Undead Life
I couldn't believe it. It was really happening...
My Name is Augustus Ray and I am, or I used to be, a day shift nursing supervisor at a 70 bed hospital in eastern Virginia. The area boarders the Chesapeake Bay and several of its tributaries, the Rappahannock, Piankatank, and the York rivers. I’ve been working here all of my nursing career. I started out as a nurse’s aide 16 years ago and worked my way up. Yea, I now, nursing is an unusual profession for a man. I think about it sometimes wondering why, but it came naturally to me. I grew up mostly with my mother and sister, both of whom are nurses. Sometimes I think I did it because I caused so much pain in other people’s lives and that this could be my way of paying it back. Easing pain instead of causing it that is. Maybe that’s why all this happened, the undead thing I mean. The human race had caused too much pain and now we were getting pay back. Wow… does that throw a twist on life or what? Sorry, but when something like this happens you start to question everything.
Odd things had been happening ever since the previous year’s flu vaccine had hit the public. Well, I should say once those who had received the vaccine started dying. They weren’t dying because of the vaccine, but only those who had received it were the ones reanimating, and then of course the one’s that they infected would also reanimate. I’m talking about completely pulseless and no respirations for at least a minute or sometimes hours and then they would start moving again, the chest would rise and fall, the body would start to move, they would completely reanimate, but they weren’t human anymore. As soon as their eyes would open and they would see anyone standing there they would start making this moaning sound, it creeps me out just to think about it, and then they would try to bite you. And not just bite you but eat you.
Usually with combative patients that weren’t being appropriately sedated they would get to a point of frustration where they would try to bite you, but they would never tear chunks of flesh from your bones. These UDs (undeads) would rip your flesh off, chew it and swallow it. We had heard of it from the CDC (Center for Disease Control) and over the news but the first time I saw it I couldn’t believe it.
The patient had been a regular at the hospital, it was now an end of life thing. He was an end stage COPD’er (chronic obstructive pulmonary disease)and there was no big mystery, he knew, his family knew, we all knew it would be just a couple of days before he died. He had made himself a DNR, a Do Not Resuscitate, so he had passed quietly and with dignity. I was in the room within 5 minutes of him passing.
Funny thing about smokers is that they want a cigarette right up until they die, nothing like being your own worst enemy. I can remember him saying “ Just get me in the wheel chair and pull off the nicotine patch.” Of course the hospital had gone “tobacco free” but for some of our patients having a cigarette was the only thing that motivated them to get out of the dam bed. Had he been capable I would not have refused this survivor of world war II a last cigarette. Any way, when he passed we followed the knew hospital protocol on deceased patients, that is we had to put them in restraints. I should have known something was going wrong when that one came down the pike.
He was not the same man when he came back. He wasn’t even a man any more, I don’t know what you would have called him. Hospital administration had gotten together when the reanimations had started and came up with an “appropriate response” just in case our hospital was to encounter one of the cases. The term undead had not officially been used yet, and probably still hasn’t. At that point in time those who had reanimated after death were being referred to has either misdiagnosed, and, or prematurely pronounced.
No one would, and still hasn’t admitted to the fact that it was probably the previous year’s flu vaccine that had kicked this whole thing off. Now I don’t know if it was the vaccine alone, or if it was in conjunction with other “breakthroughs in medication”, all I know is that we had become a nation, or even a world that had become accustomed to having all of our physical and psychological short comings being blamed on something beyond our control, and all we had to do was take a pill and life would be great. Christ, they were even coming up with diagnoses’ like “low testosterone” for guys who were in their 80’s for crying out loud. An 80 year old man running around with a hard on just doesn’t seem right to me. He would probably end up having a stroke or a heart attack. Well maybe his 30 year old girl friend, wouldn’t mind. I’m sure the pharmaceutical companies had a contingency plan for that too. Any way the longer they keep you alive the longer you can buy drugs. I'm thinking that one backfired.
Of course the pharmaceutical companies are a powerful and far reaching interest even into our federal government. The ability they had to manipulate the population is scary, which is even more evident now. No one would come out and say look, the only thing in common with all the original cases, or those not bitten and then affected is that they have all had the flu vaccine. Then we could have been aware and instituted a protocol that would have remedied the problem. We didn’t have to bash them in the head upon pronouncing them, “ I’m sorry mam your husband just passed,” CRUNCH!, but we could have done something to remove the threat of spreading the contagion.
The CDC with military assistance was attempting to pick up all the UDs as soon as they reanimated. Thank God not everyone came back, at least not yet. Once again, those of us, such as myself, who didn’t get the previous year’s flu vaccine didn’t reanimate. They stayed the way they were supposed to.. dead! With the fear of pandemics, and the near gestapo tactics to get everyone to receive the vaccine, there weren’t many who didn’t get the injection of the soul stealing anti-virus.
Of course that vital piece of information was kept suppressed, and the public in general was left uninformed. Even the health care providers, who were at highest risk of exposure, were kept in the dark. Some of us knew long before the official statement came out what was responsible and who we needed to watch for reanimation. However the public at large was kept ignorant of the facts and so the infection spread.
