Infection of the first victim began with a sharp stab of metal against flesh. The hypodermic needle plunged into his arm, its razor-sharp point slicing into the outer skin and through the living tissue below. The steel cylinder thrust downward, leaving a trail of torn and punctured cells. It sliced through the layer of fat, rupturing glistening fat cells. It slashed through thin webs of capillaries and nicked spidery nerve cells, launching electrical alarms of pain toward the victim's brain.
Finally, the needle reached the pliant surface of the arm's major blood vessel and lanced through its rubbery membrane into the pulsing blood flow. The metal invader's tip then delivered a gush of liquid into the vessel.
That injection launched billions of viruses
— precisely engineered microscopic spheres—into the victim's bloodstream. Those viruses carried a cargo of pirate genes, programmed to hijack normal cells, transforming the cells' biological function and forcing them to reproduce more of the mutant virus to relentlessly spread the infection.
These viruses did not randomly attack. Biological missiles, they were programmed to target only specific cells. Their surface was festooned with the spikes of homing molecules that would link them to only one kind of cell—like a key that fits only one lock.
As the viruses coursed throughout the bloodstream and into narrow capillaries, they began to find those targets—pigmented brownish cells near the skin surface. The viruses' targeting molecules clutched the brown cells, fusing with them and injecting the viruses' genetic cargo. Those pirate genes slithered quickly into the cell nucleus, commandeering its genetic machinery, launching their biological occupation of the unsuspecting man's body.
The emergency room triage nurse had no inkling that the first victim would abruptly shatter the early morning quiet. She paused in filling out routine forms and sighed, letting the soft fog of drowsiness envelop her for the moment.
She was deeply fatigued after a hectic night. Besides the steady stream of sick and injured, she'd had to handle two particularly nerve-wracking cases: A little boy fell out of an upper bunk and gashed open his forehead. Both child and mother had come in screaming maniacally. She'd almost had to have the mother restrained. The ER doc used a dab of superglue to close the wound of the frantic, bleeding boy, and the mother took one of her Valiums to settle her down.
Just after that a drunken, cursing man burst through the door dragging a bleeding foot and brandishing a shotgun. He'd tried to shoot a barking dog but tripped in the dark and blasted his own foot. She had been trapped behind the desk while the security guard persuaded him to give up the gun. The doc had picked birdshot out of the bellowing man for an hour.
Now thankfully, the ER had settled into a quiet lull. The overnight trauma emergencies had ceased, and the early-morning heart attacks hadn't begun yet. The nurse’s hands still hovered over the computer keyboard, but they settled in slow-motion toward the desk. As her eyes slowly closed, her head nodded forward and her chubby neck sank slightly into the collar of her pink smock, enlarging the soft folds of flesh that draped beneath her chin. Her breath came in steady somnolent puffs.
The metallic whang of a dropped instrument tray shattered the silence, startling her to woozy alertness. She managed to focus on a middle-aged man who had rushed up to her desk. His pear-shaped body was barely covered by a thin, worn plaid bathrobe. His sparse, disheveled hair stuck crazily up from his bulbous head. His jowly unshaven face sagged with sleep and age.
And that face was blue! A solid, bright blue that brought an involuntary grunt of utter surprise from the nurse.
His chest, belly and legs showed the same unrelenting blue as his face and hands.
He stared at her wide-eyed, pleadingly. His mouth opened twice, as if to say something. He released the robe, holding his palms up, but then dropped them to his sides. Then his eyes rolled back in his head, and he collapsed with an alarming thud, his skinny blue legs splayed out on the floor.
The nurse recovered enough to bark "Patient in acute distress!" to the emergency room staff. She scurried around the desk to find the man's eyes opening as she knelt down. "Sir, are you having trouble breathing? Are you having chest pains?"
