Eight

I drove home haunted. I had been going to crime scenes most of my professional life, but had never had one come to me. The sensation of being inside that photograph, of imagining I could smell and feel what was left of that body, had shaken me badly. It was almost midnight by the time I pulled into my garage, and I couldn’t unlock my door fast enough. Inside my house, I turned the alarm off, then back on the instant I shut and locked the door. I looked around to make sure nothing was out of place.

Lighting a fire, I fixed a drink and missed cigarettes again. I turned on music to keep me company, then went inside my office to see what might await me there. I had various faxes and phone messages, and another communication in e-mail. This time, all deadoc had for me was to repeat, you think you re so smart. I was printing this and wondering if Squad 19 had seen it, too, when the telephone rang, startling me.

“Hi,” Wesley said. “Just making sure you got in okay.”

“There’s more mail,” I said, and I told him what it was.

“Save it and go to bed.”

“It’s hard not to think about.”

“He wants you to stay up all night thinking. That’s his power. That’s his game.”

“Why me?” I was out of sorts and still felt queasy.

“Because you’re the challenge, Kay. Even for nice people like me. Go to sleep. We’ll talk tomorrow. I love you.”

But I did not get to sleep long. At several minutes past four A.M., my phone rang again. It was Dr. Hoyt this time, a family practitioner in Norfolk, where he had served as a state-appointed medical examiner for the last twenty years. He was pushing seventy, but spry and as lucid as new glass. I’d never known him to be alarmed by anything, and I was instantly unnerved by his tone.

“Dr. Scarpetta, I’m sorry,” he said, and he was talking very fast. “I’m on Tangier Island.”

All I could think of, oddly, were crab cakes. “What in the world are you doing there?”

I arranged pillows behind me, reaching for call sheets and pen.

“I got called late yesterday, been out here half the night. The Coast Guard had to bring me in one of their cutters, and I don’t like boats worth a damn, beaten and whipped around worse than eggs. Plus it was cold as hell.”

I had no idea what he was talking about.

“The last time I saw anything like this was Texas, 1949,” he went on, talking fast, “when I was doing my residency and about to get married . . .”

I had to cut him off. “Slow down, Fred,” I said. “Tell me what’s happened.”

“A fifty-two-year-old Tangier lady. Probably been dead at least twenty-four hours in her bedroom. She’s got severe skin eruptions in crops, just covered with them, including the palms of her hands and the bottoms of her feet. Crazy as it sounds, it looks like smallpox.”

“You’re right. That’s crazy,” I said as my mouth got dry. “What about chicken pox? Any way this woman was immunosuppressed?”

“I don’t know anything about her, but I’ve never seen chicken pox look like this. These eruptions follow the smallpox pattern. They’re in crops, like I said, all about the same age, and the farther away from the center of the body, the denser they get. So they’re confluent, on the face, the extremities.”

I was thinking of the torso, of the small area of eruptions that I had assumed were shingles, my heart filled with dread. I did not know where that victim had died, but I believed it was somewhere in Virginia. Tangier Island was also in Virginia, a tiny barrier island in the Chesapeake Bay where the economy was based on crabbing.

“There are a lot of strange viruses out there these days,” he was saying.

“Yes, there are,” I agreed. “But Hanta, Ebola, HIV, dengue, et al., do not cause the symptoms you have described. That doesn’t mean there isn’t something else we don’t know about.”

“I know smallpox. I’m old enough to have seen it with my own two eyes. But I’m not an expert in infectious diseases, Kay. And I sure as hell don’t know the things that you do. But whatever it might be in this case, the fact is, the woman’s dead and some type of poxvirus killed her.”

“Obviously, she lived alone.”

“Yes.”

“And she was last seen alive when?”

“The chief’s working on that.”

“What chief?” I said.

“The Tangier police department has one officer. He’s the chief. I’m in his trailer now, using the phone.”

“He’s not overhearing this.”

“No, no. He’s out talking to neighbors. I did my best to get information, without a whole lot of luck. You ever been out here?”

“No, I haven’t.”

