Cover

TITLES BY KIMMERY MARTIN

The Queen of Hearts

The Antidote for Everything

Doctors and Friends

NOTE TO THE READER:

The writing of this novel preceded COVID-19 and therefore there is no mention of the real-life pandemic. In this fictional universe, it does not exist.

Dedication

For Casey, Christina, Jill, Kelli, Kristin, and Whitney. I love you.

Epigraph

To everything there is a season,

A time for every purpose under heaven:

A time to be born,

And a time to die;

A time to plant,

And a time to pluck what is planted;

A time to kill,

And a time to heal

—Ecclesiastes 3:1–3

CHARACTER SPECIALTIES

Dr. Kira Marchand

Infectious Disease

Atlanta, Georgia

Dr. Candee Compton-Winfield

Emergency Medicine

New York, New York

Dr. Hannah Geier

Obstetrics & Gynecology

San Diego, California

(also in The Queen of Hearts)

Dr. Georgia Brown

Urology

San Diego, California

(also in The Antidote for Everything and The Queen of Hearts)

Dr. Vani Darshana

Internal Medicine

Berea, Kentucky

Dr. Zadie Anson

Pediatric Cardiology

Charlotte, North Carolina

(also in The Queen of Hearts)

Dr. Emma Colley

Trauma Surgery

Charlotte, North Carolina

(also in The Queen of Hearts)

ALSO FEATURING:

Dr. Jonah Tsukada

Family Medicine

San Diego, California

(also in The Antidote for Everything)

PART ONE

AFTER ARTIOVIRUS

1

This Thing’s About to Blow

KIRA

ATLANTA, GEORGIA

One balmy evening near the end of a balmy winter, A man sidled up to me in a corner of an Atlanta mansion.

He had a request.

Before I go into detail about the repellent nature of the man’s proposal, I should temper your expectations. I know very well how my voice comes across in person, let alone in the recounting of a history. I have a sense of humor, but it’s sometimes mistaken for condescension. Similarly, to my dismay, my sense of compassion during tragedy has occasionally been misinterpreted as judgment. Throughout a mass calamity in which millions of people died, we were hobbled by fear and grief and hardship and isolation, yes; but at the same time, we learned humanity is resilient beyond all reckoning. We shared a mutual hope. Women still gave birth, nurturing tiny new humans first inside and then outside their bodies. We still created art and music and literature. Our scientists continued to innovate, our doctors to heal, our educators to teach.

On a lighter note, we still extracted comedy from tragedy, finding new ways to laugh at ourselves. We swapped pandemic jokes. We watched late-night comedy routines. We captured funny snapshots, wrote pithy quips about them, and flung them into cyberspace. If a society can’t meme itself out of a disaster, what hope is there?

But this is not our collective story as a society. This is my story—and also Compton’s story and Hannah’s story and a little bit of Georgia’s story—and it represents the most difficult circumstances of our lives. For my portion, you’re stuck with my voice, such as it is.

I hope you can forgive me.

—

FOR THE LAST fifteen minutes, I’ve been hovering at this party clutching my drink—a Manhattan—trying to act as if I were interested in the beads of condensation crawling down its beveled-glass surface. Earlier, I’d attempted to infiltrate the nearest knot of people but found myself largely unable to secure any purchase in the smooth waterfall of words. Every syllable I uttered ended up the same: an aborted reach, followed by a slide back down the conversational slope.

Twenty minutes before, I’d been rolling along the streets of Buckhead as they became wider and posher and leafier, navigating past Hummers and Land Rovers and various other luxury vehicles until the huge home hosting tonight’s event floated into view like a glowing mother ship at the top of a hill. Ten thousand watts of incandescent bulbs burned brightly against the night sky, illuminating a pair of cream-jacketed valets trying to wave me down. I ignored them. No one drives my truck except me.

My truck! My truck is really an economy hatchback from which I’ve removed half of the back seat. This vehicle, which I’ve named Herman, has been with me for twelve years over multiple continents, so he doesn’t exactly boast the latest technology. He also looks like ass, having sputtered through monsoons and deserts and, in the worst of times, literal wars. I’ve replaced and rotated his tires, changed his brake pads and calipers, swapped out his filters, substituted his belts and hoses and batteries, and flushed his radiator and transmission. There are more than two hundred thousand miles on this sucker, and there’s no way I’m getting rid of him until the tragic day when he finally and irredeemably croaks. As always, driving him makes me happy.

In the house, though, I’ve lost a bit of my composure. I can’t control my fidgeting; of its own accord, my body yearns toward the door. My foot taps, a relentless, skittish beat. My face too is a failure: I can feel it settling into the kind of gritted-teeth smile produced by young kids who are being forced to pose.