The gentleman's wife I had previously spoken of had rushed in to see him when the nurse had called her to let her know the end was near. She came racing down the hallway as fast as her 77 year old legs could carry her. She went right into the room without anybody talking to her. She ignored the biohazard signs and the brand new warning signs stating in eye catching colors, "DO NOT enter without talking to staff", and then we heard the scream.
I came running from my office just down the hall and was not prepared for what I saw when I came into the room. The patient had reanimated and had both hands clamped down on his wife’s arm. Apparently she had untied the restraints when she saw that he was moving. Big.. big mistake. He had already taken a chunk of flesh out of her and was actively chewing the mouthful of tissue. The wife was screaming, trying to push his head back away from her with her other hand. It swallowed and pulled her arm in for another bite, blood gushing from the wound, she started pounding on his face. Her screams were deafening within the confines of the room. I was just kind of staring at the scene unfolding in front of me, unbelieving. An aide came running into the room fell to her knees and immediately began vomiting at the site of the gory spectacle. Sherry, a nurse I had worked with for years, came through the doorway huffing and puffing, but unlike me she moved right in on the situation. She grabbed the UDs hands that were still firmly holding onto his wife and tried to break the grip. She yelled at me to help, which prodded me out of my shock and got me moving. I grabbed gloves for me and her and tried to help.
I don’t know how strong this guy was before he died but his grip was like a freakin vice, and he was pulling us this way and that, groaning, mouth opening and closing, making that tooth on tooth chomping sound. Clack, clack, clack. I’m trying to talk to him like he's a live, a reasoning, feeling human being, and yelling at my nurses to “Watch his mouth he’s trying to bite”.
I am no weakling and know a thing or two about breaking grips but this thing was behaving like we weren’t even there. All of its concentration was on the arm that it had gained control of. I swear I broke two or three of its fingers trying to pry them off, it didn’t respond at all when we heard the obvious crack of breaking bones. It gulped down the second mouthful and started pulling her in for another bite, the wife was screaming “No! No! No!” I had to do something and started punching the thing right in the face. There was nothing I could do to stop the UD from taking another bite, it was horrible. This time the wife went pale and pased out with the UD still hold tight to her arm. The room now had a couple more nurses, one doctor, and another aide who had picked up the phone to call security.
I’m lucky I didn’t snag a tooth or get bit. Unfortunately Sherry wasn’t so lucky. In the struggle one of her fingers sustained an injury, I still don’t know to this day if it was from a bite or just an injury from the flurry of activity. Hell it might have even been my fault, but I don’t really want to think about it.
Something you would do well to remember is that fear can kill you. In a situation where life and limb are at risk giving in to fear can stop your rational thought process in its tracks. If you don’t think you don’t survive. So train yourself to think under pressure. Don’t get me wrong, fear can also be a healthy emotion. In certain situations it can allow you to run faster, move quicker, and hit with greater force, but it can also make you blow your cover, miss your shot, or put you from the frying pan into the fire, or from alive to undead.
I’m looking around me for some way to stop the UD from biting anyone else. I grab the call bell, a hard plastic remote device about the size of half a slice of bread, and shove it in this things mouth with all my might, breaking teeth as I wedge it in.” Tape! Does anyone have tape!” I shouted. I had tape in my pocket, but I was pushing down on the call bell with all I had and I wasn’t about to let up. One of the other nurses came up beside me with a roll of nylon one inch tape. “Wrap it around its head” I said, “Use the whole role.
The initial emergency in control, I start thinking like I'm supposed to. “Jan get another pair of gloves on, cover Mrs. Hudgins wound, and get her up to the ER. Pam, get another set of restraints for his legs.” I notice Sherry furiously scrubbing at her hand with an antibacterial wipe., and I tell her to get up to the ER and get it checked out. She looks at me with this watery eyed blank stare and walks out of the room. That was the last time I ever saw her. Before I left that day I learned that people with CDC IDs had come in accompanied by armed escorts and had taken Mr. & Mrs. Hudgins, and Sherry away in an unmarked black van. I had hoped Sherry would make out alright. But now I know better.
Once we had the UD restrained we just left the call bell taped into his mouth, but the dam thing never stopped gnawing on it or trying to get loose. If anyone got close enough it would try to grab them, but we had learned our lesson for that day. We tried getting a blood pressure, pulse, O2 sat, even lab work but got nothing.
The hospitalists looked pretty shaken and I could over hear them talking in their charting room. The staff could hear them and were getting a little upset at what they were saying, I had to stick my head in the room and ask them to “Please be aware of the staff listening to their conversations.” and closed the door.
I wanted to get home and make sure my family was safe but I couldn't leave the hospital before my shift was up. I at least owed that to the patients and the staff. Four more hours and I could give report, pick up a few needed items and get home. This was my second 12 hour day shift in a row and I wasn't scheduled to come back for three days. I may not even be in the state in 3 more days, hell I may not be alive in three days.