“Let’s just say they don’t exactly rotate their crops. There are maybe three family names on the whole island. Most folks grow up here, never leave. It’s mighty hard to understand a word they’re saying. Now that’s a dialect you won’t hear in any other corner of the world.”

“Nobody touches her until I have a better idea what we’re dealing with,” I said, unbuttoning my pajamas.

“What do you want me to do?” he asked.

“Get the police chief to guard the house. No one goes in or near it until I say. Go home. I’ll call you later in the day.”

The labs had not completed microbiology on the torso, and now I could not wait. I dressed in a hurry, fumbling with everything I touched, as if my motor skills had completely left me. I sped downtown on streets that were deserted, and at close to five was parking in my space behind the morgue. As I let myself into the bay, I startled the night security guard and he startled me.

“Lord have mercy, Dr. Scarpetta,” said Evans, who had watched over the building for as long as I had been here.

“Sorry,” I said, my heart thudding. “I didn’t mean to frighten you.”

“Just making my rounds. Is everything all right?”

“I sure hope so.” I went past him.

“Is something coming in?”

He followed me up the ramp. I opened the door leading inside, and looked at him.

“Nothing I know of,” I replied.

Now he was completely confused, for he did not understand why I was here at this hour if no case was coming in. He started shaking his head as he headed back toward the door leading out into the parking lot. From there, he would go next door to the lobby of the Consolidated Labs, where he would sit watching a small, flickering TV until it was time to make his rounds again. Evans would not step foot into the morgue. He did not understand how anyone could, and I knew he was scared of me.

“I won’t be down here long,” I told him. “Then I’ll be upstairs.”

“Yes, ma’am,” he said, still shaking his head. “You know where I’ll be.”

Midway along the corridor in the autopsy suite was a room not often entered, and I stopped there first, unlocking the door. Inside were three freezers unlike any normally seen. They were stainless steel and oversized, with temperatures digitally displayed on doors. On each was a list of case numbers, indicating the unidentified people inside.

I opened a door and thick fog rolled out as frigid air bit my face. She was in a pouch, and on a tray, and I put on gown, gloves, face shield, every layer of protection we had. I knew I might already be in trouble, and the thought of Wingo and his vulnerable condition thrilled me with fear as I slid out the pouch and lifted it onto a stainless steel table in the middle of the room. Unzipping black vinyl, I exposed the torso to ambient air, and I went out and unlocked the autopsy suite.

Collecting a scalpel and clean glass slides, I pulled the surgical mask back down over my nose and mouth, and returned to the freezer room, shutting the door. The torso’s outer layer of skin was moist as thawing began, and I used warm, wet towels to speed that along before unroofing vesicles, or the eruptions clustered over her hip and at the ragged margins of the amputations.

With the scalpel, I scraped vesicular beds, and made smears on the slides. I zipped up the pouch, marking it with blaze orange biological hazard tags, almost could not lift the body back up to its frigid shelf, my arms trembling under the strain. There was no one to call for help but Evans, so I managed on my own, and placed more warnings on the door.

I headed upstairs to the third floor, and unlocked a small lab that would have looked like most were it not for various instruments used only in the microscopic study of tissue, or histology. On a counter was a tissue processor, which fixed and dehydrated samples such as liver, kidney, spleen, and then infiltrated them with paraffin. From there the blocks went to the embedding center, and on to the microtome where they were shaved into thin ribbons. The end product was what kept me bent over my microscope downstairs.

While slides air-dried, I rooted around shelves, moving aside stains of bright orange, blue and pink in coplin jars, pulling out Gram’s iodine for bacteria, Oil Red for fat in liver, silver nitrate, Biebrach Scarlet and Acridine Orange, as I thought about Tangier Island, where I’d never had a case before. Nor was there much crime, so I had been told, only drunkenness, which was common with men alone at sea. I thought of blue crab again, and irrationally wished Bev had sold me rock fish or tuna.

Finding the bottle of Nicolaou stain, I dipped in an eye dropper and carefully dripped a tiny amount of the red fluid on each slide, then finished with cover slips. These I secured in a sturdy cardboard folder, and I headed downstairs to my floor. By now, people were beginning to arrive for work, and they gave me odd looks as I came down the hall and boarded the elevator in scrubs, mask and gloves. In my office, Rose was collecting dirty coffee mugs off my desk. She froze at the sight of me.

