This section of the story takes place over a long, cold winter. Lifelong Vancouverites tolerated snow once a year as long as the rains flushed it away by nightfall. This year, the first of several snowfalls came over three days in late November, the flakes thick like candlewax, and stuck to the ground. In the evenings that followed it turned to ice in sub-zero temperatures before being recoated in snow. As usual, cars fishtailed on the road. Reactions to the weather were even more drastic than usual. Sidewalks went unshovelled. Road salt became scarce. People no longer took pleasure in venting about the city’s inadequate road-clearing strategies. Some welcomed the snow as another excuse to remain housebound. They saw the cold as a disease killer and only wished it was colder. Others took it in stride as yet another burden to carry.
The death toll rose sharply as Vancouverites neared the end of the first month of quarantine. There were fifteen and then twenty-five recorded deaths in the first two weeks of the quarantine. By its fifth week, as we entered the first week of December, there were a hundred and twelve deaths. None of these figures were available at the time to the general public, as officials obfuscated and hedged. But we became aware of the steep rise in fatalities by the numbers of friends of friends, then friends, who began to display symptoms. We noticed the silence of acquaintances who were otherwise vocal on social media. New faces ran our scant groceries through the register.
People who were admitted to the hospital were placed in a special unit that became, by the end of that first month, overwhelmed and crowded. They were treated by nurses and doctors in full-body protective gear. Reports about the drastic procedures in place to contain the disease frightened many locals, even when they didn’t exhibit symptoms. Those who were admitted to the hospital were isolated. Asymptomatic Vancouverites who shared homes with patients infected with the disease were told to remain housebound for a week until they were in the clear.
Authorities, including Dr Bernard Rieux’s friend Dr Orla Castello, did not know what to make of this outbreak and took extreme measures. If they knew the rate at which infection would spread, they might not have been so scrupulous. Having read articles about the efficiency of quarantine, Rieux decided that any effort to seal plague patients from the outside world was ineffective and a violation of personal freedom. He did not share this opinion widely, but perhaps it was revealed in his manner. To outsiders, he seemed aloof and awkward but also independent-minded. Perhaps this explained why he found himself paying unofficial house calls.
The first request came from Megan Tso. Rieux was brushing his teeth before bed when his phone rang. “You’re the only person I could think of,” she told him. She was calling on behalf of a friend whose father had been feeling unwell.
Rieux later admitted that he found Tso amusing. On the phone, he merely grunted and asked for the patient’s address. He told his mother that he was seeing a patient (without mentioning she was the woman from the airport). He got dressed, slipped on a pair of hiking boots, and walked thirty minutes through another flurry. The fresh powder provided traction on the unshovelled sidewalks and icy patches along the side streets. With road salt in short supply, people had begun stealing beach sand to line the roads.
Tso, shivering in a black leather jacket, was waiting for him outside the door of an older house next to a papered-over storefront. She led him to the ground-floor suite where Isaac “Izzy” Grossman lived. The old man wore a bathrobe and lay on a lime-green tweed couch. Tso introduced Rieux to him and to his daughter Janice. Izzy looked at Rieux, who was preoccupied with his gloves and face mask, and then to his daughter. He groaned as he planted one foot on the chipped hardwood floor, then the other, exposing his genitalia.
Rieux discussed Mr Grossman’s symptoms with his daughter. He’d been weak and feverish since the morning and said that he was tired. Janice Grossman called Tso when her father began to spit up blood. “He needs to go to the hospital and get put on antibiotics,” Rieux said. “They haven’t proven as effective as usual. But the chances that he will die without them are near certain.”
Mr Grossman shook his head. “It’s a butcher shop there,” he croaked.
“There must be another way,” Tso suggested. “Can we just get the antibiotics from the drug store and give them to him?”
Rieux shook his head. “He has to be monitored closely.”
“We can do that,” Grossman insisted. “I’m out of work. What else am I going to do? Please, doctor. There’s a reason why we called you.”
Rieux said he would wait until the ambulance arrived. When he saw the red lights of the vehicle outside, Mr Grossman began to weep. His daughter was in his bedroom, opening drawers and closets in a flurry of motion in an attempt to gather his things. Mr Grossman dropped to the floor in a fetal position. Two paramedics, dressed from head to toe in protective gear, picked him up under each arm, lifted him onto a stretcher, and carried him out the door. Rieux identified himself to one paramedic, whose eyes seemed small within an oversized face mask, and offered a rundown of Mr Grossman’s symptoms.
When Janice Grossman followed Rieux with some of her father’s possessions in a reusable shopping bag, Izzy raised his arm.
“Don’t come with me,” Mr Grossman told her. “Don’t visit me.”
She became immobile. Was he upset at her? Was he trying to save her? Rieux could not tell. Grossman looked to her friend. “Of course you should go,” Tso told her. She took her by the arm and hurried her in the direction of the ambulance. Rieux moved ahead of them. From the door, he yelled at one of the paramedics to wait for her.
