Resistant
RESISTANT
Copyright © 2018 Rachael Sparks
All rights reserved, including the right to reproduce this book or portions thereof in any form whatsoever.
Published by SparkPress, a BookSparks imprint,
A division of SparkPoint Studio, LLC
Tempe, Arizona, USA, 85281
www.gosparkpress.com
Published 2018
Printed in the United States of America
ISBN: 978-1-943006-73-1 (pbk)
ISBN: 978-1-943006-74-8 (e-bk)
Library of Congress Control Number: 2018942982
“When It Don’t Come Easy”
Lyrics and Music by Patricia Griffin
Copyright © 2004, Almo Music Corp. on behalf of itself and One Big
Love Music
Used by Permission. All Rights Reserved.
Book design by Stacey Aaronson
All company and/or product names may be trade names, logos, trademarks, and/or registered trademarks and are the property of their respective owners.
This is a work of fiction. Names, characters, places, and incidents either are the product of the author’s imagination or are used fictitiously. Any resemblance to actual persons, living or dead, is entirely coincidental.
For M, R, and W, who always believe in me,
and Rube, for telling me I was capable of more.
A mighty creature is the germ,
Though smaller than the pachyderm.
His customary dwelling place
Is deep within the human race.
His childish pride he often pleases
By giving people strange diseases.
Do you, my poppet, feel infirm?
You probably contain a germ.
—Ogden Nash
TABLE OF CONTENTS
PART ONE
* * *
Chapter One
Chapter Two
Chapter Three
Chapter Four
Chapter Five
Chapter Six
Chapter Seven
Chapter Eight
PART TWO
* * *
Chapter Nine
Chapter Ten
Chapter Eleven
Chapter Twelve
Chapter Thirteen
Chapter Fourteen
Chapter Fifteen
Chapter Sixteen
Chapter Seventeen
Chapter Eighteen
Chapter Nineteen
Chapter Twenty
Chapter Twenty-One
Chapter Twenty-Two
PART THREE
* * *
Chapter Twenty-Three
Chapter Twenty-Four
Chapter Twenty-Five
Chapter Twenty-Six
Chapter Twenty-Seven
PART FOUR
* * *
Chapter Twenty-Eight
Chapter Twenty-Nine
Chapter Thirty
Chapter Thirty-One
Chapter Thirty-Two
Chapter Thirty-Three
Chapter Thirty-Four
Chapter Thirty-Five
Chapter Thirty-Six
Chapter Thirty-Seven
Chapter Thirty-Eight
Chapter Thirty-Nine
Acknowledgments
About the Author
Book Club Questions
PART ONE
* * *
No Medicines Left
CHAPTER 1
* * *
Stevigson Farm, Woods Hole, Massachusetts, November 2041
The thermometer on the window read ninety degrees Fahrenheit, enough for Rory to suspect that the typical afternoon power outage would arrive soon. Outside, the leaves on the trees were barely turning yellow at the edges, hinting at the start of a fall that wouldn’t get crisp for weeks yet. At this temperature, her research thesis would have to take an extended hiatus. Their solar panels were broken, and rolling brownouts were a common occurrence. She wanted a break anyway. Evenings felt cooler if you hadn’t been inside all day.
She saved her work with a quick tap on the hologram screen and then tapped it again to close. The projected screen and keyboard disappeared, leaving only its small flat bar. It was an outdated holo-laptop, but it worked well after she had traded computer repairs for a bushel of potatoes with a traveling electrical engineer who was passing through Woods Hole.
Yanking on boots, she headed downstairs to the back porch and out toward the orchard. Its apple trees, fruit weighting the limbs and near harvest, filled almost an acre of their farm and were a good source of income. But the apples were also a great deal of work to haul in, and that was before the labor required to make chips, jam, and cider to sell locally. Rory had always found their spindly, droopy branches rather creepy, but she admired their durability in the face of several shockingly hot winters and a few freak blizzards.
She found her father past the orchard in the back acre, where rows of wheat were also days from being ready to harvest. The crop would yield just enough for a few bags of flour. It was getting so expensive to buy now that the Midwest had reverted to dust-bowl status. He was proud of this first year’s crop, but she wasn’t keen on learning how the thresher worked.
“Aurora Rosalind. Goddess of the dawn and the harvest!” her father shouted in a mock blueblood Boston accent.
“Lord Byron, fair rogue,” she called back with a deep, mocking bow. “I thought I’d check on you before I go check the crab traps.” She reached him where he was pulling weeds from the row edges.
Her father was a tall, lanky man with a crop of sandy blond hair growing coarse with age. Dressed in his standard hat, overalls, boots, and T-shirt, he looked far more like a farmer than a doctor of science in climatology and the author of two published books. Three more books still languished on the holo-laptop for the time when the world cared again about reversing climate change. Too late to reverse, he liked to say. The earth already reversed on us. We just need to stay ahead of its inhabitants now. Of course, after the die-off, all her father really meant was the microscopic inhabitants. Even one of their own tiny family had fallen victim to bacterial resistance to medicines. Rory’s mother was three years gone, but the pain still woke her with nightmares.