“Dr. Scarpetta?” she said. “What in the world is going on?”

“I’m not sure, but I hope nothing,” I replied as I sat at my desk and took the cover off my microscope.

She stood in the doorway, watching as I placed a slide on the stage. She knew by my mood, if by nothing else, that something was very wrong.

“What can I do to help,” she said in a grim, quiet way.

The smear on the slide came into focus, magnified four hundred and fifty times, and then I applied a drop of oil. I stared at waves of bright red eosinophilic inclusions within infected epithelial cells, or the cytoplasmic Guarnieri bodies indicative of a pox-type virus. I fitted a Polaroid MicroCam to the microscope, and took instant high-resolution color photographs of what I suspected would have cruelly killed the old woman anyway. Death had given her no humane choice, but had it been me, I would have chosen a gun or a blade.

“Check MCV, see if Phyllis has gotten in,” I said to Rose. “Tell her the sample I sent on Saturday can’t wait.”

Within the hour, Rose had dropped me off at Eleventh and Marshall streets, at the Medical College of Virginia, or MCV, where I had done my forensic pathology residency when I wasn’t much older than the students I now advised and presented gross conferences to throughout the year. Sanger Hall was sixties architecture, with a facade of garish bright blue tiles that could be spotted for miles. I got on an elevator packed with other doctors I knew, and students who feared them.

“Good morning.”

“You, too. Teaching a class?”

I shook my head, surrounded by lab coats. “Need to borrow your TEM.”

“You hear about the autopsy we had downstairs the other day?” a pulmonary specialist said to me as doors parted. “Mineral dust pneumoconiosis. Berylliosis, specifically. How often you ever see that around here?”

On the fifth floor, I walked quickly to the Pathology Electron Microscopy Lab, which housed the only transmission electron microscope, or TEM, in the city. Typically, carts and countertops had not an inch of room to spare, crowded with photo and light microscopes, and other esoteric instruments for analyzing cell sizes, and coating specimens with carbon for X-ray microanalysis.

As a rule, TEM was reserved for the living, most often used in renal biopsies and specific tumors, and viruses rarely, and autopsy specimens almost never. In terms of my ongoing needs and patients already dead, it was difficult to get scientists and physicians very excited when hospital beds were filled with people awaiting word that might grant them a reprieve from a tragic end. So I never prodded microbiologist Dr. Phyllis Crowder into instant action on the occasions I had needed her in the past. She knew this was different.

From the hall, I recognized her British accent as she talked on the phone.

“I know. I understand that,” she was saying as I knocked on the open door. “But you’re either going to have to reschedule or go on without me. Something else has come up.” She smiled, motioning me in.

I had known her during my residency days, and had always believed that kind words from faculty like her had everything to do with why I had come to mind when the chief’s position had opened in Virginia. She was close to my age and had never married, her short hair the same dark gray as her eyes, and she always wore the same gold cross necklace that looked antique. Her parents were American, but she had been born in England, which was where she had trained and worked in her first lab.

“Bloody meetings,” she complained as she got off the phone. “There’s nothing I hate more. People sitting around talking instead of doing.”

She pulled gloves from a box and handed a pair to me. This was followed by a mask.

“There’s an extra lab coat on the back of the door,” she added.

I followed her into the small, dark room, where she had been at work before the phone had rung. Slipping on the lab coat, I found a chair as she peered into a green phosphorescent screen inside the huge viewing chamber. The TEM looked more like an instrument for oceanography or astronomy than a normal microscope. The chamber always reminded me of the dive helmet of a dry suit through which one could see eerie, ghostly images in an iridescent sea.

Through a thick metal cylinder called the scope, running from the chamber to the ceiling, a hundred-thousand-volt beam was striking my specimen, which in this case was liver that had been shaved to a thickness of six or seven one-hundredths of a micron. Smears like the ones I had viewed with my light microscope were simply too thick for the electron beam to pass through.