"No, uhhhh, I'm . . . " But before he could finish, a doctor and another nurse rushed up. They took one surprised look at the man, and one puzzled glance at each other. Then the doctor crouched at his side. The nurse, a sturdy middle-aged woman in a uniform slightly limp from the night's labors, paused to shout back for a gurney, which an orderly brought immediately. The triage nurse stood back, marveling at the blueness of the man. She was now thoroughly awake.
With brisk efficiency, the doctor, the sturdy nurse, and the emergency tech hoisted the man onto the gurney.
"Sir, can you breathe?" asked the doctor as he placed his stethoscope on the hairy blue chest, listening to the man's heart as they rushed the gurney through the fluorescent-lit emergency room and swerved it into the last treatment cubicle on the left. The open cubicle contained a bed and a full complement of emergency equipment—a heart monitor, blood pressure monitor, oxygen source and glass-fronted cabinets filled with medical supplies. They lifted the man onto the bed and wheeled the gurney away.
“Well, yeah, I’m okay,” the man answered groggily. “I’m just—”
“Are you having chest pains?”
“No, I . . . just woke up and I was blue.” His brown eyes showed rising fear. A sheen of sweat formed on his blue upper lip.
“You just woke up? You were asleep, or did you faint?”
“I was asleep. I fainted just now. I’m scared.”
“Well, sir, you just relax. We’ll find out what’s wrong.”
“What’s wrong is I’m blue,” he mumbled. “Am I okay?”
The doctor, a slim man in his thirties wearing baggy light green scrubs, issued orders to the sturdy nurse, as another short dark-haired nurse joined them. Again, he placed his stethoscope on the man’s chest and listened intently as the sturdy nurse tore the paper covers off adhesive electrodes and fastened them to the man’s chest. Shortly, the heart monitor added its reassuring metronomic beep to the bustle of the room.
“Heart sounds okay. Lungs are clear,” said the doctor quietly. He stared at the monitor screen, its luminescent dot tracing a reassuringly regular pattern of peaks and valleys across the small screen. “Heart looks okay.” He opened the man’s mouth.
“Lug, I’g jus’ glue,” gurgled the man past the doctor’s tongue depressor, as he checked the man’s airway for obstruction. Satisfied that the way was clear, he stood back.
“Sir, we’ve got to do these tests to find out. Just relax,” said the doctor, as the sturdy nurse slipped an oxygen tube under his nose.
The dark-haired nurse deftly slid the needle of an IV catheter into the back of his hand, knitting her dark brows at the difficulty of finding the blue vein against the blue skin. Her brows relaxed as she satisfied herself that she hit the vein and taped the catheter into place.
Inserting another needle into his arm, the dark-haired nurse drew vials of rich dark-red blood and handed them out the door for testing.
The team was cool, efficient . . . and increasingly puzzled.
“Stick on a pulsox,” said the doctor, but the dark-haired nurse was already slipping the plastic pincer of a pulsoximeter over the man’s fingertip and scrutinizing the readings from a small box to which it was attached.
“Blood oxygen is okay,” she said.
The doctor continued to stare at the cardiac monitor, as if his concentration would force the tan box to give up secrets to the man’s condition. He transferred the intense gaze to the patient, who looked back, trying to read something in the thin face besides a practiced impassiveness.
The doctor picked up the patient’s hand and examined it closely, front and back. He scrutinized the face and neck, and worked his way down to the chest, stopping at moles, wrinkles, and the many interesting hair follicles. Then he proceeded to the bony middle-aged legs and the wide ungainly feet.
“Yup, sir, you are definitely blue all over,” he announced. “Y’know, this doesn’t look like a cyanotic pattern to me. His face is blue, his chest is blue.” The doctor looked toward the man’s waist. “He’s all blue. If he was cyanotic, just his extremities would be blue. And look at this.”
The sturdy nurse stepped dutifully forward, and the dark-haired nurse craned to look over her shoulder. “The bottoms of the feet are lighter. And up here . . .” he took one of the man’s hands, “. . . the palms are lighter. Maybe this is some kind of pigment disorder. Now, you’re sure blood gases are okay?”