And then my conscience started creeping in, nagging at me. Should I call Mark, my night shift relief, and tell him what was going on. For that matter should I call the entire night shift from all the units and warn them. But then who would take care of the patients and I would be obligated to stay until relieved as would the rest of the day shift staff. I hate my conscience, it freezes my actions, makes me indecisive, wastes time... shit! Four hours to go.
Chapter 1 ready 1/15/12
I got a page for an outside call, and dialed up the operator. She said it was someone from the CDC that they were in route and wanted to talk to someone in charge. I told her to put them through. I don’t remember the name of the agent but he was all business. What is your name and position? “Augustus Ray, Nursing supervisor.” How many pulseless active patients do you have? I had to think about it for a second, “One” How many people have been bitten? “One maybe two.” What do you mean maybe two? “A second person sustained injuries from an unknown source.” How long ago were the victims bitten? “Approximately 20 minutes ago.” Where are these victims now? ”They are in the ER, except the patient who bit them. He is restrained in room 126 on the medical surgical floor, and why are you calling them victims?” I’ll ask the questions here. “He said matter of factly. “What are the victim’s names?” Gloria Hudgins the patient’s wife, and Sherry Waters an RN from our facility.” Do not move the victims and keep them under constant surveillance, if they exhibit any unusual symptoms or expire restrain them. “ “What do you mean expire?” “We will be at your emergency room squad bay entrance in 15 min be there to meet us. Click! Yes, nice talking to you too asshole, I thought.
Environmental service doesn’t want to go into room 126 to clean up the blood spill. I tell them the patient is restrained and to just keep out of his reach, and to be careful not to get any of the blood on them. They look at me somewhat hesitantly, and one of them mumbles something about being in the room with an undead. “What did you say? “ “People like that, trying to eat you, no heartbeat, they are already dead and come back. The undead.” I just looked at him or more accurately, through him, thinking to myself, “How could I not have realized this? I didn’t want to admit it but this guy is completely right”
At that point my attitude changed, I was no longer curious as to what was happening to these people, dying, reanimating, biting others, and the process starting all over again. Now I felt the need to protect my staff, the patients, myself and, oh shit!.. my family. Looking at the ES worker I asked, “Do you still work here?” “Yes “came a surprisingly quick response. “Then do your job and get that spill cleaned up. Make sure you gown, glove and mask, and roll a biohazard bag into the room. You can leave the door open if you want until you finish but let no one else in the room.” He nodded and went off to get an isolation set up.
I went straight to my office and called my wife at home. “Linda are the kids all there?” Yes they’re all here watching TV or on the computer. I can’t get John to..” ”Linda listen to me. There is something not right with some of the patients here, and something not right with the way it’s being handled.” “What do you mean…” Just listen Linda. Get the kids rounded up, and head up to your folks house, I would avoid Harrisburg if you can. Augustus what’s going on what’s happening?” “Linda please, just think of this as an unplanned vacation. It could be nothing but I want you guys up in the PA mountains removed from populated areas for now. Don’t worry about valuables, but you do need to run into the bank and close out all the accounts, there should be about $12,000, leave me $2,000 and take the rest. Tell John to take his .22” “What!!?..” “Yes and 400 rounds… let me talk to him.” Augustus we are not taking a gun.” “Linda if what’s happening is what I think is happening that gun may be the only thing to keep you safe. Now let me talk to John.”
I can hear her call him to the phone, and he puts up his usual protest. Linda’s already getting a little testy and gives him a hard time for not moving fast enough. While he’s lumbering to the phone I pick up the other line and dial 899. “Riverside Walter Reed Hospital Emergency Room, This is Rita. How can I help you?” “ Hey Rita this is Augustus how’s the bite victim.. I mean patient from the floor and Sherry?” John comes on the other line in his usual annoyed tone “Yeah” “Hey buddy hold on a minute OK?” “OK” and I put him on hold. “Sorry Rita. How are they doing?” “Well Sherry’s doing fine, she’s actually helping out with Mrs. Hudgins who’s not doing so well.” “What do you mean, let me talk to the charge nurse please.” “Hold on. “Sandy, Augustus wants to talk to you.” I can hear in the back ground. “This is Sandy” “Listen Sandy If anybody expires up there you need to put them in four point soft restraints as soon as they die.” “What are you talking about, I’m not going to do that with family in the room.” “Sandy the two people we sent up there were injured by a patient that had expired.” Sandy had been in the ER for years and even though we were a rural hospital we had seen our share of violent injuries and death. She had seen a couple of reanimated cases come through, and I could sense her processing what I had just told her. Hesitantly she replied “I understand.” “Sandy?” I said questioningly. “You must protect yourself and our staff.” “I always do.” “I know you do but things are getting a little dicey, and if we get compromised who will take care of everyone else. Don’t take any chances.” Sandy was the kind of person who loved a challenge and loved the pressure, she was always thinking of what the ER needed to function and I’m glad she was there that day. “I said I understand” she replied. “Good, call me if you need me.” I told her. “Humph.” was her response, as she resented the implication that they would ever need my help. I hear the click of her hanging up the phone.