Knowing this at autopsy, I had fixed liver and spleen sections in glutaraldehyde, which penetrated tissue very rapidly. These I had sent to Crowder, who I knew would eventually have them embedded in plastic and cut on the ultramicrotome, then the diamond knife, before being mounted on a tiny copper grid and stained with uranium and lead ions.

What neither of us had expected was what we were looking at now, as we peered into the chamber at the green shadow of a specimen magnified almost one hundred thousand times. Knobs clicked as she adjusted intensity, contrast and magnification. I looked at DNA double-stranded, brick-shaped virus particles, two hundred to two hundred and fifty nanometers in size. I stared without blinking at smallpox.

“What do you think?” I said, hoping she would prove me wrong.

“Without a doubt, it’s some type of poxvirus,” she hedged her bets. “The question is which one. The fact that the eruptions didn’t follow any nerve pattern. The fact that chicken pox is uncommon in someone this old. The fact that you may now have another case with these same manifestations causes me great concern. Other tests need to be done, but I’d treat this as a medical crisis.” She looked at me. “An international emergency. I’d call CDC.”

“That’s just what I’m going to do,” I replied, swallowing hard.

“What sense do you make of this being associated with a dismembered body?” she asked, making more adjustments as she peered into the chamber.

“I can make no sense of it,” I said, getting up and feeling weak.

“Serial killers here, in Ireland, raping, chopping people up.”

I looked at her.

She sighed. “You ever wish you’d stayed with hospital pathology?”

“The killers you deal with are just harder to see,” I replied.

The only way to get to Tangier Island was by water or air. Since there wasn’t a huge tourist business there, ferries were few and did not run after mid-October. Then one had to drive to Crisfield, Maryland, or in my case, go eighty-five miles to Reedville, where the Coast Guard was to pick me up. I left the office as most people were thinking about lunch. The afternoon was raw, the sky cloudy with a strong cold wind.

I had left instructions for Rose to call the Centers for Disease Control and Prevention (CDC) in Atlanta, because every time I had tried, I was put on hold. She was also to reach Marino and Wesley and let them know where I was going and that I would call as soon as I could. I took 64 East to 360, and soon found myself in farmland.

Fields were brown with fallow corn, hawks dipping and soaring in a part of the world where Baptist churches had names like Faith, Victory and Zion. Trees wore kudzu like chain mail, and across the Rappahannock River, in the Northern Neck, homes were sprawling old manors that the present-generation owner couldn’t afford anymore. I passed more fields and crepe myrtles, and then the Northumberland Courthouse that had been built before the Civil War.

In Heathsville were cemeteries with plastic flowers and cared-for plots, and an occasional painted anchor in a yard. I turned off through woods dense with pines, passing cornfields so close to the narrow road, I could have reached out my window to touch brown stalks. At Buzzard’s Point Marina, sailboats were moored and the red, white and blue tour boat, Chesapeake Breeze, was going nowhere until spring. I had no trouble parking, and there was no one in the ticket booth to ask me for a dime.

Waiting for me at the dock was a white Coast Guard boat. Guardsmen wore bright orange and blue antiexposure coveralls, known as mustang suits, and one of the men was climbing up on the pier. He was more senior than the others, with dark eyes and hair, and a nine-millimeter Beretta on his hip.

“Dr. Scarpetta?” He carried his authority easily, but it was there.

“Yes,” I said, and I had several bags, including a heavy hard case containing my microscope and MicroCam.

“Let me help with those.” He held out his hand. “I’m Ron Martinez, the station chief at Crisfield.”

“Thanks. I really appreciate this,” I said.

“Hey, so do we.”

The gap between the pier and the forty-foot patrol boat yawned and narrowed as the surge pushed the boat against the pier. Grabbing the rail, I boarded. Martinez went down a steep ladder, and I followed him into a hold packed with rescue equipment, fire hoses and huge coils of rope, the air heavy with diesel fumes. He tucked my belongings in a secure spot and tied them down. Then he handed me a mustang suit, life vest and gloves.

“You’re going to need to put these on, in case you go in. Not a pretty thought but it can happen. The water’s maybe in the fifties.” His eyes lingered on me. “You might want to stay down here,” he added as the boat knocked against the pier.