“Yeah, and the arterial blood’s nice and red,” said the dark-haired nurse, a lilt of puzzlement in her voice.
“Also, look at the blue,” he instructed the nurses. They did so. “Something interesting here. This isn’t a cyanotic shade of blue, either. This isn’t a blue from lack of oxygen. This is another blue.”
“Yeah, yeah, now that you mention it . . .” said the dark-haired nurse. Indeed, the blue was a pure blue, a rich simple blue that needed no description other than blue. It was a little darker than bluebonnets, a little lighter than blue jeans. But blue was a sufficient descriptor.
“What’s your name?” asked the doctor.
“Mr. Harding, I’m Doctor Lesser. You breathing okay?”
“Yeah, doc. What do I got? Why’m I blue?”
“Well we don’t know, but we’re sure going to find out. How old
“Tuesday. I don’t know the date.”
“It’s the fourteenth,” said Lesser.
“The fifteenth,” corrected the sturdy nurse.
“Oh. Right,” said Lesser. Lesser went on to quiz Harding about the president and the town he was in. He concluded that Harding was lucid, or at least as lucid as a man could be who had just changed color.
“Tell me how did this come on?” asked Lesser. He directed Harding to sit up and tapped his blue knees and elbows with a little rubber hammer, eliciting the appropriate subtle twitches that revealed healthy reflexes.
“Well, last night when I went to bed, I looked kind of funny. Y’know maybe a little bluish. But I thought it was the light or something. I was tired. Then I got up this mornin’, I was blue . . . all over!”
A knowing smile dawned on the doctor’s face. “Mr. Harding, what drugs are you on?”
“Well, Tylenol, vitamins, that’s about it.”
“No colloidal silver? For a rash, maybe? You know, that turns skin blue.” He looked up triumphantly at the nurse.
“Gee, no, nothing like that. Tylenol and vitamins. One-a-Day. Could vitamins do it?”
The doctor’s triumphant smile faded back into impassive seriousness. “Hmm. No. Well, Mr. Harding, it looks to me like you don’t have anything immediately dangerous. You fainted because you were scared, right?”
“Yeah, my dad died when he was my age. Heart attack. Wouldn’t you be?”
“Sure would,” smiled Lesser. “But your heart sounds perfectly normal. As far as we can tell, it’s just your skin. So let’s see if we can settle your mind by finding out what’s going on.”
“Yeah, sure, thanks.” The steady beep on the heart monitor began to slow slightly, as Harding relaxed.
“Let’s do a chest x-ray while we’re waiting for the blood tests. Get Mr. Harding to give us a urine sample, and tell ‘em to do a drug screen,” he told the sturdy nurse.
“What do we call this?” asked the sturdy nurse, scanning the coding sheet. “You know the x-ray techs. Got to have a good reason for the chest film.”
“Well, fiddle . . .” The doctor scratched his head. “I guess we call it ‘pigmentation dermatopathia of unknown origin.’ Colored skin. But also add ‘possible pulmonary involvement.’ That ought to keep them happy.”
“Yeah, that’ll do,” said the sturdy nurse. She helped a shaky Harding to the bathroom, where he dutifully delivered a stream of normally colored urine into a clear plastic cup. Feeling reassured by the outcome, he sat gratefully down in a wheelchair brought by an orderly, who took him out for a chest x-ray, past the nursing station. The sturdy nurse was intently filling out the forms, and the dark-haired nurse was edging toward a nearby ward to tell her friends what she’d seen. By the time he arrived back in the treatment room, Dr. Lesser was leaning against the door jamb, leafing through papers on a clipboard.
“Blood chemistry’s okay,” he said, pursing his lips in concentration. “Liver’s okay, kidneys look okay . . . white blood count’s up just a bit. But not much, really. No drugs, no methanol in the urine.” He paused and looked up. “Mr. Harding, are you sure you’re not taking any other medication?”
