Book Name: White Water, Black Death
Author Name: Shaun Ebelthite
“A cruise ship is the perfect target for a biological attack”
These are the chilling words emailed to the Seaborne Symphony in the mid-Atlantic.
Magazine editor Geneva Jones has been sent on the trans-Atlantic cruise to help secure a major advertising agreement from the CEO of the cruise line Rachel Atkinson, but her efforts to win her over are curtailed by a mysterious crew death. Geneva suspects foul play. Rachel insists its suicide. A former investigative journalist, Geneva can’t resist digging deeper, but what she finds is far more devastating. There’s an Ebola outbreak on the ship, everyone is trapped aboard and Rachel is trying to keep it secret.
Geneva knows enough about Ebola to be terrified, but she’s also onto the biggest story of her career. As panic surges through the ship, she becomes fixated on a single question. How was the virus brought aboard? The answer is worse than she could have imagined, and the greatest exposé she’ll ever get, if she can only prove it.
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Ebola. It sounded better suited to a field clinic than a cruise ship. If this was Ebola, she was utterly fucked. Emma knew without any doubt that she was right though. She’d been right before the WHO and CDC contacted them, before Bermuda closed its border, before the FBI launched its investigation.
She’d realised before anyone else what this was, but had been too afraid to accept it.
Little good acceptance would have done anyway. The virus was deadly in more than half of all infections, even with expert supportive care. A person could go from perfectly healthy to dead in a few days. Most of her patients were exposed to the virus more than a week ago, and began showing symptoms three to four days later. They had forty-eight hours left, if that.
According to Rachel, Miami was more than seventy four hours sailing at full speed.
Even if Bermuda had taken them ashore, they’d still die. Once the bleeding started there was very little any hospital could do.
And her patients were bleeding.
It started in the stools and urine, then the nose, ears and eventually the eyes. The young girl she’d examined just two days ago was bleeding from every orifice.
Emma could see the vague shape of her body on a mattress between a white sheet and the windows. She was trying to give the worst-off patients what privacy she could. They had to be stripped down to their underwear and constantly sponged in a futile attempt to control the fever.
Some sort of privacy was all she could give them.
The girl’s mother was with her, sponging her and periodically being sick in a wastepaper basket. There were no more buckets available, even the disposable vomit bags had run out. Emma had just a few boxes of paracetamol left and only one of Imodium, her last remaining Ovartin would be used to save as many as she could when they were within airlift range of the US.
All other medication of any use had run out during the night.
She was using 19th century means to treat the most deadly virus of the 20th century.
“You’re all right my baby,” the woman was telling her daughter, the girl was trembling violently. Emma didn’t need to see her face to know she would be looking at her mother with wide, terrified eyes. Dozens of her patients had given her the same stricken look in the last twenty-four hours.
Emma couldn’t remember their names, but their faces were there like skulls in Ntarama church.
“Fight it Megan, we’ll be home soon,” the woman said.
She hadn’t let her daughter see her cry. Her husband’s body was one of those wrapped in a sheet in a line with four others that had died during the night. They’d been placed next to the doors on the left of the lounge, nearest the bar. Crew in protective gear would come to collect them soon and take them to the hold.
“You’re going to be okay, Megan.”
The girl would be dead within the next two hours.
“Doctor?” Emma felt a hand on her arm, the fingers clutching nervously, almost politely. “Her temperature is getting worse.” The young woman, her sandy blond hair hanging in clumps in her face, was looking at her with a wild optimism that made Emma feel like a fraud. “Could you come and see her?”
And do what?
“Of course,” Emma smiled, following the girl to her friend. She’d been brought in during the night when the ‘clinic’ was being set up. She lay shivering on a bare mattress, dark stains all around her. Emma lifted her chart, little more than a sheet of paper from one of the cruise line’s notepads and pretended to examine it. ‘Lucy’ scrawled just below Seaborne’s elaborate goldleaf logo.
The vitals noted by Ryan showed a clear trajectory. She wasn’t bleeding from any orifices yet, but her temperature was dangerously high, her blood pressure dangerously low and her blood urea nitrogen and creatinine were elevated. Her kidneys were failing and she was haemorrhaging internally.
Emma couldn’t waste resources on her.
“I’ll get her something right away,” she told Lucy’s friend. The girl flashed a relieved smile, slipping her hands into two plastic bags. She put a damp cloth on Lucy’s pink forehead.
All Emma could give her were electrolytes.