“I don’t get seasick but I am claustrophobic,” I told him as I sat on a narrow ledge and took off my boots.

“Wherever you want, but it’s gonna be rough.”

He climbed back up as I began struggling into the suit, which was an exercise in zippers and Velcro, and filled with polyvinyl chloride to keep me alive a little longer should the boat capsize. I put my boots back on, then the life vest, with its knife and whistle, signal mirror and flares. I climbed back up to the cabin because there was no way I was going to stay down there. The crew shut the engine cover on deck, and Martinez strapped himself into the pilot’s chair.

“Wind’s blowing out of the northwest at twenty-two knots,” a guardsman said. “Waves cresting at four feet.”

Martinez began pulling away from the pier. “That’s the problem with the bay,” he said to me. “The waves are too close together so you never get a good rhythm like you do at sea. I’m sure you’re aware that we could get diverted. There’s no other patrol boat out, so something goes down out here, there’s no one but us.”

We began slowly passing old homes with widow’s walks and bowling greens.

“Someone needs rescuing, we got to go,” he went on as a member of the crew checked instruments.

I watched a fishing boat go past, an old man in hip-high boots standing as he steered the outboard motor. He stared at us as if we were poison.

“So you could end up on anything.” Martinez enjoyed making this point.

“It wouldn’t be the first time,” I said as I began to detect a very revolting smell.

“But one way or another, we’ll get you there, like we did the other doctor. Never did get his name. How long have you worked for him?”

“Dr. Hoyt and I go way back,” I said blandly.

Ahead were rusting fisheries with rising smoke, and as we got close I could see moving conveyor belts tilted steeply toward the sky, carrying millions of menhaden in to be processed for fertilizer and oil. Gulls circled and waited greedily from pilings, watching the tiny, stinking fish go by as we passed other factories that were ruins of brick crumbling into the creek. The stench now was unbearable, and I was certainly more stoical than most.

“Cat food,” a guardsman said, making a face.

“Talk about cat breath.”

“No way I’d live around here.”

“Fish oil’s real valuable. The Algonquin Indians used cogies to fertilize their corn.”

“What the hell’s a cogy?” Martinez asked.

“Another name for those nasty little suckers. Where’d you go to school?”

“Doesn’t matter. Least I don’t got to smell that for a living. Unless I’m out here with schleps like you.”

“What the hell’s a schlep?”

The banter continued as Martinez pushed the throttle up more, engines rumbling, bow dipping. We sailed by duck blinds and floats marking crab pots as rainbows followed in the spray of our wake. He pushed the speed up to twenty-three knots and we cut into the deep blue water of the bay, where no pleasure boats were out this day, only an ocean liner a dark mountain on the horizon.

“How far is it?” I asked Martinez, hanging on to the back of his chair, and grateful for my suit.

“Eighteen miles total.” He raised his voice, riding waves like a surfer, sliding in sideways and over, his eyes always ahead. “Ordinarily, it wouldn’t take long. But this is worse than usual. A lot worse, really.”

His crew continued checking depth and direction detectors as the GPS pointed the way by satellite. I could see nothing but water now, moguls rising in front, and behind, waves clapping hard like hands as the bay attacked us from all sides.

“What can you tell me about where we’re going?” I almost had to shout.

“Population of about seven hundred. Until about twenty years ago they generated their own electricity, got one small airstrip made of dredge material. Damn.” The boat slammed down hard in a trough. “Almost broached that one. That’ll turn you over in a flash.”

His face was intense as he rode the bay like a bronco, his crewmen unfazed but alert as they held on to whatever they could.

“Economy’s based on blue crabs, soft-shell crabs, ship ’em all over the country,” Martinez went on. “In fact, rich folks fly private planes in all the time just to buy crabs.”

“Or that’s what they say they’re buying,” someone remarked.

“We do have a problem with drunkenness, bootlegging, drugs,” Martinez went on. “We board their boats when we’re checking for life jackets, doing drug interdictions, and they call it being overhauled.” He smiled at me.

“Yeah, and we’re the guards,” a guardsman quipped. “Look out, here come the guards.”

“They use language any way they want,” Martinez said, rolling over another wave. “You may have a problem understanding them.”