“No, I just take Tylenol. And I got allergies.”
“Oh. You take allergy shots?”
“Yeah, one about a week ago.”
“Oh.” Lesser was disappointed. An allergic reaction to a shot would have come much quicker. But it was something at least, and he noted it on the chart.
“Well, sir, let’s admit you to the hospital so we can get to the bottom of this. I think it’s time we get some specialists in here.” Lesser paged chief of staff, Lori Meadows. This was big enough to get her involved. After fifteen minutes, a kind of tension came rolling down the hall like a psychic wave. Such tension always heralded the approach of Lori Meadows. Doctors, nurses, orderlies, and even patients always seemed to snap to some form of attention, whether sitting, standing, leaning or prone on stretchers. The petite, middle-aged woman strode into view wearing an ever-crisp lab coat, light brown hair efficiently wrapped into a tight bun and an utter refusal to tolerate the presence of any disease whatsoever in her patients. Disease represented disorder, chaos in the elegant perfection that she demanded of the functioning human body. Rumor had it that she had once cured a vicious case of pneumonia by bullying the germs out of her patient.
As Lesser braced himself, he knew she would be extremely displeased at this unknown pathological interloper in her hospital. She cocked her head suspiciously at Lesser as he gave his briefing in the hall, prepared to pounce on the slightest clue to solve the hated mystery.
Then she entered Harding’s room, peering at him as if dissecting him with her eyes. But she was surprisingly gentle as she examined him, questioned him, and studied his chart. Every patient of hers was an innocent victim of whatever demon had visited itself upon him. Satisfied that all possible information had been taken in, she and Lesser stepped into the hallway of the emergency department.
“Okay, now,” she said, wrinkling her brow in irate puzzlement and reciting the results out loud to help her reveal the villain. “His examination’s normal. EKG normal, chest x-ray normal . . . blood gases, hematocrit, prothrombin time, blood urea nitrogen, calcium, phosphorus, creatinine, bilirubin . . . all normal. His blood pH is okay?” Lesser nodded. “But white cell count’s up, eh?”
“Yeah, a little, but not much.”
“Soooooo, we’ve got no congestive heart failure, no congenital heart disease, no Raynaud’s disease, no polyarteritis nodosa, no Buerger’s disease, no scleroderma, no dermatomyositis, no systemic lupus erythematosus, no arteriosclerosis, no polycythemia, no obliterative vascular disease, no syringomyelia, no arteriovenus aneurysm, no myxedema, and no poisoning.” She stared at Lesser, challenging him to think of another possibility.
“Doesn’t look like it,” admitted Lesser. “And he promised us he didn’t dye himself blue. Didn’t take colloidal silver.”
“So, like you first said, we’ve got pigmentation dermatopathia of unknown origin. That’s nada.” She shook her head at the enigma and stalked off to plunder the medical library, ordering that Harding be admitted.
By nine the next morning, Harding’s small room in La Vista Community Hospital was crowded with specialists and their egos, summoned by Meadows. Each had arrived smiling, confident. Each had interviewed Harding, taken notes, consulted memories, checked reference works. The smiles slowly faded, replaced by wrinkled brows, distracted peering at the ceiling in puzzlement. Harding was at first stoic, a little embarrassed. As the morning wore on, he lay stolidly in his bed, his stomach growling, becoming more frustrated. Besides the endless blood and urine samples he’d given, he grew weary of the repeated questions about his work as a lumber salesman (no exposure to chemicals), his travels (to Los Angeles recently), his medicines (Tylenol, vitamins, allergy shot). He was also wheeled down the hall for an MRI scan and a CAT scan, spending uncomfortable periods lying alone in coldly sterile rooms, while beige multi-ton, humming machines enveloped his body.