Part of this reaction is physical. Even though the room, a grand, high-ceilinged sweep of space, has been cleared of furniture, the air circulates poorly. Flames roar in a ten-foot-high fireplace anchoring one end of the room, its mantel heaped with drying pine boughs and berry-encrusted twigs. The beribboned garland is clearly meant to invoke a festive yuletide spirit, but in me it produces a burning desire to figure out where the fire extinguishers are stored. Whoever decorated the mantel didn’t hold back elsewhere either; even without furniture, the room appears to have been fluffed by a herd of manic elves. There’s red and green shit everywhere: glass stars, hunks of mistletoe, human-sized nutcrackers standing sentinel in the corners, all of it somewhat shimmery from the radiance of the fire.

But my discomfort stems not just from the ostentatious decoration, or from the oppressive warmth, or from the perfumed but acrid scent of other people surrounding me, shooting up my nose like a chemical weapons attack. It’s not only the sound, the chittering and cackling of too many voices straining to make themselves heard.

It’s the bodies.

Even if I close my eyes and block my ears, I can sense them. Mere feet from me, they span all directions, appropriating space, emitting sound waves and social urgency and, without a doubt, respiratory particles.

A party, it should be obvious, is not my thing. By now, you’ve gleaned a few more facts about me, or you think you have. Socially awkward, you’re thinking; oversensitive. Insecure. Or maybe this: too introspective.

I feel the need to defend myself from your assumptions, even though they are logical. Despite my earlier warning, I’m actually good with people. My people, anyway. I like my people. I’m not a hermit or overwhelmed by sensory stimuli either; I can state without any exaggeration that I’ve endured some of the harshest conditions the planet has to offer.

I’m just not great around a lot of people. Especially now.

To my left, a blond bejeweled woman in her fifties gazes with rapt attention at an older man at her side, her fingers stroking the green circular pin at the top left of her long, floaty dress. His suit sports a corresponding pin, also on the left, at his lapel. Next to him, another couple, a beefy white man and a rail-thin, much younger woman, display their respective pins in the same spots. I reach for my pin, securely attached to the right side of my blazer. There’s no mandate regarding pin placement—you can put it anywhere on your torso you like, as long as it’s easily visible—but to me it’s come to serve as a signal for handedness. Right-hand-dominant people tend to pin theirs on the left, and vice versa, making it easy to keep a running tally of the lefties.

I’ve spent little time in society over the last several months, but still, I’m amazed at the ease with which these people have adapted to the fear that first gripped the world not even two years ago. The acute sickness caused by the artiovirus is rare now, vanquished by an army of public health servants, and, ultimately, a vaccine, but our world still bears the ghostly imprints of the lost: children who live with grandparents instead of parents, schools without qualified teachers, and above all, hospitals still in crisis mode because of a lack of doctors and nurses and cleaners and techs. There are, however, still plenty of hospital administrators.

Despite our losses, merriment shines on most of the faces here. Please understand: I don’t judge them, these people who are trying to return to the past. I understand the urge to repress the memories. Everyone lost someone. The particular hell of the artiovirus was its precise targeting of the otherwise young and healthy. It turned our immune systems against us, generating not a cytokine storm but a cytokine tsunami, sometimes felling people in a matter of hours. You could feel fine in the morning and be dead by evening.

But, as everyone in the country now knows, the virus harbored an even more terrible secret, one we would not suspect for months.

—

WHEN A HAND brushes my shoulder, I expect one of the three friends who are meeting me here tonight, or possibly somebody I know from the time when I worked at the CDC. Instead, I encounter a ferrety bald man who’s made the unfortunate decision to groom his mustache into a pencil-thin line. The effect is reminiscent of a cartoon villain or, perhaps, a weasel.

“Artie Smert,” he says, offering his hand in what appears to be a misguided reflex. Even before the pandemic I wasn’t big on shaking hands, so I ignore his outstretched arm. Batting his eyes, the man attempts to execute a face-saving maneuver by raising the hand to smooth back his hair, which might seem a tad more natural if he weren’t bald. After a brief awkward slide along his scalp, the hand drifts back down to his side.

I hadn’t intended to make this guy look stupid, so I offer him an elbow to bump. Unfortunately this doesn’t go any better, as he’s grabbed a business card from his pocket and apparently mistakes my gesture as an invitation to deposit the card on my elbow. I retrieve it with my other hand and study it.

“You’re Dr. Kira Marchand,” says the man. “I’ve been wanting to meet you for some time.”

The voice rings a bell. I read the card again. “Artie Smart?”

“It’s Smert, actually, not Smart. Are you familiar with the Midwest? The Dakotas, maybe?”