“When does crab season end?” I asked, and I was more concerned about what was being exported than I was about the way Tangiermen talked.

“This time of year they’re dredging, dragging the bottom for crabs. They’ll do that all winter, working fourteen, fifteen hours a day, sometimes gone a week at a time.”

Starboard, in the distance, a dark hulk protruded from the water like a whale. A crewman caught me looking.

“World War Two Liberty ship that ran aground,” he said. “Navy uses it for target practice.”

At last, we were slowing as we approached the western shore, where a bulkhead had been built of rocks, shattered boats, rusting refrigerators, cars and other junk, to stop the island from eroding more. Land was almost level with the bay, only feet above sea level at its highest ground. Homes, a church steeple and a blue water tower were proud on the horizon on this tiny, barren island where people endured the worst weather with the least beneath their feet.

We chugged slowly past marshes and tidal flats. Old gap-toothed piers were piled high with crab pots made of chicken wire and strung with colored floats, and battle-scarred wooden boats with round and boxy sterns were moored but not idle. Martinez whelped his horn, and the sound ripped the air as we came through. Tangiermen with bibs turned expressionless, raw faces on us, the way people do when they have private opinions that aren’t always friendly. They moved about in their crab shanties and worked on their nets as we docked near fuel pumps.

“Like most everybody else here, the chief’s name is Crockett,” Martinez said as his crew tied us down. “Davy Crockett. Don’t laugh.” His eyes searched the pier and a snack bar that didn’t look open this time of year. “Come on.”

I followed him out of the boat, and wind blowing off the water felt as cold as January. We hadn’t gone far when a small pickup truck quickly rounded a corner, tires loud on gravel. It stopped, and a tense young man got out. His uniform was blue jeans, a dark winter jacket and a cap that said Tangier Police, and his eyes darted back and forth between Martinez and me. He stared at what I was carrying.

“Okay,” Martinez said to me. “I’ll leave you with Davy.” To Crockett, he added, “This is Dr. Scarpetta.”

Crockett nodded. “Y’all come on.”

“It’s just the lady who’s going.”

“I’ll ride you to there.”

I had heard his dialect before in unspoiled mountain coves where people really are not of this century.

“We’ll be waiting for you here,” Martinez promised me, walking off to his boat.

I followed Crockett to his truck. I could tell he cleaned it inside and out maybe once a day, and liked Armor All even more than Marino did.

“I assume you’ve been inside the house,” I said to him as he cranked the engine.

“I haven’t. Was a neighbor that did. And when I was noticed about it, I called for Norfolk.”

He began to back up, a pewter cross swinging from the key chain. I looked out the window at small white frame restaurants with hand-painted signs and plastic sea gulls hanging in windows. A truck hauling crab pots was coming the other way and had to pull over to let us pass. People were out on bicycles that had neither hand brakes nor gears, and the favorite mode of travel seemed to be scooters.

“What is the decedent’s name?” I began taking notes.

“Lila Pruitt,” he said, unmindful that my door was almost touching someone’s chain link fence. “Widder lady, don’t know how aged. Sold receipts for the tourists. Crab cakes and things.”

I wrote this down, not sure what he was saying as he drove me past the Tangier Combined School, and a cemetery. Headstones leaned every way, as if they had been caught in a gale.

“What about when she was last seen alive?” I asked.

“In Daby’s, she was.” He nodded. “Oh, maybe June.”

Now I was hopelessly lost. “I’m sorry,” I said. “She was last seen in some place called Daby’s way back in June?”

“Yes’em.” He nodded as if this made all the sense in the world.

“What is Daby’s and who saw her there?”

“The store. Daby’s and Son. I can get you to it.” He shot me a look, and I shook my head. “I was in it for shopping and saw her. June, I think.”

His strange syllables and cadences sprung, tongued and rolled over each other like the water of his world. There was thur, can’t was cain’t, things was thoings, do was doie.

“What about her neighbors? Have any of them seen her?” I asked.

“Not since days.”

“Then who found her?” I asked.

“No one did.”

I looked at him in despair.

“Just Mrs. Bradshaw come in for a receipt, went on in and had the smell.”