Johnny buddy, how’s it going? “Fine” was the usual inconvenienced response. John I need you to listen to me very closely. Do you hear me? “Yeah” “Seriously son things are getting out of hand here at work, and they may be things that could affect you and your mom and your sisters. There’s silence, I think I have his attention. “You guys are going to go up to PA for a while and stay with grandma and Grandpa OK?” “But why?” John would be happy to sit in front of the TV, computer, his Xbox, or his kindle all the time if we allowed, so any thing that removes him from that comfort zone is a bother. “John I need you to get your .22, your cleaning kit, and 400 rounds from the ammo box.” “I tell you what , just take one hundred rounds out for me and put them in a plastic bag and leave them in the cabinets.” I now had his complete attention. “I want you to make sure the safety is on, load it, wrap it in a towel and put it where you can reach it easily in the green van. Do you understand?” “Yes dad.” He hardly ever calls me dad.
“John, are you OK with this?” “Yes.” John is only 13 years old, but I have always expected him to behave as an adult. Yes I know, not fare to him at all. I’m not sure why I have been so hard on him, it could be the lack of a relationship my father and I had, or it may be the fact that he’s always been a big kid. He’s taller than me already at 5’11” plus, and weighs in at about 180lbs. I didn’t get that big until I was at least 16. He is a gentle giant though, better than his dad ever was, smarter too, and the doc says he will end up around 6’4”. Where the heck did that come from? Anyway, a better son a father couldn’t ask for.
“Mom is going to need some help keeping an eye on things during the trip, so no movies, iPod, or Gameboy OK?” He hesitates just a second, wanting to complain but comes through, “OK.” “ I love you son and I will see you soon.” “Love you to dad.” There’s the dad again, I like the way it sounds. “OK, put your mom back on.” “Hey John, wait a second.” “Yeah dad.” “If anything happens remember what I taught you about shooting.” “OK” “What did I teach you John?” I was hoping he would just recite it to me. “Relax, aim center mass, exhale, slow squeeze, eyes open” “Perfect buddy, but from now on I want you to aim center mass on the head. Do you understand?” There was a slight pause and then ”OK dad”. “Where are you aiming?” and without hesitation he replies “Center mass on the head.” “Good boy, now let me talk to your mom.
I proceeded to discuss with Linda the things we thought were important: batteries, flashlights, personal hygiene items, canned foods, can opener, bottled water, a radio, cell phones and chargers. Clothes were the big sticking point, of all things, Lanette has always taken pride in her and our families appearance, and the closets are packed full, so getting her to keep the wardrobes to just a couple of outfits for each season was difficult. She was still having difficulty grasping the potential impact of what was happening. I told them not to worry about the pets that I would take care of them, at that point I didn’t really know what I was going to do with them, but the kids protested to the point that I agreed to let them take the cat and leave the dog. They would also take the GPS, the small fire safe with all of our legal papers, a couple of the fishing poles and tackle, sleeping bags, blankets etc., etc.
We decided that they would leave as soon as they got things packed up. They could fill up at the Walker’s Corner 7-11 in town and wouldn’t have to stop again until they got to her folks house. Linda would drive the Astro van; it was a 2003 with 190,000 miles but was holding up well and was the only vehicle we had that could haul everything with the three kids. She called a couple hours later saying they were getting ready to leave and that our daughter Lori, a rising sophomore at Lynhurst College had plans for a date later that night after working her job as a waitress at the White Gull Inn. The long and short of it ended up being that she would leave with the family but she would be driving her new Chevy Cruze, I didn’t argue. The van gave Linda a view advantage and if something happened to one of the vehicles they could pile into the other. I expressed the need for them to stay within sight of each other and to communicate frequently. We had just gotten the brand new 2011 vehicle for Lori so she would have reliable transportation to go back and forth to Lynhurst and to get to her clinicals. The Cruze got great gas mileage and only needed an oil change every 8 to 10 thousand miles. It might be a handy little vehicle to have around if things got tight. Lilly, my middle child, rounded out the family. She was in 10th grade at a local private school and doing wonderfully. Her home work load was significant which was her primary concern. I told her I would smooth things over with her teachers if need be. She argued, she always argued, and we end up disagreeing but doing what needs to be done. I swear she’ll be the end of me.
Linda would call me at their usual check points; getting onto I 95 at Fredericksburg, getting onto Rt 81 at Front Royal, getting through Harrisburg, and of course arriving at her folks house in Pillman, PA. I think she called more for herself, to help her keep her sanity with the 7 to 8 hour drive and the kids acting up, but I did appreciate it. This time I reminded her to call and keep me updated as to their progress. If something had gone wrong on their trip I wouldn’t have been able to do anything to help them and it was eating at me big time. Again my conscience was bugging me. Do I ask them to wait and then go with them? The delay in their departure could be critical and I would miss my next shift at the hospital. Better to stick with the current plan, I reassured myself. Get them some place out of the way before things hit the fan. I told them all good bye and tried to concentrate on the job at hand.
