I found Lorenzo in the lowliest of the local taverns by the harbor. As I entered, a scrawny three-legged dog chased a piglet across the straw floor, stopping only to urinate against the leg of a table. Though it was not yet noon, revelers filled the tavern, which reeked of spilt ale and burnt meat. It took me a moment to sight Lorenzo on the far side of the room, where he tottered on his chair with a whore straddling his lap.

Rafael, he called to me, instead of his usual honorific of Signore Pasqua. Come drink with us, my good master!

You are already drunk, Lorenzo, I observed upon reaching his table.

And so should you be, he announced, causing the wench on his lap to cackle and raise her mug in agreement.

There is work to be done, I said. More work than ever.

Lorenzo laughed bitterly, and his voice grew louder still. The only work left for us is to bide our time until death gets around to claiming each of us, too.

Not all of the afflicted die, I said. There is hope for some. And it is our duty as surgeons to offer them the best opportunity for survival or, at the very least, a modicum of comfort in their dying.

Tell that to my mother, my father, my sisters, and especially my brother!

There are no words to soothe such losses, I said. However, no loss, no matter how great, permits us the luxury of abdicating our duty.

Lorenzo slammed his mug onto the table, spilling ale over it, and labored to his feet, toppling the harlot to the floor. You are a decent man and a good teacher, Rafael, he cried. But you are a cruel fool to confuse high-mindedness for hope!

Chapter

Seven

The long silences are the worst, Alana thinks, as she listens to her boss, Monique Olin, breathe on the other end of the secure voice-over-Internet line. She remembers the parting words of Gavin Fielding, her Scottish predecessor at NATO: “Don’t believe the fuckin’ Mother Teresa act! Monique can be one terrifying old cow when she doesn’t get her way.”

In the eighteen months since Alana assumed her role as director of biological surveillance for NATO, she has come to realize that Fielding was only half joking about their mutual boss. Alana respects and even admires the fiftyish Frenchwoman, who has risen to the level of assistant secretary general, one promotion away from the very top of the old boys’ club that NATO continues to be. Among other responsibilities, Olin oversees Chemical, Biological, Radiological, Nuclear Defense, or CBRN as it’s always referred to at headquarters. She can be collaborative in her approach, but once her mind is made up she demands absolute compliance. And God help anyone who thinks otherwise.

Olin finally breaks the silence on the line. “So you went to Genoa despite my explicit instructions?”

“Monique, it’s the first case of pneumonic plague Western Europe has seen in several hundred years!”