“Crab for supper again? Catch me a lobster for once, will you?” “Get your boat working again, and I will,” she retorted.
“I’m a meteorologist with a pitchfork. You’re the smart one.”
“I’m a microbiology student with a crab trap.” She squinted at him, but secretly she loved these games. Since they’d lost her mother, these teasing moments revived her in their memories.
“You’re a doctoral candidate with a master’s in bioengineering and a minor in biochemistry. Make it run on potato peels,” he said. She was already heading away toward the docks.
“I’ll get a real doctorate just about the year that a seventies-era marine engine can be converted to biofuel.”
“Got your knife and Mace?” he called after her with a father’s worry. Rory waved a hand up that gripped her knife without turning around, and then she hooked it onto the back of her belt.
Byron watched his daughter walk away, now at twenty-three as tall as her mother and just as lean as he. Her hair was darker, wavy, its length bouncing against her back as she walked. He could still see the toddler version of her, walking hand in hand with her mother, always curious, forever trying to pocket or eat whatever she found. She still had the curiosity, the resilience she’d shown then, traits her mother, Persephone, had passed on to her. More than she realized.
The die-off had left them with little more than their wits and the land they owned, but Byron knew how valuable their wits really were. With the population cut by almost 15 percent by the time Rory was seven, and no antibiotic
s developed yet to combat the resistance of every common bacterial enemy of humans to the antibiotic medicines available, survival skills seemed as valuable as job skills. They still had minimal infrastructure—even electricity and internet most days—but nobody needed a climatologist to tell them that Woods Hole, Massachusetts, was exhibiting the weather he had grown up around in his Raleigh, North Carolina, childhood. They had made a decision, as a family, to turn this family vacation spot into a real farm. It had felt less like a sacrifice than a strategy. Then Persephone had left them, a victim of the very bacteria she had long struggled to develop medicines against. Right now, he couldn’t tell if they were winning. But he suspected that the long game rarely felt that way.
CHAPTER 2
* * *
US Army Task Force for Epidemiology and Antimicrobial Research (TEAR) Laboratory, Bethesda, Maryland
The team of eight researchers around the massive conference table worked on their laptops in impatience, reviewing their presentation. Their coffee was ice-cold by the time their audience of three finally arrived. Everyone was on their feet, as if they’d instantly been drafted and suddenly knew how to salute.
“General Kessler,” the lead scientist greeted the tall, barrel-chested general with black eyes and a close crop of pepper hair.
“Dr. Rajni,” he said with a brief handshake and a glance over the other seven scientists. General Bill Kessler didn’t like doctors. He needed them, but he didn’t trust or like them.
Rajni couldn’t remember the other men in uniform but nodded respectfully and said, “Officers, please sit.”
“Yes. Let’s make this efficient. Tell me when we’ll have antibody stock.”
Silence filled the room like smoke, and Rajni glanced back at his team to encourage them to begin the presentation. From the center of the round table, the holo-projector sent a column of soft light up through the center of the room, and an image of a 3-D, multiheaded, multicolored blob appeared to float in the center. It stuttered, disappearing for a few moments while the scientists frantically tried to restore it.
“I miss the days of projectors and flat screens,” Kessler sighed. “Hologram laptops, hologram projectors—why can’t we just fucking project onto a wall or use a damned screen instead of dust mites?”
The holograms suddenly reappeared, now sharp and visible as their light sources illuminated particles in the air and earned an unimpressed huff from Kessler.
Clearing his throat, Rajni—looking a decade older than his forty-five years—pointed to the blob as it began to animate, moving in space toward an oblong, elliptical body that appeared in the animation. He pointed to the elliptical shape.
“That is a bacterium with the pan-resistant antibiotic resistance genes, able to resist all our existing antibiotics. This, to the side, is an antibody from within a healthy, immune-competent individual who was able to survive infection by a pan-resistant bacteria.” As he further narrated, the antibody latched onto the bacterium, and another larger cell body soon appeared, matching up to exposed sites on the antibody, then quickly engulfing the whole combination. “In a normal, healthy person with the ability to survive—”
“Dr. Ranji, we’ve seen this all before,” interrupted Kessler. “We know how survivors’ immune systems work, how the mac . . . macrama . . .” He waved a meaty hand.
“Macrophages?” the doctor supplied.
“Yes. Macrophage immune cells from our bodies eat the bacteria after the antibodies latch on. I need to know what you’ve engineered for the rest of us who are lucky to have survived this long without being exposed. What’s next.” It was an order, not a question.
Ranji looked over at his team and nodded, and they nodded back. Now the animation showed a differently colored antibody attaching to the bacteria. Nothing more happened.