I blink at the non sequitur. “I was raised in Kentucky. I bounced around the world for a while and now I live here, but I’ve never lived in the Midwest. Why?”

“My friend in the Dakotas pronounces smart as smert.”

This line of conversation is of such confusing irrelevance I do not know how to respond. No wonder I always go mute at parties. “You left a bunch of messages with my office last year,” I say finally. “You’re a television producer.”

“That’s right!” says Smert jauntily, as if responding to even a modicum of positivity on my part. “We’d love to work with you on a show about female doctors during the pandemic. People recognize you from those press conferences where you explained what was happening . . .” Here, his eyes slide to the side. People don’t like to mention the worst outcome that can occur if you survive ART, or if they do, it’s usually in an undertone.

Some months into the pandemic, certain unpleasant truths about the illness began to make themselves known. By then we knew the basics: who was most likely to contract it, who was most likely to die. Like a typical virus, ART targeted the very young, the very old, and the weak. But this particular mortality curve followed an unusual shape when it came to the age distribution of the dead. Like an ongoing M, it peaked and fell and peaked and fell and peaked again; it turned out the virus had a predilection for strapping adults in the prime of their lives. Like a food snob, it cultivated its tastes precisely. It preferred men to women, eastern seaboarders over southwesterners, people with type A blood over types O or B, and so on and so on through a range of attributes. But it would—and did—devour anyone who crossed it, if the mood struck.

What we didn’t know then would turn out to be far worse than the immediate deaths. ART causes a delayed but catastrophic complication in a small but significant percentage of people, brought about by an autoantibody targeting certain proteins in the brain. As of today, we cannot predict who will suffer this effect, or when, although we believe it is likeliest to occur within a year or two of recovery from the initial illness. Now that we’ve conquered the virus, all of humanity is united in the fervent desire to find a cure for its most infamous sequela. Barring that, they want a predictive test. Everyone wants to know who will get the complication.

Artie Smert warms to his pitch. “That press conference you did with POTUS? You’re a natural-born speaker.”

I offer him a glance of considerable skepticism.

“It’d be a limited-run series,” he says, one finger unconsciously tracing the line of his mustache. “But not depressing. We’d allude broadly to the details of the pandemic—the deaths, the morbidity, the cratering and recovery of the financial sector—but there’s no appetite out there for another exposé of those circumstances. Everyone on earth’s already familiar with them. And you know, no need to go into detail about the . . . brain thing either: this isn’t a horror film.”

“Then what?” I ask.

“This series,” he says proudly, “will focus on the personal stories of those on the front lines, especially those with an unusual story to tell. In particular, the series would focus on you.”

If Smert considers this approach to be an enticement, he’s mistaken. I don’t watch television. While I have streamed a scientific documentary or two, I’ve never seen a reality show. I am ignorant of celebrity news. I barely even talk to regular people, unless I already know and like them.

Speaking of people I know and like, I spy my friends—Vani, Compton, and Hannah—perhaps twenty feet away, standing together but each speaking to people I don’t recognize. None of them lives in Atlanta; they’re here to support me when I give a speech later tonight. How had they managed to strike up such animated conversations with strangers?

Vani, my closest friend, catches my eye first, but then again Vani generally catches everyone’s eye first. She’s my age—early forties—and infinitely more alluring. Tonight, indifferent to the attention she draws, she’s dressed in an electric-yellow silk concoction with an array of jeweled bracelets crawling up her arms. Even from this distance, I can read her expression, so characteristic of Vani, somehow combining an aura of peace with a ridiculous, endearing sense of humor. She’s like a human embodiment of both Xanax and one of those party drugs that make people giggly.

Compton flanks her, her cap of sleek dark hair set off by an equally sleek black dress. Compton is the Ritalin to Vani’s Xanax; she’s beaming an intense, skeptical look to two chatty blond men who appear to be in their forties. On her other side, Hannah, pink-cheeked and fair, with her shapeless dress and messy bun, might have registered as dowdy compared to the other two were it not for the warmth in her expression, which she’s aiming at an older gentleman who is apparently hard of hearing. He’s got a hand cupped round his ear and I’m fairly certain the entire room can hear him shouting delightedly in her direction.

Oblivious to my distraction, Artie’s still going strong. “We’d want to showcase your particular, ah, style in the show, of course. You were one of the first Americans to contract the illness. You were one of the few worldwide experts on this particular virus before the pandemic. People must wonder: why does a woman want to become an expert on germs?”

Why? I’ve considered viruses to be my mortal enemy ever since missing my own tenth birthday party after coming down with what my mother erroneously referred to as “the stomach flu.” The stomach flu is not a flu at all, but everyone on earth is familiar with its symptoms.