The job at hand of course was making it through the last four hours of my shift. I reviewed my census sheet for all of the units and checked the ER status board. There were a couple of patients on the Med Surg floor who were on comfort measures. If we have a patient on comfort measures it’s just that. We have exhausted all efforts to improve their health and after discussions with the family, and patient if possible, we set a goal for a painless death. This includes, of course, working with the family in any way necessary. I checked those particular patients’s vaccine status and yes, of course they had both received the flu vaccine for that year. We keep soft wrist restraints and posey vests on all the units. Posy vests won’t control arms or legs but it will keep a person in the bed if secured properly. I called materials management and checked our current stock of restraints which was adequate. I asked Clay to put extra on all units for the time being. As usual the response was “No problem”.
As I went to do a visual check on the par closets, where we keep material for the units, and get an update on our comfort care patients my beeper went off. I didn’t actually jump, but I think my heart did. I pulled up the information and as I feared the CDC had arrived in the ER and wanted to know where I was. I stopped at the nearest phone and called up to the ER. “ Hey Rita.” She interrupts me with a hushed voice “Augustus these folks don’t look to happy, and they want you up here now.” Rita, tell them I’m checking on a few important issues and I’ll be right up. I’ll be there in five minutes.” I didn’t wait for the reply, because it didn’t make any difference. I had to ensure the safety of the patients and staff and the CDC would have to wait.
I took the back hallway to the ER so I could avoid the lobby and the ER waiting area. I would usually stop and talk with other Lakeview Hospital employees, visitors and patients, and then see how busy the ER waiting area was to get a feeling for how busy the rest of the facility was going to be. However this time I didn’t want to get held up by pleasantries, and I didn’t want anyone to pick up on how uneasy I was feeling. I was usually very calm and collected, a reassuring force within the facility, but right now I was having to work at keeping my thoughts focused on the tasks at hand, and what my options were with regard to dealing with the upcoming interaction with the CDC.
As soon as I went through the security doors into the ER I saw them standing at the nurse’s counter. They were giving Rita a hard time about something, I assumed it was about getting me up there quicker. She saw me a frustrated expression on her face and rolled her eyes in the direction of the group of men. There were five of them, two in complete Hazmat gear with their respirators pulled up on top of their heads, one with a lap top already out on the counter and typing away while giving Rita an ear full, and two in black fatigues with side arms. The guy on the lap top glanced over at Rita and followed her stare right to me. I’m still 40 feet down the hallway coming towards them and this guy calls out “Are you Augustus Ray?” He’s in a hurry, and means business, I think to myself. I make eye contact and keep my mouth shut and maintain my pace until I’m within five feet. “Yes I am, I’m the nursing supervisor you spoke with.” “I thought I told you to meet us here in 15 minutes.” I don’t like this guy already, but for productivities sake I must play nice. “Yes you did. “ I say in a pleasant controlled tone. “However I have responsibilities throughout the hospital and this issue is currently under control.” I sense him tensing up, and his face gets a little red. “Is there somewhere private we can talk?” He apparently has some experience with diplomacy. Just then Sandy brushes by me and uses the opportunity to express her displeasure at the new distractions that are taking up space in her ER. “Augustus can we get this taken care of, they’re in the way and we’ve got patients to take care of.” She looks right at this guy and waves her hand at the rest of his group. “I’ll take care of this as soon as possible Sandy, thank you.”
“We can talk in the nurse’s lounge. Are the weapons necessary?” His immediate response was a firm “Yes!” and then he added “You really don’t know what you’re dealing with do you.” I leaned toward Rita and asked if security was still up here, she informed me that they were. I then told her to contact the Glower County Sherriff’s Department and let them know what was going on in our ER. Sandy spoke up, apparently monitoring the conversation, “We did that as soon as they came through the door Augustus.” “I should have known Sandy, thank you.” “ My men need to get started right away. Where are the victims?” I’m not comfortable with the term victims. The patients who were involved are here in the ER, but I need to know what’s going on before anything else happens.” He starts to grab me by the arm and begins walking towards the lounge. I overestimated his diplomacy. I twirl my arm over his dislodging his grip and give him a little pop with the palm of my hand against his shoulder, effectively knocking him back a few steps and into one of his black kackied goons. “I am perfectly capable of making it to the lounge under my own power. Thank you very much.” I start off towards the lounge holding my arm up to indicate the direction we should go.
Yes he’s pissed and his entourage isn’t sure how to respond, but to their credit they maintain their composure. The ER staff isn’t impressed with the little exchange and keep right on working. I can guarantee they have experienced a lot more stressful situations than this CDC crew. As we’re walking towards the lounge I ask Sandy how Sherry and Mrs. Hudgins are doing. “ Sherry’s fine, but Mrs. Hudgins is in shock, we’re giving her fluids and running lab work.” “Thank you Sandy.” Rita will you page the charge nurse for the Med Surg floor and inform her that 2 to 4 members of the CDC will be coming down to room 126. She says “OK” as she picks up the phone. “Mike!” Mike’s the security guard on duty. “Would you direct these gentlemen to room 126, and contact Wayne to let him know what’s going on?” Wayne is the head of security, among other things at the hospital. “Sure Augustus. Right this way gentleman.” Mike stands there waiting. Grabby turns to the others in his group, the situation seems to be in control up here, go secure victim zero and then we will take care of the others.
