“Hello, Natalie?”
“Oh thank Christ, Rams.” The nickname is a holdover from their college days, and Natalie is the only person who continues using it. “I kept calling 911 and it wasn’t going through. I—” She pauses and cries quietly. “Are you home? I need your help. I don’t know what to do.”
“Yes, of course. I’m here, Natalie. Where are you? Are you all right? What happened?” Ramola has the disorienting sensation of being outside herself, observing this moment from a temporal distance that has yet to be achieved or earned, and it’s as though she expected this call and what is sure to be the delivery of devastating news.
“I’m in the car. Halfway there. I’ll be at your place in five minutes.”
Ramola runs to the bay window, throws open the curtains, exposing the view of the front lot. “Why aren’t you at home? Are you having contractions?”
“I had to leave. Something terrible happened. I really need help.” Her normally assured, insistent voice loses its force the longer she speaks so by the end of her third sentence she sounds like a timid child.
“I’m going to help. I promise.”
Natalie whispers, “Ow, fuck,” in a high-pitched voice, one that breaks into hitching sobs.
“What is it? Are you all right, Natalie? Do you need me to come to you?”
“My arm really fucking hurts.” Natalie grunts as though attempting to reset herself. “We were attacked by some guy. He was infected. Paul was bringing groceries inside and we were in the living room talking, just talking, and I don’t remember about what . . .” She trails off.
“Natalie, you still there?”
“Some guy walked in. He opened the screen door and walked right in our fucking house, and Paul tried to close the door on him, but he fell, and . . . And—and I tried to help Paul, and Paul—” She splinters into shards of tears again, but briefly recovers with a deep, wavering inhale. “The guy killed Paul and he bit my arm.”
Ramola gasps, covers her mouth, and staggers away from the window as though she might see the scene described play out in the lot. What can she say? What can she possibly say to Natalie?
After the initial shock of the news dissipates, the clinical doctor in her brain takes over, wanting to know more about Paul, to ask if Natalie’s sure he’s dead. She wants to ask about the bite on her arm—did it break the skin?—and ask about the infected man, what he looked like, what symptoms he was displaying.
“Oh my God, Natalie. I don’t know what to say—I’m so sorry. Please do your best to focus on driving until you get here. We need you in one piece.”
“There’s a chunk missing from my arm already.”
Ramola cannot tell if Natalie is laughing or crying. “Yes, well, we’ll get your arm cleaned up and we’ll get you vaccinated.” Ramola is aware she’s using the royal “we” she often employs with her patients.
“Rams, Paul is gone. He’s gone. He’s fucking dead. What am I going to do?”
“We’re going to get you to a hospital. Straightaway.” Ramola runs into the kitchen. From under her sink she pulls out a box of Nitrile gloves. They’re from her clinic but she uses them at home for cleaning. Holding her phone against her ear with a shoulder, she puts on a pair of gloves and asks, “Are you close?”
“I just passed under the viaduct.”
The granite-and-limestone Canton Viaduct is a two-hundred-year-old leviathan stretching seventy feet above Neponset Street. Ramola lives only a few blocks away.
Ramola says, “Are you feeling light-headed? Do you need to pull over? I can come to you.” She plucks her handbag from the kitchen table, double-checks that her car keys are inside. Whether or not they swap vehicles there’s no way she’s letting Natalie drive anywhere once she gets here. Ramola pins her medical ID badge to the front of her sweatshirt. She’s wearing plaid flannel pajama bottoms, her “comfy trousers,” but she won’t waste time changing out of them.
“I’m not stopping. I can’t. I’m running out of time to get help, right? Aren’t they saying the virus works fast?”
“You’ll be here soon and we’ll get you help. I’ll stay on the phone with you. Or would you prefer to drive with two hands? Feel free put me on speakerphone or drop me if you need to, if it feels safer. I’m watching out my front window. I can wait on the roadside as well.”
“No!” Natalie shouts and sounds to be on the verge of hysteria. “Do not go outside until I get there.”
Ramola dashes to the linen closet and grabs two towels and slings them over her shoulder. Then it’s back to the kitchen for a bottle of water and the half-full hand-soap bottle next to the sink before returning to the front door. She slips her bare feet into her jogging sneakers.
“Rams, what’s all that noise? You’re not going outside are you?”
“No. I’m gathering things, waiting by the door, stepping into my trainers.”
“You don’t still call them ‘trainers.’” Natalie’s voice goes little again, and it breaks Ramola’s heart.
“I do because that’s what they are.” Ramola unzips the overnight bag, places the water and soap inside and resumes her window watch. “I won’t go outside until I see you. That is a promise.” Ramola opens her phone’s text screen and scans through the group chat with Jacquie and Bobby, and pauses on the message about a patient already being feverish within an hour. The presentation of symptoms with this new virus is astronomically fast compared to a normal rabies virus. A typical rabies patient, when untreated, won’t exhibit symptoms for weeks, sometimes even months. Beginning its journey at the bite or exposure site the virus slowly travels to the brain via the sheathings of the nervous system, progressing at a rate of one or two centimeters per day. Once symptoms present (fever, nausea, dizziness, anxiety, hydrophobia, delirium, hallucinations, extreme agitation), it means the virus has passed through the patient’s brain barrier, which is the medical point of no return. If rabies enters the brain, there is no known cure, and the virus is nearly 100 percent fatal.
Lisa told me one patient of hers is one hour post exposure, fever and aches already.
One bloody hour. Natalie is indeed running out of time.
There are muffled bumps or knocks coming from the phone’s speaker and Natalie sounds like she’s at the bottom of a well. “Still there, Rams? I put you on speaker.”
“Yes, I’m here.”
“Do we need to switch cars? I’ve kind of bled on this one.”
“That’s not necessary as—” She stops from launching into an explanation of how the virus is transmitted via saliva and not transmitted through blood. There isn’t even a blood test to determine if you have been infected. Multiple tests have to be performed on saliva, spinal fluid, and hair follicles on the base of the neck looking for rabies antibodies and antigens.
Ramola bounces on her heels, willing her friend’s car to pull into the lot. “Usually I don’t have to encourage you to drive over the speed limit, but you have my permission to do so, Natalie, as long as you—”
“I stabbed the guy. Right between the shoulder blades. I think I killed him, but I was too late to save Paul.” Her “Paul” is a sputtering whisper, and then she explodes into semi-intelligible shouting and screaming.