A virus is one of the oddest entities in the universe. Neither living nor dead, it exists in a suspended netherworld, waiting to encounter a creature it can invade. Unlike normal life-forms, a virus cannot replicate itself; it is dependent on hijacking the machinery of a living cell in order to reproduce. They do this fantastically well, attaching themselves to the surface of a cell before penetrating it. Whatever vital functions the cell was carrying out are forgotten as it transforms into a kind of zombie factory to create more virus. Eventually—such as in the case of influenza—the doomed cell explodes, spewing out up to a million little viral soldiers, many of which are deformed mutants. The functional ones attack new cells, churning out even more viral swarms. They are deeply creepy little fuckers.

Still, Artie Smert hadn’t asked me to describe the characteristics of a virus. He’d asked why a woman would want to study germs. This question once again strikes me mute, which is fortunate, because if I’d had the wits to answer, everyone would have witnessed language incompatible with party manners. In my case, however, I’d taken a roundabout route to my expertise. I started my career as an internal medicine doctor with an aid organization, and it wasn’t until after my husband died of a sudden undiagnosed illness that I returned to the States and completed a fellowship in infectious disease, followed by special training in battling pandemics. My mentor at the CDC, a man named Waliedine Katz, turned me on to the artiovirus.

“And, yes,” Mr. Smert goes on, oblivious to my mental detour, “you’d be the perfect person to explain the efforts to defeat the—” He breaks off, fluttering both hands at his temples to indicate the worst outcome of the virus.

“I can send you abstracts from some of the latest papers,” I say. I catch Hannah’s eye and wave, hoping she’ll interpret the gesture as a distress signal. It seems to work; she nudges Compton and Vani and points in my direction. Even from a distance, I sense their protectiveness; this is the first time I’ve been at a public function in a very long time.

“Sure,” says Smert. His beady eyes tighten, focusing on my face. “But what people would really want to hear about, I think, is your personal story during the pandemic.”

I take an involuntary step back. Could Smert possibly know the real reason I left the CDC?

Having alluded to the subject he’d like to broach, Mr. Smert inexplicably stalls out. To combat my escalating pulse, I take in and blow out small, measured dollops of air, waiting for him to bring down the hammer. Finally, I do it myself.

“You want to talk about why I’m no longer at the CDC, I’m guessing.”

“Certainly,” he says. “I realize the pandemic was difficult for you on a personal level as well as a professional one. The, ah, situation with your children . . .”

I wait, but there is no more. He must not know—or at least he must not know for sure—the details of what I did.

By some miracle, an account of my behavior at the tail end of the pandemic, known to only a handful of people, had not filtered through the medical community in Atlanta and out to the general public. Still, for ethical reasons, I’d disclosed my action to a few people at the hospital and at the CDC, hoping some greater good would come of my transgression. To my relief, the story of what happened behind the scenes never blew up. Or, to employ a bit of irony: it never went viral.

But if this man suspects what I did, how long before some legitimate news reporter catches wind of it? The thought sends an antsy ripple crawling up my spine. Somehow, somewhere along the line, Mr. Smert must have managed to connect with someone who knows the truth.

I recall those days in fragments, long, unbroken streams of timeless waiting, my mind suspending itself in a protective haze where thoughts dissolved into nothingness before they could fully form. The blurred metallic edges of a hospital bed; the plinky little drip of IVs; slats of light cutting through parallel rows of blinds and falling in stripes across my forearms; exhaustion giving way to confusion. Sometimes this nightmarish haze sharpens into shards of distinct terror and I remember that final moment.

It haunts me still.

“I’m not interested in being on TV,” I say to Smert as my friends wade through the mob to reach my side. Up close, Vani, Hannah, and Compton present dramatically different approaches to evening makeup, Vani’s glossy lips and curled eyelashes and vivid yellow—yellow?—eyeshadow contrasting with Hannah’s unadorned eyes and the slash of crimson outlining Compton’s smirky half smile.

Smert switches tactics, pivoting to my friends. “Are you ladies coworkers of Dr. Marchand?”

Only Hannah smiles back at him. “We’re old medical school friends,” she says before anyone can stop her. “I’m Hannah—I’m an ob-gyn in San Diego. Vani practices internal medicine in Kentucky, and Compton’s an ER doc—she was in New York City during the pandemic.”

Perking up at the words ER and New York City, Smert swings his attention toward Compton, but upon encountering her total absence of expression, he swings right back to me. During our med school years, if we needed to deflate some horny clown in a bar—metaphorically or literally—we deployed Compton, who even then possessed a brittle, ball-busting sophistication. I know her well enough to state that a warm core of generosity lurks within her, but you have to excavate a layer of straight-up ferocity to reach it. We love her for it.

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