He also assured the doctors emphatically over and over that he’d not dipped himself in dye, ink, paint, food coloring, or any other substance. To make sure the blue was fully skin deep, the dermatologist was called in—a thin, young man with magnificently bushy hair flowing out either side of his scalp, but with only a few scraggly strands on top. He used a tiny needle-like probe to extract a plug of skin from his arm and sent it off for study at the pathology lab. That microscopic examination done, the dermatologist proceeded to a minute examination of Harding’s skin, every inch of it, much to Harding’s discomfiture. The results of that scrutiny convinced the dermatologist that a lecture to his colleagues was in order, if the cause of this strange malady were to be traced. He glanced at Meadows, who nodded her stern consent.
“If you’ll excuse me, Mr. Harding, I would like to show my colleagues some important aspects of your . . . uh . . . situation. May I undrape you?” asked the dermatologist. He peered through large horn-rimmed glasses expectantly at Harding.
“What for?” Harding was beginning to blush, an arresting sight, as his facial color transformed subtly from a pure blue to a purplish blue, as the flush of red blood spread across his skin. The doctors watched with fascination.
“I’d like to show the nature of the color distribution.”
“Well, yeah, okay.”
“You’re sure, now? If you’re a bit shy about it, we’ll understand.”
“Well, uh, no. If it’ll help you get rid of this thing . . .” He laid back, determined to endure the indignity for the sake of being cured. The dermatologist drew a curtain around the bed, pulled away the sheet and helped Harding remove his hospital gown, revealing his body in all its middle-aged corpulent glory. The blush continued to spread, like the purple haze over a mountain at sunset. He lay in his bed, looking mostly at the ceiling, but occasionally at the doctors.
“Notice that he is not a uniform blue,” began the dermatologist, extending a silver telescoping pointer to aid his lecture. He tapped his subject’s shoulder, stomach, knee. “His skin has all the shadings of naturally colored skin, except that the color is in different values of blue, not brown.” The dermatologist took Harding’s hand. “You will see that the palms are lighter, as are the soles of the feet,” he said, laying the pointer on Harding’s feet, causing Harding’s blue toes to twitch nervously. “The freckles are darker here . . . here . . . and here.” The dermatologist tapped forearm, forehead, and chest with the pointer.
The physicians left Harding alone to recover from his embarrassment, except for a psychiatrist named Ephraim Goldstein, a spare, wrinkled gnome of a man. Goldstein stayed behind, attempting gently to make sure that Harding wasn’t so depressed over his plight that he might try something drastic. Harding assured the intense little man that he was
only blue on the outside, and Goldstein promised to return.
As the crowd of doctors gathered outside his room, some still amused, some discussing the case, an intensely serious, rail-thin nurse called Meadows from down the hall. Meadows stepped away to talk briefly on the nurses’ station phone, and returned toward the group, a mysteriously puckish look on her face.
“Doctors, I think we should proceed to room three oh four,” she said with a hint of the southern accent that led some to theorize she had descended from a Confederate general of the same name. The group followed her to the room, where, fully occupying the bed, tears streaming down her face, lay Joy Chambers, a huge woman with great jowls and small close-set eyes. She blew her nose, saw the doctors, and let out a miserable sob that shook the entire bed. She was bright red. The red of a stop sign. The red of the American flag.
By that afternoon, the La Vista, California Community Hospital held five unusually colored patients. A pretty, tearful teenager named Ellen Lucius was blue like Harding. A muscular construction worker named John Lance was red like the now-hysterical Joy Chambers. But a secretary named Ada Frye was a bright yellow, which was particularly distressing to her, because the black woman’s skin had once been a lovely rich dark caramel. By that afternoon, word had reached the puzzled La Vista doctors that County Medical Center ten miles away had one blue, one red, and two yellows. But Central Presbyterian Hospital only
had a blue.
The doctors again conducted thorough investigations, and at five p.m. they gathered in the ward to compare notes. By now they had begun to refer to the patients by color “sort of like M&M’s,” said Lesser, an impish twinkle in his eyes. “Except there aren’t any blue M&M’s,” asserted a rotund toxicologist. “It’s not a good simile.”