Rieux and Tso stood in the snow and watched the ambulance disappear. After some careful hand washing with the sanitizer he brought with him, Rieux exchanged his mask for a toque. Tso was already wearing her jacket as she held open the door. She thanked him for coming on short notice. “Which way are you going?” she asked.
He pointed in one direction; she was going in the other. She’d walk with him anyhow. Under a streetlight, he noticed the freckles on her nose and her wide cheekbones. She seemed to him like someone who was tired of being pretty, who downplayed her looks—an attitude and behaviour that served as an erotic dog whistle to a particular kind of person. “I’ve got nothing better to do,” she said. “It’s funny how time works. We’re all worried about our lives being dramatically shortened, but in the meanwhile, we just wait, playing video games.”
“I wish I could take a break,” he said.
“But you’re not someone who takes vacations, am I right?”
“Not true,” he blurted out. “My wife and I cycled through the Swiss Alps two years ago. The year before that we hiked the West Coast Trail.”
She laughed. “How many calories did you burn?”
Along Main Street, there seemed to be more people but less traffic than usual at this time of night. Some businesses had posted signs apologizing, in neighbourly language, for temporarily closing. Others kept their doors open, despite a lack of customer interest or inventory, to maintain normalcy. They passed a sandwich board outside one restaurant that had this message written in chalk: “We still have wine (for now). Come inside!”
Tso offered to buy Rieux a glass of wine, and he hesitated only for a moment before he followed her inside. The restaurant was full of people still wearing jackets, the ice half-melted on their boots, and the music evoked his idea of a European discotheque in the 1970s. The server, a tall, tanned woman in latex gloves, recognized Tso, who shrieked in surprise and asked her about her massage school training. After they finished chatting, she handed them menus and wine lists with items struck out with black marker. His eyes were drawn to the black lines. The missing text looked like classified information. “I’m sorry,” the server, whom Tso introduced as Gudrun, told her. “But we ran out of the tempranillo yesterday.”
“Are you picky about red wine?” Tso asked Rieux. He shook his head. She looked relieved. Tso picked one of the remaining wines and the waitress took their menus.
“Do you come to Vancouver often?” he asked her. “How do you know everyone?”
She told him it was only her second visit to the city. “I don’t know anyone here. I met Janice when I arrived a month ago. She’s become my Vancouver sister—or daughter. And the waitress, I met her the other day—it’s a long story. She didn’t even tell me she worked here.” The server brought a half-carafe of wine and two glasses. Tso poured. “It’s actually easy to make friends. We’re all going through something momentous and unique. I have no one here who I know well, who understands. I’ve chatted with my aunt and my friends back home, but it’s stilted. They don’t know what’s going on in this place, and I can’t describe it to them.”
“It’s easy to make friends when strangers want to talk to you,” he told her. He regretted that his statement sounded like an accusation. He was tired and would have blown off Tso’s request if it had come from anyone else, but her charisma compelled him, in part, because it was the inverse of his. Even as a child, he couldn’t make friends, and in university did his lab projects un-partnered. He compensated by joining clubs and playing team sports. He became a general practitioner, not a researcher—a better fit for his solitary temperament and idealism—so he could have the chance to speak to people. “It’s a talent I don’t have,” he admitted.
“It can be a curse,” she told him. “You’re always promising people—without even promising them—more than you can deliver.” She made so much eye contact, it felt like she was showing off.
“But people beg me to make promises—to predict outcomes, to give assurances,” he said, turning to his glass. He downed the wine in a gulp. “At least that’s how it is in my line of work.”
“Are you worried you’ll get sick?” she asked.
He shrugged. “I take every precaution. If I get sick, it will be because I am doing my work.” Her attention drifted to the candle between them, which allowed him to continue thinking through her question. “I see patients, good people who have led healthy lives, fall ill for no reason other than genetics or bad luck. Dropping dead during this quarantine would at least serve some purpose.”
“I’m not worried about dying. I wrote a book about it—”
“I haven’t read it. Sorry.”
“I’m not book-shaming you. The gist of the book was, dying gives life meaning. We clear space and feed the earth when we pass on.”
“That’s common sense,” he blurted out, then realized how rude he sounded. “Sorry, that didn’t—”
“The wine’s really gotten to your head,” she told him, pouring the rest of the carafe into his glass. “Yes, you’re right, the book doesn’t reshape the history of thought. But what I was trying to do was shift, in a small way, our collective mindsets. I told readers to start planning their funerals in their thirties, not when they’re in their eighties and on their deathbeds. I wanted them to think about the people they leave behind—family, friends—as a gift.”
“So you’re in good shape for this epidemic?” he asked her.
“No way. Death I can handle, but being sick frightens me. Not having family or anyone who knows me well enough to call a good friend, should I fall mortally ill, scares me. I figure Janice is my only lifeline.”
When they’d finished their wine, Rieux paid the bill, despite Tso’s protest, and then waited with her until she got into a cab. He didn’t remember his walk home but woke up in bed with his hiking boots on. He clomped into the bathroom and vomited. In a panic, he took his own temperature and concluded he was only hungover (without having had much to drink). Remorse washed over him, a feeling that exceeded anything he did or admitted to feeling. In the churning of regret, he was possessed by a need to speak to Elyse. He tried the number she’d given him, but the call didn’t go through because he hadn’t used the proper country code. When he got a recorded message asking him to try again, he didn’t bother to search for the correct number. Instead he dialled the clinic and told the receptionist he was feeling unwell.