“Did this Mrs. Bradshaw go upstairs?”

“Said she not.” He shook his head. “She went on straight for me.”

“The decedent’s address?”

“Where we are.” He was slowing down. “School Street.”

Catty-corner to Swain Memorial Methodist Church, the white clapboard house was two stories, with clothes still on the line and a purple martin house on a rusting pole in back. An old wooden rowboat and crab pots were in a yard scattered with oyster shells, and brown hydrangea lined a fence where there was a curious row of white-painted cubbyholes facing the unpaved street.

“What are those?” I asked Crockett.

“For where she sold receipts. Quarter each. Drop it in a slot.” He pointed. “Mrs. Pruitt didn’t do direct much with no one.”

I finally realized that he was talking about recipes, and pulled up my door handle.

“I’ll here be waiting,” he said.

The expression on his face begged me not to ask him to go inside that house.

“Just keep people away.” I got out of his truck.

“Don’t have to worrisome about that none.”

I glanced around at other small homes and trailers in their sandy-soil yards. Some had family plots, the dead buried wherever there was high ground, headstones worn smooth like chalk and tilted or knocked down. I climbed Lila Pruitt’s front steps, noticing more headstones in the shadows of junipers in a corner of her yard.

The screen door was rusting in spots, and the spring protested loudly as I entered an enclosed porch sloping toward the street. There was a glider upholstered in floral plastic, and beside it a small plastic table, where I imagined her rocking and drinking iced tea while she watched tourists buying her recipes for a quarter. I wondered if she had spied to make sure they paid.

The storm door was unlocked, and Hoyt had thought to tape on it a homemade sign that warned: SICKNESS: DO NOT ENTER!! I supposed he had figured that Tangiermen might not know what a biological hazard was, but he had made his point. I stepped inside a dim foyer, where a portrait of Jesus praying to His Father hung on the wall, and I smelled the foul odor of decomposing human flesh.

In the living room was evidence that someone had not been well for a while. Pillows and blankets were disarrayed and soiled on the couch, and on the coffee table were tissues, a thermometer, bottles of aspirin, liniment, dirty cups and plates. She had been feverish. She had ached, and had come in here to make herself comfortable and watch TV.

Eventually, she had not been able to make it out of bed, and that was where I found her, in a room upstairs with rosebud wallpaper and a rocker by the window overlooking her street. The full-length mirror was shrouded with a sheet, as if she could not bear to see her reflection anymore. Hoyt, old-world physician that he was, had respectfully pulled bed covers over the body without disturbing anything else. He knew better than to rearrange a scene, especially if his visit was to be followed by mine. I stood in the middle of the room, and took my time. The stench seemed to make the walls close in and turn the air black.

My eyes wandered over the cheap brush and comb on the dresser, the fuzzy pink slippers beneath a chair that was covered with clothes she hadn’t had the energy to put away or wash. On the bedside table was a Bible with a black leather cover that was dried out and flaking, and a sample size of Vita aromatherapy facial spray that I imagined she had used in vain to cool her raging fever. Stacked on the floor were dozens of mail-order catalogues, page corners folded back to mark her wishes.

In the bathroom, the mirror over the sink had been covered with a towel, and other towels on the linoleum floor were soiled and bloody. She had run out of toilet paper, and the box of baking soda on the side of the tub told me she had tried her own remedy in her bath to relieve her misery. Inside the medicine cabinet, I found no prescription drugs, only old dental floss, Jergens, hemorrhoid preparations, first-aid cream. Her dentures were in a plastic box on the sink.

Pruitt had been old and alone, with very little money, and probably had been off this island few times in her life. I expected that she had not attempted to seek help from any of her neighbors because she had no phone, and had feared that if anyone had seen her, they would have fled in horror. Even I wasn’t quite prepared for what I saw when I peeled back the covers.

She was covered in pustules, gray and hard like pearls, her toothless mouth caved in, and dyed red hair wild. I pulled the covers down more, unbuttoning her gown, noting the density of eruptions was greater on her extremities and face than on her trunk, just as Hoyt had said. Itching had driven her to claw her arms and legs, where she had bled and gotten secondary infections that were crusty and swollen.

