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about their appointment. Originally, she was the one who had cajoled Dominic into couples’ counseling. But six months into the weekly sessions—with so little, if any, progress made—Lisa has lost faith in the counseling, their counselor, and, if she’s being totally honest, their twelve-year marriage itself.

“My day’s going to be crazy,” she says. “I’ll have to meet you there.”

“See you there. Looking forward to pulling more Band-Aids off with the skin still attached,” he says in what she realizes is an attempt at lightheartedness. “Love you, Lees.”

“See you soon,” Lisa says as she hangs up, struck by her husband’s uncharacteristic words of affirmation and her struggle to reciprocate them.

She thinks again of her sister’s reaction when Lisa finally confessed—after a second Moscow mule—to her growing sense of detachment and progressive loss of interest in their sex life, and how it had only made Dominic more affectionate and attentive.

“And that surprises you?” Amber asked. “People are emotional lemmings. The more you pull away, the more they throw themselves into it.”

“It being off a cliff?” Lisa said.

“Yeah. In your case, a really rocky one, too.”

Lisa brushes off those thoughts as she pulls into the on-call parking lot at Harborview Health Care Center. She spent countless hours at the hospital during her residency, but she never got accustomed to the vastness of the campus. Or to the sounds, smells, and frantic busyness of the place. As the biggest regional medical center in the Pacific Northwest, Harborview spans five city blocks and runs four separate intensive care units for trauma, cardiac, burn, and medical patients. Lisa heads straight for the East Building, which houses the medical ICU.

She weaves through the bustling corridors and rides the elevator to the sixth-floor ICU, where she identifies herself to the indifferent clerk at the front desk. She has to wait a few minutes before a chatty nurse named Mick, with colorful tattoos that encircle both biceps and resemble cuffs to his scrub tops, arrives and then leads her past individual glassed rooms—each housing a patient besieged by medical gadgetry—to the negative-pressure isolation rooms at the far end of the unit.

As a student, Lisa used to love the rush that came during rotations in critical care, but she never adjusted to the deaths and the heartbroken families that were so often the outcome of all the medical drama.

They reach the first of the isolation rooms, and Mick hands her the personal protective equipment, or PPE, kit. A folded gown supports a pair of gloves and an N95 mask, which filters out all microbial-sized particles. He departs with a quick wave.

Lisa slides the gown on top of her clothes and secures her mask snugly over her mouth and nose. The simple steps conjure grim memories of donning PPE during the dark days when COVID-19 terrorized Seattle. As she is pulling on the second glove, an African American man with contemplative brown eyes appears beside her. “You’re from Public Health?” he asks as he slips into his own gown.

“Yes. Lisa Dyer.”

“Edwin Davis. I’m on for ICU.” He closes his eyes briefly and shakes his head. “And what a disaster of a day it’s been.”

“I can only imagine.” In Lisa’s experience, intensivists—the doctors who treat ICU patients—rarely if ever appear so fazed. Or dejected. “When did the meningitis cases show up?”

“We got the first call from the ER yesterday, late afternoon. A fifteen-year-old with suspected septic shock. By the time I got there—twenty minutes later—he was already dead. Six more kids rolled in over the course of the night and into the morning. Two others never made it out of the ER. One died up here. The other three are all on life support.” Edwin sighs. “I can’t say with confidence that any of them are going to survive. At least with COVID-19, most of the ones who died were much older.”

His despondence is contagious. “And the lab confirmed it’s meningococcus?” Lisa asks.

“The medical microbiologist ran stat gram stains on the cerebrospinal fluid as well as PCRs,” he says, using the acronym for polymerase chain reaction, a rapid sequence test that allows for almost instant DNA recognition—the genetic equivalent of a reliable witness at a police lineup. “He says he still has to confirm it with further testing, but he’s convinced it’s meningococcus type B.”

The mention of the pathogen’s specific type sends a chill down Lisa’s spine. Neisseria meningitidis, more commonly known as meningococcus, is among the deadliest of bacteria. And type B is the most feared of the four major subtypes, because of the lethal outbreaks it causes, and its notorious resistance to most vaccines.

None of that would be news to Edwin. So, instead, Lisa asks, “Do we know how many kids attended this Bible camp?”

“A ton of them. Not to mention camp counselors and other staff.” He arches an eyebrow. “A lot of contacts for your team to track down.”

“It’s what we do.” Lisa hides her doubt behind a matter-of-fact shrug. “And what about your staff? Have they been put on prophylactic antibiotics?”

He nods. “Anyone who’s had direct contact with the cases has already been put on Rifampin and cipro.”

“Including you?”

“I got the first dose,” Edwin says as he secures his own mask. “No ‘women and children first’ policy around these parts.”

Lisa turns her attention to the nearest room, where, behind the glass, a freckled girl with long dark hair lies motionless on the stretcher. A tube leads from her mouth to the ventilator, while other lines extend from her neck and arms and connect her to the transparent bags of fluid that dangle above her. A nurse dressed in full PPE on the near side of the bed adjusts one of those bags, while across from her, a stooped man in the same garb hovers awkwardly over the patient without touching her.

“Kayla Malloy,” Edwin says. “Sixteen years old, same ballpark as the others. She’s the most recent victim to reach us. Got to the ER just over two hours ago. Her kidneys have shut down, and we’re struggling to

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