“Despite numerous promising approaches, the antibodies either directly from donors or from mouse and synthetic models were successful at receptor binding sites either in vitro or in vivo, but phagocytic cell response is lacking or insufficient to reduce the burden of pan-resistant- gene-positive cells enough to allow survival. The donor models seem to be the only models where receptor binding is successful in triggering the full immune cascade that will allow for defeat of a pan-resistant bacterial infection.”
“You mean . . . it doesn’t work?” Kessler squinted angrily.
Rajni nodded. “I mean that the antibody latches on, but the macrophages don’t finish the kill. Put simply, for whatever reason, the bacteria infecting the victim do not die. Instead, the victim dies. Dr. Simon can provide more detail on the reasons we suspect for failure.”
A young black woman stood up and wrung her hands as she spoke. “We’ve examined the receptor binding in the donor survivor blood and haven’t yet been able to identify the unique parameters that create a positive-binding and subsequent immune cascade environment. It’s not simply the antibody alone. Some other unknown factor seems to be at play.”
“Maybe the antibodies are not binding fully?” suggested one of the officers, who had a bachelor’s degree in biology.
“We’ve ruled that out as a possibility. Binding is successful and abundant.”
“Are they on some sort of . . . I don’t know, special diet? Vitamins?” Kessler barked.
Dr. Simon shook her head. “We’ve controlled for such factors. There are no special reasons that we can identify why the donors work and the others don’t.”
Kessler practically growled in frustration before a fist came smashing down on the table. “There are hardly any donors left! It’s been almost four years and seventy million dollars—you’ve probably bled them dry already! How in the holy fuck have you all screwed this up so badly?” He surged to his feet. “You’re supposed to be the best goddamned researchers in the world!”
Dr. Simon visibly trembled, but Rajni was cool and composed.
“The best goddamned researchers in the world,” he said, his mild Pakistani accent the only thing to betray his discomfort, “are mostly dead. We’re what you have left, and we are just as upset at our lack of progress.”
“Well, who the fuck is going to figure this out? The world is waiting to attack us, and we’ve got half the military defenses we had fifteen years ago. Who do I need to hire?” Kessler bellowed.
Rajni shrugged. “There is no one. I think only my mentor could have solved this.”
“Who? Where is he?”
“She. Dr. Persephone Tyler-Stevigson. She’s dead. She died over two years ago when we were beginning to make progress.” He looked down, overcome for a moment with regret as he recalled their last words.
“She’s dead.” Kessler visibly regained control over his temper, glancing at his officers. “That’s terrible. I’m sorry. Did she die here?”
Rajni was silent.
Dr. Simon spoke up. “No. She had decided to go back to her family farm and take care of her husband and daughter.” She paled when Rajni sent her a quelling glare.
“Ah. One of those survivalist types,” Kessler replied smugly. “Not in the Midwest, I hope.”
“She was from Woods Hole, Massachusetts,” Rajni said quietly. “She cannot help us now. We must keep working and hopefully try to discover more donors who haven’t self-reported their infection survival.”
One of the officers leaned across the table. “We’ve given you every donor we have. We’ve scoured the nation. Do you think they’re in hiding or otherwise avoiding detection?”
A young doctor from the group cleared his throat, and the officer’s instant glare in his direction caused a nervous pause before he explained, “Probably, though not intentionally. Our data are just too fractured with lack of complete reporting. So many hospitals and medical examiners have closed, and their mortality data weren’t reported to the CDC. We lack a nationalized database of survivors—that is, survivors who actually contracted a resistant infection and managed to recover. If such a database existed, well . . .”
Dr. Rajni completed his thoug
ht. “We wouldn’t be needing to meet.”
“Explain.”
“General Kessler, we’ve discussed this before. We really lack the epidemiological data to reveal the most vulnerable populations. It seemed intuitive when the elderly were the most commonly infected, but then the bacteria transferred the antibiotic resistance so successfully across species that there was no most-likely-to-be-infected type of patient; everyone seemed equally at risk. We need to know what is in common amongst survivors, and our current pool of donors is not revealing any clues. We can’t take the handle off the pump.”
“What?” Kessler snarled again. “What pump?”
Rajni shook his head sadly. “Sorry. It’s an old epidemiology term. Dr. John Snow, the father of epidemiology, famously ended a cholera outbreak in London by removing the handle from the water pump that he suspected was the source of the outbreak. It ended the cholera epidemic.” He sighed. “But we have no such easy answer.”
A silent miasma of tension, sadness, and frustration filled the room. Kessler nodded with finality: the meeting was ended.
“Keep working. We’ll find more donors.”
All the scientists glanced at each other uncertainly, not understanding that they were dismissed. Rajni gave them a toss of his head toward the door and they all filed out, Rajni closing the door behind him. The bacteria animation hung frozen in air over the center of the table before the military men.
Kessler took a deep breath. “I want eyes on the farm of that dead doctor—Staig-whatever?”
“Persephone Tyler-Stevigson,” his officer read from notes on the table.
“Right. Eyes on the farm immediately. Maybe the family knows something. Maybe she kept working.”
“Eyes on the farm. Yes, sir.”
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