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.