Rieux left the house to sidestep his concerned mother. He took his bike out but was forced to choose the roads carefully. A patch of black ice would further strain the medical system. He stopped on Broadway to chug a bottle of water and find something to eat. His ambitions that day were to expend some physical energy. He hoped to ride to the university and back. While in line for his bagel, he received a text from Castello. She wanted to see him at the hospital. “I’m calling in a favour,” she wrote. “Actually, I am calling in two.”
They had not spoken since her tirade of frantic messages. Rieux replied that he was on his way. The day had opened up like one extended airport layover as soon as he called in sick, so he was relieved by Castello’s invitation. He biked along the Seawall, a ride made easier by the absence of tourists, enjoying the burn of the frosty air on his cheeks.
Castello waited outside the doors of the auxiliary hospital—a wing of the unfinished medical centre that would replace St. Paul’s Hospital the next year—reserved for patients with the disease. She had a new blunter hairstyle and was wearing makeup. She swiped Rieux in and led him to a room where they both changed into protective clothing. “We are short-staffed in the auxiliary hospital,” she told him. “You used to work a day a week in the lung clinic. I was wondering whether I could convince you to work here for a couple of shifts.”
She knew he would be curious. And she knew that he never declined her requests. “Someone I know was admitted yesterday,” he told her. “May I visit him?”
Castello pointed at a nurse behind the desk who asked for the patient’s name. “His last name is Grossman,” he told her. “I don’t know his first name. He would be in his sixties. He was admitted last night.”
The nurse turned to her screen and leaned into it. “There was an Isaac Grossman who passed away last night, two hours after he was admitted. But he was eighty-five years old.”
Perhaps he was young-looking for his age, thought Rieux. It seemed unlikely that two people with that name would come in at the same time. His bloody coughing was, in retrospect, a terminal event, a flag of surrender from betrayed lungs.
“Sorry,” Castello said. “Come with me. You should take a look at what we have here.”
There was a range of suffering here, from those moaning listlessly in agony—fresh admittees—to those who looked content in their disease-racked repose. Castello and Rieux visited the bed of a fifty-one-year-old man who had been one of the first people admitted for the bubonic version of the disease. Within the first day, he had developed disseminated intravascular coagulation—a clotting of the blood followed by organ failure—and was placed in an induced coma. His legs became gangrenous and needed to be amputated.
“He woke up for the first time yesterday and asked the nurse to scratch his toes,” Castello said, her dry laugh like a snare beat.
The patient was sleeping. He had the kind of handsome, imperious face that one saw immortalized in stone, on horseback, in a European capital—possibly he was a banker or lawyer. He needed a shave and for someone to run a comb through his silver hair. But this man was one of the lucky ones. The odds of dying of the disease were comparable to winning the lottery; so were the odds of surviving it. He was intact—more or less—and soon he would be transferred to another wing in the hospital for rehabilitation.
“He doesn’t look like somebody who should be sick, am I right?” Castello asked. “The disease can strike anybody, but he looks like someone who gets all the breaks in life.”
“I don’t believe in eugenics,” Rieux said. “But I see what you mean.”
“Victor thinks his DNA makes him invincible,” Castello said. “Do you know that my surname is the Italian word for castle?”
“I didn’t, but it makes sense,” Rieux replied.
“Victor’s family comes from a town two hundred kilometres from Florence. The other day he told me that he’s descended from plague survivors. He was bragging. He believes that people with Southern European ancestry have genes that will protect them from this new outbreak.”
“I’m glad you’re talking to him again,” he told her. “His views were always … provocative.”
“It’s not entirely fun,” she said. “But we still have our secret language. It gets tiring to ask questions no one else can answer.”
Rieux offered himself for shifts in the auxiliary hospital whenever they didn’t conflict with his duties at the clinic. He dreaded his evenings alone with his mother even as he regretted neglecting her.
“I have one more request,” Castello said as they removed their protective gear and washed their hands. “This one is more personal.”
The man responsible for her son’s death would be having a parole hearing later that week. Castello would be giving a victim’s impact statement. Her lawyer had asked for a delay in the hearing given her high-profile role in the disease resistance efforts, but to delay his hearing would affect the killer’s rights. She wanted Rieux to attend. “Victor will be there, if you can’t make it,” she told him. “But even when we were happily married, he was never someone I could lean on.”
Rieux knew he would say yes. Castello rarely used to make requests. Now they seemed to burst forth, urgent and irate. He’d thought that, at this point, she would mention the barrage of phone calls and text messages she’d sent him, but then it occurred to him that she might not remember them. “It’s much easier for me to administer an injection or set a broken bone,” he said. “Why do you ask me to do such hard things?”
“The answer is so obvious, I feel stupid saying it,” she said. She had removed all the protective gear except for a face mask. “Because you live to help.”