Do you not believe that the pestilence would follow after me? I asked.

Undoubtedly, he agreed. But pockets of refuge will be spared.

And what of the sick here in Genova? I demanded. Did we not owe them a debt of obligation?

Jacob indicated the graves all around us and asked, what do we possibly have left to offer the infirm?

I persisted, perhaps only out of the same stubborn pride that vexed Camilla so thoroughly it drove her to once liken me to a blind jackass. I told Jacob that we do make a difference by draining patients’ boils, bleeding them when the humors are unbalanced, and applying other time-honored remedies.

Jacob stared at me in disbelief. Then he spoke the words that sank my heart even lower: Rafael, we doctors have failed our patients so utterly that it astounds me they have not yet turned on us.

Even though we have failed them thus far, it does not mean that we always will, I replied.

The old Jew’s only response was to strike his shovel into the unforgiving soil. Nothing more was said between us as we gave my Camilla back to the earth.

Do I not fear the pestilence? you might ask. I fear it more with every agonizing death I witness. With each victim who is covered in weeping sores. Every man, woman, or child whose lungs are so filled with bloody phlegm that there is no space for other vital humors. Yet the thought of being one of the few spared, alone and destitute, frightens me so much more.

Chapter

Five

Nico is waiting outside the hotel for Alana with a cup of espresso in each hand and greets her with a quick peck to both cheeks. There’s an unexpected chill in the spring air, and she appreciates the coffee as much for its warmth as its refreshing bite.

Nico’s hair is slicked back, each strand in place, and his pressed shirt and matching navy jacket are contoured to his chest. But his face reveals a different story. Alana remembers the look too well. Eight years later, it’s even more pronounced. The eyes more bloodshot, the bags beneath them deeper. She also notices the tiny clusters of veins snaking along his cheeks that she hadn’t observed yesterday. She thinks back to all those nights-before from their time together—Nico insisting on opening a second or third bottle of wine when he should have stopped at least one sooner.

Time hasn’t dulled her memories. Alana can still picture the moment she first laid eyes on Nico in the one-room compound that passed for a hospital in rural Angola. She had already heard at length from the chain-smoking English nurse who drove her in from the airport about the “movie-star-gorgeous” Italian doctor, but Alana hadn’t expected him to be such a natural leader. He was only thirty-two at the time, a year older than Alana, but he ran the little hospital with veteran authority, seamlessly navigating critical decisions and agonizing dilemmas such as how to ration their limited supply of potentially life-saving intravenous fluids. But Alana, who was fresh out of training and determined to prove herself on her first WHO assignment, refused to be awed or outperformed. She kept her distance at first. It was only after Nico contracted cholera, and Alana had to nurse him to health, that their mutual attraction burst through. Within a week of his recovery, they were sleeping under the same mosquito netting. They got very little rest, though, working eighteen-hour days and spending much of their downtime intertwined in sweaty embraces, their heated sexual chemistry intensified by the life-and-death nature of their mission. After two months in Angola, she was head over heels in love in a way she had never experienced.