I got a page for an outside call, and dialed up the operator. She said it was someone from the CDC that they were in route and wanted to talk to someone in charge. I told her to put them through. I don’t remember the name of the agent but he was all business. What is your name and position? “Augustus Ray, Nursing supervisor.” How many pulseless active patients do you have? I had to think about it for a second, “One” How many people have been bitten? “One maybe two.” What do you mean maybe two? “A second person sustained injuries from an unknown source.” How long ago were the victims bitten? “Approximately 20 minutes ago.” Where are these victims now? ”They are in the ER, except the patient who bit them. He is restrained in room 126 on the medical surgical floor, and why are you calling them victims?” I’ll ask the questions here. “He said matter of factly. “What are the victim’s names?” Gloria Hudgins the patient’s wife, and Sherry Waters an RN from our facility.” Do not move the victims and keep them under constant surveillance, if they exhibit any unusual symptoms or expire restrain them. “ “What do you mean expire?” “We will be at your emergency room squad bay entrance in 15 min be there to meet us. Click! Yes, nice talking to you too asshole, I thought.
Environmental service doesn’t want to go into room 126 to clean up the blood spill. I tell them the patient is restrained and to just keep out of his reach, and to be careful not to get any of the blood on them. They look at me somewhat hesitantly, and one of them mumbles something about being in the room with an undead. “What did you say? “ “People like that, trying to eat you, no heartbeat, they are already dead and come back. The undead.” I just looked at him or more accurately, through him, thinking to myself, “How could I not have realized this? I didn’t want to admit it but this guy is completely right”
At that point my attitude changed, I was no longer curious as to what was happening to these people, dying, reanimating, biting others, and the process starting all over again. Now I felt the need to protect my staff, the patients, myself and, oh shit!.. my family. Looking at the ES worker I asked, “Do you still work here?” “Yes “came a surprisingly quick response. “Then do your job and get that spill cleaned up. Make sure you gown, glove and mask, and roll a biohazard bag into the room. You can leave the door open if you want until you finish but let no one else in the room.” He nodded and went off to get an isolation set up.
I went straight to my office and called my wife at home. “Linda are the kids all there?” Yes they’re all here watching TV or on the computer. I can’t get John to..” ”Linda listen to me. There is something not right with some of the patients here, and something not right with the way it’s being handled.” “What do you mean…” Just listen Linda. Get the kids rounded up, and head up to your folks house, I would avoid Harrisburg if you can. Augustus what’s going on what’s happening?” “Linda please, just think of this as an unplanned vacation. It could be nothing but I want you guys up in the PA mountains removed from populated areas for now. Don’t worry about valuables, but you do need to run into the bank and close out all the accounts, there should be about $12,000, leave me $2,000 and take the rest. Tell John to take his .22” “What!!?..” “Yes and 400 rounds… let me talk to him.” Augustus we are not taking a gun.” “Linda if what’s happening is what I think is happening that gun may be the only thing to keep you safe. Now let me talk to John.”
I can hear her call him to the phone, and he puts up his usual protest. Linda’s already getting a little testy and gives him a hard time for not moving fast enough. While he’s lumbering to the phone I pick up the other line and dial 899. “Riverside Walter Reed Hospital Emergency Room, This is Rita. How can I help you?” “ Hey Rita this is Augustus how’s the bite victim.. I mean patient from the floor and Sherry?” John comes on the other line in his usual annoyed tone “Yeah” “Hey buddy hold on a minute OK?” “OK” and I put him on hold. “Sorry Rita. How are they doing?” “Well Sherry’s doing fine, she’s actually helping out with Mrs. Hudgins who’s not doing so well.” “What do you mean, let me talk to the charge nurse please.” “Hold on. “Sandy, Augustus wants to talk to you.” I can hear in the back ground. “This is Sandy” “Listen Sandy If anybody expires up there you need to put them in four point soft restraints as soon as they die.” “What are you talking about, I’m not going to do that with family in the room.” “Sandy the two people we sent up there were injured by a patient that had expired.” Sandy had been in the ER for years and even though we were a rural hospital we had seen our share of violent injuries and death. She had seen a couple of reanimated cases come through, and I could sense her processing what I had just told her. Hesitantly she replied “I understand.” “Sandy?” I said questioningly. “You must protect yourself and our staff.” “I always do.” “I know you do but things are getting a little dicey, and if we get compromised who will take care of everyone else. Don’t take any chances.” Sandy was the kind of person who loved a challenge and loved the pressure, she was always thinking of what the ER needed to function and I’m glad she was there that day. “I said I understand” she replied. “Good, call me if you need me.” I told her. “Humph.” was her response, as she resented the implication that they would ever need my help. I hear the click of her hanging up the phone.
