1
AVA
Phoenix Ridge Hospital was buzzing with excitement. The air was electric with the sort of twisted anticipation of medical personnel faced with life-threatening events. Three people were being life-flighted in—something that didn’t happen every day. Usually, it was the other way around, but this time was different.
The patients were coming in from a well known local survivalist group. Sandra Watson had led this group for almost two decades, but she was also coming in as one of the patients. Something had happened, but no one knew what it was, only that it wasn’t the usual problems that the hospital generally anticipated from the group. Outdoor injuries like cuts, scrapes, sprains, even broken bones had happened over the years, but Sandra’s abilities were incomparable, even these injuries were rare under her tutelage.
Doctor Ava Jackson was on standby, waiting for the patients to arrive. An accomplished neurologist, her expertise was world renowned.
She had grown up in Phoenix Ridge, even taken some of Sandra’s survivalist classes as a teenager. Ava listened to the reports coming in as the patients were transported and trying to make sense of the symptoms. The emergency technicians were saying rabies, but it didn’t make sense. The onset was too fast, for one, and none of the students had seen or noticed any animals getting close to the class, much less reported any bites.
The other three members of the group were also being transported to the hospital for assessment, though they were not showing any of the symptoms of the ones coming in by medevac.
Ava tapped her foot as she waited, she already knew she would need help with this. Her specialty was neurology, but if this was something infectious, this would be outside her scope.
“Doctor Jackson?” Ava’s thoughts were interrupted by the head nurse, Kellie Hawthorne. Kellie was on the shorter side, barely coming up to Ava’s shoulder, though she was older. She had been a nurse in the hospital for almost thirty years, twice as long as Ava. With short curly hair and a stern face, she kept the nursing staff running like a well-oiled machine.
Ava blinked a couple of times before responding. “Yes?”
“The chopper should be landing in about two minutes, do you want to be there for triage?” Kellie asked.
“Yes, I do,” Ava answered, and followed Kellie as they walked quickly toward the elevator and headed up to the roof to meet the helicopter. Thethump-thump-thumpof helicopter blades started to vibrate the walls as it dropped the last few feet to the roof access.
Gurneys were already set up, waiting for the patients to arrive, nurses and technicians holding the equipment steady as the helicopter came to a slow landing on the center of the roof, buffeting air around them. Ava held her lab coat with one hand and tried to keep her dark hair from flying all over the place with the other as the chopper landed, but she could already tell things were far worse than they anticipated. She could see the jerky movements of the patients before they were even brought out of the helicopter.
All three of the patients were strapped down on litters, which is expected with air transport, but all three of them seemed to be fighting for their lives. Their eyes were wild, and their movements jerked as though they had no control over their bodies. Ava could not tell from her perspective whether they were even aware of their surroundings.
The last patient moved from the medevac was Sandra. Ava recognized her immediately, but she wasn’t moving, and not just unconscious, she was stiff, almost frozen. Her eyes were open, and her mouth twisted in what almost looked like a snarl, but she seemed to be carved out of wax.
Ava rushed over to the gurney when they lifted Sandra onto it and began wheeling her toward the elevator. “Sandra, can you hear me?”Ava shouted over the roar of the helicopter. Ava’s heart almost stopped when Sandra’s eyes darted toward her, though no other muscle in her body moved.
“Get her admitted and have all of them started on Baclofen,” Ava barked at the nurses, then turned to the EMTs. “Do we know what happened?”
The tech, a young woman named Yasmine, shook her head. “We don’t really know, at first we thought it could be rabies, but the others never saw or heard about any animal bites, and we checked as quickly as we could, but we didn’t find any evidence of bites. According to the witnesses, it came on fast. They were setting up the campsite and expected to stay for two weeks when the first patient, Jesse, started to complain of cramps. Sandra advised her to drink some more water and electrolyte solution, but then the second patient, Amy, started saying the same thing—within the hour all three were all in convulsions. Heather, one of the others in the ambulance, grabbed Sandra’s sat-phone and called it in.”
Ava checked her watch. “When did all this start?”
“The call came in at 11:18, they reported the symptoms started about an hour before,” Yasmine answered. “It took us some time to get out there. Sandra likes to get as far away from civilization as possible, and out there in the mountains, it’s just…” Yasmine shook her head. It had been over six hours since the initial call.
“Okay,” Ava said. “You did great, all of you.”
Yasmine nodded, but Ava could tell she didn’t completely believe it. They turned away from each other; Yasmine headed back to the helicopter and Ava to the elevator. Everyone else had made it down to the second floor already. Ava tapped her foot as she waited for the elevator to come back to the roof. She racked her brain to figure out what could be causing this. Neurological symptoms like this weren’t natural, but there shouldn’t have been anything toxic out there, nothing that could cause this.
The elevator door finally opened, and Ava hit the button for the second floor. When the door opened, the floor was already in motion. All of the nurses and techs were circling, and Ava felt a moment of pride beforeforcing herself to focus. This was something that their hospital was not prepared for, but the staff was well trained, and worked like a machine, even in the face of something they’d never encountered before.
Ava went first to Sandra’s bed and out of pure habit grabbed her chart though there was not much in there beyond what Yasmine had told her. The Baclofen seemed to be working, Sandra’s body remained frozen, but she appeared to be relaxing slightly and her face had lost the snarl. Her limbs were still tense but rested on the bed. The others were still moving with fits and jerks, but it was less violent than even a few minutes before.
“Sandra?” Ava said gently. Again, Sandra’s eyes looked toward her, but she still couldn’t move her head. “It’s Doctor Ava Jackson, blink if you can hear me.”
With a great amount of difficulty, Sandra managed to close her eyes and open them again.
“Do you know what happened? Blink once for yes, twice for no,” Ava said.
Sandra blinked twice, though it seemed to take all of her effort.
“Okay, Sandra,” Ava said. “We will figure this out, and we will make sure all of you are taken care of.”
A technician approached the bed to take some bloodwork, and Ava nodded at her, leaving Sandra’s side. She went to see the other patients, but the symptoms all seemed to be similar, though the others had been sedated. She hoped Sandra would be soon. She checked their vitals, heart rates and blood pressure were both elevated, and they all had fevers. Everything in their list of symptoms pointed to rabies, but the onset was too fast, and there were no animal bites, at least nothing that they’d found yet.