“We thought she was just seasick, she’d been feeling iffy since before yesterday, but we thought maybe it was from the sunburn. We made her come to the pool deck party last night.”
Lucy’s friend wasn’t showing symptoms yet, but Emma had let her stay because she didn’t have enough healthy people to look after the sick. The girl was using plastic bags to protect herself.
It was shameful.
Emma made her way across the lounge, trying to muster a smile and a kind, reassuring word as she went. A teenage boy with acute diarrhoea and vomiting would be prioritised for antiemetics and loperamide. It would make his death more comfortable, but his mother thought it was treatment. A wife was told her husband would get diazepam within the hour. The woman was just a wrinkled face to Emma, they were all blurring into one swarming mass of people she couldn’t help. The woman’s husband had a rash over his chest and stomach that looked like a war-torn archipelago. A diffuse erythematous maculopapular rash that was also desquamate.
He wouldn’t survive the next three days. A sedative would ease his suffering.
It was inhuman.
Disaster triage, ‘resource allocation based on potential medical benefit’ was what medical textbooks called it.
She’d have to sedate most of her patients soon, she couldn’t keep this act up indefinitely.
Emma had crossed a line during the night, entering unexplored, ethically gray territory. She would have her medical license revoked for it. She was lying to her patients to keep them calm, giving them placebos because there wasn’t enough of the real thing.
She had to lie. Ebola was terrifying enough. Ebola without anyway for the ship’s doctor to treat it would cause total hysteria, endangering everyone on-board.
“Five more incoming,” Ryan sighed, a walkie-talkie held in a gloved hand that hung loosely by his side. They were probably both infected.
A patient could present with symptoms anywhere between two days and three weeks after exposure to it. A week was the average.
It was only a matter of time before he started experiencing nausea and an elevated temperature. Emma wasn’t throwing up yet, but she knew it would come. Fatigue was the first symptom. Extreme fatigue. The long hours she was working in the clinic masked it for the first day or so, now she could feel the tell-tale achiness in her joints, the oversensitivity of her skin. She wouldn’t be able to control the shivering soon.
“Ryan,” she thudded heavily across what had been the marble dancefloor a few days ago to where her nurse was checking someone’s temperature. “How many have we lost?” she asked in a whisper, tiptoeing around the truth, afraid to wake it.
Emma had forgotten. He’d told her at sunrise. Emma never forgot details like this, but now she couldn’t hold onto to basic information. Couldn’t concentrate.
“Are the opiates still in the clinic?” Emma wasn’t sure why she was asking, she had the key to the medical stores and if she did need the morphine and acetaminophen and other painkillers she would get them herself.
“Yes,” said Ryan, but there was a question in his eyes.
Emma was looking for permission. She wanted to ease the suffering, but Morphine could be lethal to someone already presenting with low blood pressure.
“Doctor, you need to sit down. You need to rest.”
“I’m going to do another round.”
“Miss Atkinson is already…”
Emma tried to turn, but her feet wouldn’t follow her body’s lead. She stumbled awkwardly, almost falling into a row of patients lying on haphazardly arranged mattresses. They’d been in orderly rows last night.
A hand caught her arm, holding her up.
“One hand for the ship, doctor.” Rachel smiled at her like they were waiting for the dinner announcement. “I’ve asked some of the crew to clean things up a bit, I hope you don’t mind? I think the smell is what gets to people most. I know it does me.”
That smile again.
Emma’s opinion of the CEO had been low even before the emergency meeting in the captain’s office two nights ago. Now she was convinced she must be crazy. Worrying about the cleanliness of her lounge with death all around them, closing in like a creeping tide. She’d been going from one passenger to the next, making chit-chat and cracking jokes for the last hour.
Emma hadn’t given sanitation a thought for hours. Early this morning some of the crew already quarantined in the lounge had volunteered to help, but she needed an army to empty buckets, clean up feces and vomit, hand out water and fresh towels, let alone actually try to treat any of the more than two hundred people now crammed into the room.
Even if she did have the medicine and equipment she needed, she didn’t have enough hands.
“You are going to sit here behind the bar and rest for half an hour,” Emma hadn’t realised Rachel was leading her to the other side of the lounge, through a maze of makeshift screens and mattresses. “We’re going to clean up, then I’m going to have a chat with you about what you need.”
“Medicine,” said Emma. “Need more. We’ve run out of…”
“We can get it airlifted from Bermuda,” said Rachel, handing Emma a bottle of water. “Have something to drink and close your eyes for a few minutes.”