“Boy are you out of touch,” teased Lesser. “There’ve been blue ones for a long time.” A brief argument ensued, resulting in the dispatching of the rail-thin nurse to the candy machine next to the cafeteria. She returned and spread the candy buttons on a tray on the nursing station counter, arranging them meticulously by color. The group intently scrutinized the candies, their obsession stemming, no doubt, from the fact that they couldn’t solve the real problem—the strange malady afflicting their patients.
“See, blue ones,” said Lesser triumphantly. “They ditched the tan ones.”
“Yeah, well, the red ones cause cancer,” warned the nurse darkly.
“Ladies, gentlemen,” said Meadows. “Enough with the M&M’s. Let us address the cases at hand.”
The doctors and nurses began munching the experimental candies and continued their discussion. First, they decided to gather the affected La Vista patients in an isolation ward, since they represented the possibility of some sort of communicable disease. The two men were wheeled into one room, and the three women in another. Harding and Lance began to
compare notes, as nurses swathed in isolation gowns, masks and surgical gloves bustled in and out of the room, bringing food and taking vital signs.
“Hey, man, what if this is permanent?” asked Lance, vigorously rubbing the back of his arm, and checking his fingers for residue, although it would have been hard to see against the red of the fingers.
In the women’s ward, the yellow Ada Frye was also half-heartedly comforting Joy Chambers, who still hiccupped an occasional sob, her bulk making the action an almost seismic event.
“I’m gonna die!” she mourned. “I’m inflamed. I’m gonna jus’ bleeeeeed and die!” The tranquilizer she’d received had begun to slur her speech, and her sobs weren’t shaking the bed anymore.
“Hey, yeah, this is bad, that’s true,” said Ada Frye. “But we gonna get over this. We not gonna be colored like this for good. The doctors will find something. It’s food or something. Or the smog, or some drug.”
“Ohmigod! I look like a cartoon!” sobbed Ellen Lucius, minutely examining her perfect-but-blue teenaged face with a hand mirror. “Like, it looks real permanent. This would absolutely ruin my chances for cheerleader! Everybody’ll stare! It would be the absolute end of my life!”
“Maybe it’s an allergy,” said Ada Frye. “I got allergies.”
“Yeah, me too,” snuffled Joy Chambers, sinking into the pleasant fog of the tranquilizer. “I take shots.”
“You take shots? Like, I take shots!” exclaimed Ellen Lucius.
“Dr. Clayton?” asked Ada Frye.
“Yeah, I think. Yeah, that’s him! Next to the Domino’s Pizza!” exclaimed Ellen Lucius, putting down her mirror in teenaged amazement.
“Yeah, Clayton,” agreed Joy Chambers.
“That little scum!” screamed Ada Frye.
Had the women not fallen into an angry clucking of denunciation, they might have heard the bellowed conclusion of a similar conversation in the next room as John Lance shouted “that little jerk! he did this!”
As the patients raged on, a young man pushing a meal cart down the hall paused outside their door. If anybody had noticed him, they would have seen that he stopped just a little too long at each doorway, peering in just a little too intently at the patients. He pushed his horn-rimmed glasses up on his nose, seemingly a nervous habit, because the glasses were staying put quite nicely. He went on to deliver the meal cart to its proper place on the ward and retreated to a quiet corner. There, he took out a gray, bound notebook and spent fifteen minutes assiduously writing notes.
Had anybody paid any attention to him, they would have noted his remarkably round face, his dark little eyes, his dark eyebrows, and his small, straight nose. His little bow-mouth seemed to be set into his pale face like the parts to a Mr. Potato Head stuck into a cantaloupe. His ears were intricate fleshy shells, also seeming to be stuck into the sides of the round head. The ears were accentuated by his short crewcut, which he rubbed occasionally, seeming to relish the tactility of the brushy hair.
Closing the notebook, he slipped away, unnoticed by the busy doctors and nurses, who paid little attention to people such as him.