35,000 Feet Above the South Indian Ocean
November 11, 12:09 P.M., South Africa Standard Time
To Dr. Amy Howard, the South African A330-200 Airbus was a long, lovely whisper that forced her to leave her laboratory.
Four times a year, the forty-three-year-old endocrinologist flew from the O’Connell Research Lab at the University of Cape Town to the Australian Endocrine Center at the University of Notre Dame in Perth.
At present, the two scientific research facilities were working on enhanced forms of radioactive iodine for treatment of a hyperactive thyroid. The pharmaceutical firm EndoXX had not only given them a five-year grant, they insisted on face-to-face meetings to keep key research secure. The firm had two mottos. The official one was “Everything for Wellness.” The unofficial one was “Everything Important Stays Off-line.”
That was fine with Dr. Howard. EndoXX’s security concerns furnished her with something that passed for a social life. Her career, her life, was about finding new ways to heal “that bloody gland.” Thyroid cancer had taken her mother when she was ten.
The flight had departed three hours late, forty-five minutes earlier, and Dr. Howard had done exactly nothing but sit in the plastic bucket seat in the terminal and now on the comfortably padded cushion here. The business-class seating was quite roomy, the aisle to her left was spacious, and the big, balding man to her right was quietly watching a movie on his tablet. There was a lot of red and strobing white lights coming from the screen. A pillow, firmly but casually tucked against the armrest, blocked most of it.
The visual busyness did not bother her, much. The man was happy. Every now and then he would talk to the screen. He fidgeted several times with the shade, seeking the precise position to cut down glare without blocking his view of the sea. At this time of year sunlight was full and blazing from before 4:30 A.M. until well after 8:00 P.M. Securing some comfortable darkness was always a challenge.
Once in a while the man snuck a look in her direction, as if to make sure he wasn’t bothering her. He needn’t have worried. As someone who saw fatal cancers every week, she had learned not to let little intrusions bother her. Besides, a seat in a packed aircraft was the price of doing what made her happy. Amy was looking forward to spending time with Dr. Maggie Mui, a Hong Kong expatriate who had become a good friend. Amy was short, thin, and long-divorced. Maggie was tall, athletic, and had a husband and young daughter. Though neither woman acknowledged it, each was doing her own empirical study as to who was the happiest.
Once an analytical medical professional, always an analytical medical professional, she thought.
Beyond the man, outside the now half-shaded window, Amy saw an untextured wall of blue that occasionally glistened with fleeting fireflies of sun. There were also occasional flourishes of distant thunder from somewhere nearer Antarctica. It always astounded her to think that a century ago, explorers used to claw across the surface of the South Pole, freezing and hungry, both nearly to death.
And I’m sitting here with a laptop, an empty bag of peanuts, and a Perrier—
Thinking of the laptop made her feel she should finally be working. Dr. Howard was a few days behind on the latest research and she reached for her carrying case under the seat—
The man in the seat beside Amy coughed suddenly and violently. It was so strong that he doubled over his seat belt and hit his forehead on the seat in front of him. His earbuds went flying and Amy could hear tinny screams coming from the tablet.
She turned to the man as he inflated slowly, like a Thanksgiving parade balloon.
There were other hacking coughs behind her, here and there. She suddenly felt a tickle deep in her chest, like the sudden onset of flu. She cleared her throat. The tickling worsened.
No sooner had Amy’s neighbor started to settle back than a second cough threw him forward again. This time he speckled the seat back with blood.
Amy immediately scooched toward the aisle-side armrest in case there was another spray of blood.
“Sorry—sorry—” the man said in a thick New Zealand accent.
“Don’t worry, I’m a doctor.” She handed him the small bottle of Perrier. “Drink this. I’ll inform the flight attendant. We have to get you back on the ground.”
Dr. Howard leaned into the aisle and looked for a flight attendant. No one was about. She felt a tickle in her throat. Dry, recycled airplane air, she decided.
Unbuckling her belt, she rose—just as the tickle became a burning in her gut. She gripped the back of the seat in front of her as the pain intensified rapidly, hotter and more fiercely unsettled than indigestion. It rose swiftly up her throat and blew toward her mouth, causing a violent contraction of her neck muscles. She coughed, an eruption that brought blood and what felt like phlegm to the back of her mouth.
Her mind raced even as her body struggled.
The peanuts? Contaminated beverages? Toxic air circulation? A Typhoid Mary onboard?
Amy leaned her chest against the seat back, swallowing and trying to rally. In the dim light of the cabin she saw that she was the only one standing. As she sought to move into the aisle, the plane suddenly shuddered and dipped forward slightly. She fell against and slightly over the seat back. Below her, a young man was coughing hard into his hand.
“Christ!” he cried as he drew bloody fingers from his mouth.
Beside him, a woman was hacking up blood.
The plane righted itself and the intercom came on. There was no message, only coughing and an aborted attempt by a flight attendant to advise the fastening of seat belts.
Almost at once the plane nosed down again, steeper than before and this time without recovering. There were screams now, interspersed with the coughs. Amy barely heard them as another fire rose in her esophagus. She could feel the inside flesh burning, blistering—dissolving? Was that even possible?
The woman’s knees folded. She fell to the floor between her seat and the one in front of it, landing scrunched in a fetal position. Her head flopped back as she coughed up blood in waves. It plumed up then came down on her face, spilled down her chin. Looking straight up, she saw the big man beside her bent over the armrest, retching.
In the glow of his tablet she saw that it wasn’t dinner her companion was spewing. It was him. His insides. His eyes were globes, and if the man’s airway had been cleared he might have screamed. So would she, but the heat rose again, bringing more than fire. Her throat and nasal passages were both clogged with a substance, thicker than blood and more metallic-tasting. She tried to turn over so her head would face down, so the stuff might drain, but the downward tilt of the aircraft and its screaming descent pressed her into the under-seat storage. She couldn’t scream, she couldn’t breathe, she couldn’t clear the liquid mass that filled her solidly from the stomach to her sinuses.
Then she heaved and hacked and the blockage surged forcefully from her mouth and nose. Her neighbor’s blood and tissue did the same, and everywhere around her she heard the gagging and retching and moans of the passengers.
She could no longer breathe. Tauntingly, an air mask dangled above her. Her insides cooled somewhat and her body was chilled and trembling on the outside.
Rapid … onset … pneumonia … Ebola …
That wasn’t medically possible.
Sarin gas … she thought … terrorism?
Whatever this might be, it was quickly lethal. In her final moments of consciousness, the doctor thought to try and get her phone to record what was happening. Her right cheek was pressed against her bag. She struggled to snake her hand inside—
She retched dry heat, nothing more. At the same time, blood began to cloud her vision and clog her ears. She could now hear her own rapid, erratic heartbeat thudding in her blood-clogged ears.
Her fingers were shaking as she pushed them forward. She tried wheezingly to draw breath but her chest felt hollow, as though her lungs had been removed.
That was what her neighbor had regurgitated? Liquefied organs?
Amy Howard died without thinking any more about that possibility, without reaching her phone. She died without feeling the impact as the jetliner nose-dived into the rocky shoreline of the barren southern coast of Marion Island. The power-dive collision caused a three-hundred-foot-high fireball that melted the permafrost and obliterated overgrown storage shacks near the crash site. Rolling outward, the blast killed the seabirds nesting on the rough coastline along Crawford Bay.