Emma was sitting now. Perched on a footstool, her head below the bar’s countertop so that all she could see were bottles of water on shelves all around her. There were more than two hundred bottles of water stoked behind the bar, she’d noted it down somewhere. Rachel said there were another eleven thousand available in the hold.
“I’m going to have to start sedating patients soon,” said Emma. “As more die, those left are going to get increasingly agitated.”
“That’s not necessary yet.” Rachel was kneeling in front of her. “Doctor,” she waited for Emma to lift her eyes. “Promise me you won’t do that yet.”
Emma nodded, looking down at her gloved hands. The gloves were unnecessary now, serving as part of a costume rather than a purpose.
“Tristan?” Rachel was looking for a member of the cruise staff, her voice carrying over the moaning of a man nearby. “Is there any way for us to discreetly put out a call for volunteers to help here? The doctor’s overwhelmed, we need as many of our first aid people as we can get.”
“I’ll ask security to pass the word.”
“I’ll call Richard,” Rachel lifted the phone behind the bar. “We need to get supplies airlifted from Hamilton.”
Rachel was taking over her clinic, but Emma could only feel relief.
She hadn’t been alone like this since the day before yesterday. Was that the last time she slept? Emma couldn’t remember, but she could remember how many bottles of water there were. How many patients were there in the lounge now? She needed to ask Ryan. Should be keeping a runny tally. Why wasn’t she able to remember these details? Emma flicked through her notebook and found the page.
Why had she put a question mark next to it? She must have intended to double check with Ryan. She’d do a headcount herself, he was as overworked as her. She made a note to find out the total number of Ebola cases throughout the ship.
Shouldn’t be sitting here doing nothing.
“…almost heaven, West Virginia, blue ridge mountain, Shenandoah river…”
Emma stood up, incredulous. Singing. Her patients were singing. It was just a few people at first, the Philipino staff mainly, who, despite being sick, had also volunteered to help in trying to keep the lounge clean.
“life is old there, older than the trees…”
They were being led by Rachel, standing in front of a group of children all singing along, clapping out of time. There were thirty-five children in the lounge. Emma could remember that. Almost all the children on-board.
“younger than the mountains, growing like a breeze…”
Most of them had been brought in by parents who weren’t sick yet. Emma had intended to enforce a strict quarantine, but couldn’t separate children from their parents.
Everyone was infected anyway. Quarantine was a plan that failed as soon as it started.
The voices grew, spreading through the lounge until everyone who had the energy was singing, joining in on the chorus, some filming on their phones.
“country road, take me home, to a place I belong…”
Rachel had lifted a small boy up, his hands in the air in glee, beaming at his dad like he’d won a prize. Jack, though his mother called him Jackie. She was feverish behind one of the curtains; she would likely die during the night. His father wasn’t showing symptoms yet. He might survive until they reached Miami. His son wouldn’t.
“West Virginia, mountain mamma…”
The doors closest to the bar opened, two security guards with tasers at the ready and ten crewmen in masks and gloves, come to remove the bodies.
“take me home, country road.”
Rachel caught Emma’s eye and launched into the chorus once more.
With most patients in the lounge distracted by Rachel and the children, Emma stumbled forward to help them lift the dead. She’d been focusing so much on what medication and treatments her patients needed, and dwelling on her inability to provide it, that she’d forgotten one of the worst parts about being ill.
She watched the first three bodies carried to one of the elevators on the other side of the lobby and tried to remember how many had died. What had Ryan said? She needed to see what was being done with the bodies, she had to make sure they were being treated respectfully.
She gestured to Rachel and then stumbled over to the lift, catching the alarmed glance of a passenger on a mattress closest to the door. By tomorrow, even Rachel wouldn’t be able to keep the flood gates closed. Panic was going to set in tonight. Several dozen people were unlikely to make it through to the morning and with death on every other mattress in the lounge, Emma and Rachel’s deception would be laid bare.
She wasn’t escaping, she would come back. She wasn’t abandoning them.
By tomorrow, she would be incapacitated anyway, and would be unable to control the diarrhea. She’d end up soiling herself like so many of her patients, whose shame she’d had to ignore as she or one of the crew helped them clean themselves.
It was absurd, but this was what scared her most. Not death.
Shaun Ebelthite was born in Namibia, raised in South Africa and educated in Dubai in the Middle East where he is a maritime and cruise journalist. He has been covering all aspects of ocean transport for more than five years and runs the Middle East’s foremost online cruise magazine. He has had two children’s books published, and is now branching out into a new genre with his first thriller.
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White Water, Black Death
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