“God help you,” I muttered in pain.

I imagined her itching, aching, burning up with fever, and afraid of her own nightmarish image in the mirror.

“How awful,” I said, and my mother flashed in my mind.

Lancing a pustule, I smeared a slide, then went down to the kitchen and set my microscope on the table. I was already convinced of what I’d find. This was not chicken pox. It wasn’t shingles. All indicators pointed to the devastating, disfiguring disease variola major, more commonly known as smallpox. Turning on my microscope, I put the slide on the stage, bumped magnification up to four hundred, adjusted the focus as the dense center, the cytoplasmic Guarnieri bodies, came into view. I took more Polaroids of something that could not be true.

Shoving back the chair, I began pacing as a clock ticked loudly from the wall.

“How did you get this? How?” I talked to her out loud.

I went back outside to where Crockett was parked on the street. I didn’t get close to his truck.

“We’ve got a real problem,” I said to him. “And I’m not a hundred percent sure what I’m going to do about it.”

My immediate difficulty was finding a secure phone, which I finally decided simply was not possible. I couldn’t call from any of the local businesses, certainly not from the neighbors’ houses or from the chief’s trailer. That left my portable cellular phone, which ordinarily I would never have used to make a call like this. But I did not see that I had a choice. At three-fifteen, a woman answered the phone at the U.S. Army Medical Research Institute of Infectious Diseases, or USAMRIID, at Fort Detrick, in Frederick, Maryland.

“I need to speak with Colonel Fujitsubo,” I said.

“I’m sorry, he’s in a meeting.”

“It’s very important.”

“Ma’am, you’ll have to call back tomorrow.”

“At least give me his assistant, his secretary . . .”

“In case you haven’t heard, all nonessential federal employees are on furlough . . .”

“Jesus Christ!” I exclaimed in frustration. “I’m stranded on an island with an infectious dead body. There may be some sort of outbreak here. Don’t tell me I have to wait until your goddamn furlough ends!”

“Excuse me?”

I could hear telephones ringing nonstop in the background.

“I’m on a cellular phone. The battery could die any minute. For God’s sake, interrupt his meeting! Patch me through to him! Now!”

Fujitsubo was in the Russell Building on Capitol Hill, where my call was connected. I knew he was in some senator’s office but did not care as I quickly explained the situation, trying to control my panic.

“That’s impossible,” he said. “You’re sure it’s not chicken pox, measles . . .”

“No. And regardless of what it is, it should be contained, John. I can’t send this into my morgue. You’ve got to handle it.”

USAMRIID was the major medical research laboratory for the U.S. Biological Defense Research Program, its purpose to protect citizens from the possible threat of biological warfare. More to the point, USAMRIID had the largest Bio Level 4 containment laboratory in the country.

“Can’t do it unless it’s terrorism,” Fujitsubo said to me. “Outbreaks go to CDC. Sounds like that’s who you need to be talking to.”

“And I’m sure I will be, eventually,” I said. “And I’m sure most of them have been furloughed, too, which is why I couldn’t get through earlier. But they’re in Atlanta, and you’re in Maryland, not far from here, and I need to get this body out of here as fast as I can.”

He was silent.

“No one hopes I’m wrong more than I do,” I went on in a cold sweat. “But if I’m not and we haven’t taken the proper precautions . . .”

“I’m clear, I’m clear,” he quickly said. “Damn. Right now we’re a skeleton crew. Okay, give us a few hours. I’ll call CDC. We’ll deploy a team. When was the last time you were vaccinated for smallpox?”

“When I was too young to remember it.”

“You’re coming in with the body.”

“She’s my case.”

But I knew what he meant. They would want to quarantine me.

“Let’s just get her off the island, and we’ll worry about other things later,” I added.

“Where will you be?”

“Her house is in the center of town, near the school.”

“God, that’s unfortunate. We got any idea how many people might have been exposed?”

“No idea. Listen. There’s a tidal creek nearby. Look for that and the Methodist church. It has a tall steeple. According to the map there’s another church, but it doesn’t have a steeple. There’s an airstrip, but the closer you can get to the house, the better, so we don’t have to carry her past where people might see.”