiotics, it’s unclear whether those are effective given the bacteria’s resistance. In coming days and weeks, experimental treatment with various broad-spectrum drugs will hopefully be able to provide more than mere anecdotal evidence.

Meanwhile, the Health Department has requested a selected task force of ethicists to advise on treatment protocols, especially with an eye toward survival rates and lasting side effects. “No one officially wants to be the one to make the call, but with a limited number of hospital beds available, prioritization of patients has come into question,” said Mr. Warbler, one of the members of the task force. “It is only rational to consider quality of life as part of that equation and whether or not it’s better to let some people die.”