Johnny buddy, how’s it going? “Fine” was the usual inconvenienced response. John I need you to listen to me very closely. Do you hear me? “Yeah” “Seriously son things are getting out of hand here at work, and they may be things that could affect you and your mom and your sisters. There’s silence, I think I have his attention. “You guys are going to go up to PA for a while and stay with grandma and Grandpa OK?” “But why?” John would be happy to sit in front of the TV, computer, his Xbox, or his kindle all the time if we allowed, so any thing that removes him from that comfort zone is a bother. “John I need you to get your .22, your cleaning kit, and 400 rounds from the ammo box.” “I tell you what , just take one hundred rounds out for me and put them in a plastic bag and leave them in the cabinets.” I now had his complete attention. “I want you to make sure the safety is on, load it, wrap it in a towel and put it where you can reach it easily in the green van. Do you understand?” “Yes dad.” He hardly ever calls me dad.
“John, are you OK with this?” “Yes.” John is only 13 years old, but I have always expected him to behave as an adult. Yes I know, not fare to him at all. I’m not sure why I have been so hard on him, it could be the lack of a relationship my father and I had, or it may be the fact that he’s always been a big kid. He’s taller than me already at 5’11” plus, and weighs in at about 180lbs. I didn’t get that big until I was at least 16. He is a gentle giant though, better than his dad ever was, smarter too, and the doc says he will end up around 6’4”. Where the heck did that come from? Anyway, a better son a father couldn’t ask for.
“Mom is going to need some help keeping an eye on things during the trip, so no movies, iPod, or Gameboy OK?” He hesitates just a second, wanting to complain but comes through, “OK.” “ I love you son and I will see you soon.” “Love you to dad.” There’s the dad again, I like the way it sounds. “OK, put your mom back on.” “Hey John, wait a second.” “Yeah dad.” “If anything happens remember what I taught you about shooting.” “OK” “What did I teach you John?” I was hoping he would just recite it to me. “Relax, aim center mass, exhale, slow squeeze, eyes open” “Perfect buddy, but from now on I want you to aim center mass on the head. Do you understand?” There was a slight pause and then ”OK dad”. “Where are you aiming?” and without hesitation he replies “Center mass on the head.” “Good boy, now let me talk to your mom.
I proceeded to discuss with Linda the things we thought were important: batteries, flashlights, personal hygiene items, canned foods, can opener, bottled water, a radio, cell phones and chargers. Clothes were the big sticking point, of all things, Lanette has always taken pride in her and our families appearance, and the closets are packed full, so getting her to keep the wardrobes to just a couple of outfits for each season was difficult. She was still having difficulty grasping the potential impact of what was happening. I told them not to worry about the pets that I would take care of them, at that point I didn’t really know what I was going to do with them, but the kids protested to the point that I agreed to let them take the cat and leave the dog. They would also take the GPS, the small fire safe with all of our legal papers, a couple of the fishing poles and tackle, sleeping bags, blankets etc., etc.
We decided that they would leave as soon as they got things packed up. They could fill up at the Walker’s Corner 7-11 in town and wouldn’t have to stop again until they got to her folks house. Linda would drive the Astro van; it was a 2003 with 190,000 miles but was holding up well and was the only vehicle we had that could haul everything with the three kids. She called a couple hours later saying they were getting ready to leave and that our daughter Lori, a rising sophomore at Lynhurst College had plans for a date later that night after working her job as a waitress at the White Gull Inn. The long and short of it ended up being that she would leave with the family but she would be driving her new Chevy Cruze, I didn’t argue. The van gave Linda a view advantage and if something happened to one of the vehicles they could pile into the other. I expressed the need for them to stay within sight of each other and to communicate frequently. We had just gotten the brand new 2011 vehicle for Lori so she would have reliable transportation to go back and forth to Lynhurst and to get to her clinicals. The Cruze got great gas mileage and only needed an oil change every 8 to 10 thousand miles. It might be a handy little vehicle to have around if things got tight. Lilly, my middle child, rounded out the family. She was in 10th grade at a local private school and doing wonderfully. Her home work load was significant which was her primary concern. I told her I would smooth things over with her teachers if need be. She argued, she always argued, and we end up disagreeing but doing what needs to be done. I swear she’ll be the end of me.
Linda would call me at their usual check points; getting onto I 95 at Fredericksburg, getting onto Rt 81 at Front Royal, getting through Harrisburg, and of course arriving at her folks house in Pillman, PA. I think she called more for herself, to help her keep her sanity with the 7 to 8 hour drive and the kids acting up, but I did appreciate it. This time I reminded her to call and keep me updated as to their progress. If something had gone wrong on their trip I wouldn’t have been able to do anything to help them and it was eating at me big time. Again my conscience was bugging me. Do I ask them to wait and then go with them? The delay in their departure could be critical and I would miss my next shift at the hospital. Better to stick with the current plan, I reassured myself. Get them some place out of the way before things hit the fan. I told them all good bye and tried to concentrate on the job at hand.
The job at hand of course was making it through the last four hours of my shift. I reviewed my census sheet for all of the units and checked the ER status board. There were a couple of patients on the Med Surg floor who were on comfort measures. If we have a patient on comfort measures it’s just that. We have exhausted all efforts to improve their health and after discussions with the family, and patient if possible, we set a goal for a painless death. This includes, of course, working with the family in any way necessary. I checked those particular patients’s vaccine status and yes, of course they had both received the flu vaccine for that year. We keep soft wrist restraints and posey vests on all the units. Posy vests won’t control arms or legs but it will keep a person in the bed if secured properly. I called materials management and checked our current stock of restraints which was adequate. I asked Clay to put extra on all units for the time being. As usual the response was “No problem”.
As I went to do a visual check on the par closets, where we keep material for the units, and get an update on our comfort care patients my beeper went off. I didn’t actually jump, but I think my heart did. I pulled up the information and as I feared the CDC had arrived in the ER and wanted to know where I was. I stopped at the nearest phone and called up to the ER. “ Hey Rita.” She interrupts me with a hushed voice “Augustus these folks don’t look to happy, and they want you up here now.” Rita, tell them I’m checking on a few important issues and I’ll be right up. I’ll be there in five minutes.” I didn’t wait for the reply, because it didn’t make any difference. I had to ensure the safety of the patients and staff and the CDC would have to wait.
I took the back hallway to the ER so I could avoid the lobby and the ER waiting area. I would usually stop and talk with other Lakeview Hospital employees, visitors and patients, and then see how busy the ER waiting area was to get a feeling for how busy the rest of the facility was going to be. However this time I didn’t want to get held up by pleasantries, and I didn’t want anyone to pick up on how uneasy I was feeling. I was usually very calm and collected, a reassuring force within the facility, but right now I was having to work at keeping my thoughts focused on the tasks at hand, and what my options were with regard to dealing with the upcoming interaction with the CDC.
As soon as I went through the security doors into the ER I saw them standing at the nurse’s counter. They were giving Rita a hard time about something, I assumed it was about getting me up there quicker. She saw me a frustrated expression on her face and rolled her eyes in the direction of the group of men. There were five of them, two in complete Hazmat gear with their respirators pulled up on top of their heads, one with a lap top already out on the counter and typing away while giving Rita an ear full, and two in black fatigues with side arms. The guy on the lap top glanced over at Rita and followed her stare right to me. I’m still 40 feet down the hallway coming towards them and this guy calls out “Are you Augustus Ray?” He’s in a hurry, and means business, I think to myself. I make eye contact and keep my mouth shut and maintain my pace until I’m within five feet. “Yes I am, I’m the nursing supervisor you spoke with.” “I thought I told you to meet us here in 15 minutes.” I don’t like this guy already, but for productivities sake I must play nice. “Yes you did. “ I say in a pleasant controlled tone. “However I have responsibilities throughout the hospital and this issue is currently under control.” I sense him tensing up, and his face gets a little red. “Is there somewhere private we can talk?” He apparently has some experience with diplomacy. Just then Sandy brushes by me and uses the opportunity to express her displeasure at the new distractions that are taking up space in her ER. “Augustus can we get this taken care of, they’re in the way and we’ve got patients to take care of.” She looks right at this guy and waves her hand at the rest of his group. “I’ll take care of this as soon as possible Sandy, thank you.”
“We can talk in the nurse’s lounge. Are the weapons necessary?” His immediate response was a firm “Yes!” and then he added “You really don’t know what you’re dealing with do you.” I leaned toward Rita and asked if security was still up here, she informed me that they were. I then told her to contact the Glower County Sherriff’s Department and let them know what was going on in our ER. Sandy spoke up, apparently monitoring the conversation, “We did that as soon as they came through the door Augustus.” “I should have known Sandy, thank you.” “ My men need to get started right away. Where are the victims?” I’m not comfortable with the term victims. The patients who were involved are here in the ER, but I need to know what’s going on before anything else happens.” He starts to grab me by the arm and begins walking towards the lounge. I overestimated his diplomacy. I twirl my arm over his dislodging his grip and give him a little pop with the palm of my hand against his shoulder, effectively knocking him back a few steps and into one of his black kackied goons. “I am perfectly capable of making it to the lounge under my own power. Thank you very much.” I start off towards the lounge holding my arm up to indicate the direction we should go.
Yes he’s pissed and his entourage isn’t sure how to respond, but to their credit they maintain their composure. The ER staff isn’t impressed with the little exchange and keep right on working. I can guarantee they have experienced a lot more stressful situations than this CDC crew. As we’re walking towards the lounge I ask Sandy how Sherry and Mrs. Hudgins are doing. “ Sherry’s fine, but Mrs. Hudgins is in shock, we’re giving her fluids and running lab work.” “Thank you Sandy.” Rita will you page the charge nurse for the Med Surg floor and inform her that 2 to 4 members of the CDC will be coming down to room 126. She says “OK” as she picks up the phone. “Mike!” Mike’s the security guard on duty. “Would you direct these gentlemen to room 126, and contact Wayne to let him know what’s going on?” Wayne is the head of security, among other things at the hospital. “Sure Augustus. Right this way gentleman.” Mike stands there waiting. Grabby turns to the others in his group, the situation seems to be in control up here, go secure victim zero and then we will take care of the others.
