SHAYNE M. BELL

Anomalous Structures of My Dreams

OF COURSE IT WASN'T A private room. Medicare doesn't pay for that. Never mind that next door was an empty room with two beds never slept in. I had to share a room. Never mind that when you're sick enough to be hospitalized, the last thing you want is for a perfect stranger and usually the stranger's family and friends to watch you be that sick. It was cheaper to keep two people in one room, end of discussion, throw up if you have to and let a roomful of strangers watch you do it.

I was admitted late in the day. The man in the bed next to mine lay there breathing raspily, watching them move me in. He never said a word. His frail little wife and, I assumed, daughter stood up to make room for the nurses and me. I nodded at my roommate, but that was all -- what do you say when nurses are helping you into one of those ridiculously high hospital beds, putting a needle into the back of your wrist to start an IV drip, and injecting you with antibiotics?

"Can I get you anything?" one of the nurses asked me when she was through with her part in the little drama.

Yes, I thought, get me out of here. Get me well and get me out of here.

When my roommate's visitors were gone and it was late and all the TVs were off, the two of us in that room still lay awake. He'd cough, trying not to make a lot of noise, then I'd do the same. "What are you in for?" he asked me suddenly through the curtain separating our beds. His question made it sound as if we were criminals about to discuss our crimes.

"Pneumonia," I said. "Noninfectious." I did not go on to say that it was PCP pneumonia and that this AIDS-related opportunistic infection would kill me if my doctor didn't find a way to kill it first. I did not have an immune system left to fight it with.

"I've got pneumonia, too," he said, wheezing. He coughed hard. No way! I thought. They'd put me in a room with somebody coughing up yet another strain of lung killer I couldn't fight? "What kind?" I asked. "They don't know," he said. "Something rare."

In the night, when he was sleeping, I unhooked myself from the IV and oxygen feed and walked out to the nurses' desk, hospital gown tied shut and held shut as well. I asked the head nurse about the condition of the man in the bed next to mine. I figured I had a right to know. "It's not to worry," she said. "Mr. Schumberg can't possibly be infectious. He should be getting better soon."

"But if he has something different from me and I catch it -- I can't fight it. I could be in serious trouble."

"Your physician approved your room assignment. You can talk to her about it in the morning, but I'm sure you'll be fine."

It was all she would say. Patient confidentiality rules forbade her from telling me anything specific about my roommate. I walked back to my bed and saw that the man next to me had an IV pentamadine drip just like mine. That fit serious pneumonia treatment. I wondered what strain he had.

Even I could see that by morning my roommate was not getting better. He was noticeably worse. All he could do was cough. Our nurse started his pentamadine drip, then she started mine. I felt the cold drug course through my veins and around to my heart and brain. I did not understand why the nurses couldn't warm the drug first, why they couldn't at least let it sit on a counter and come to room temperature. They always took it straight from the refrigerator and started it icy cold into my veins. I had asked them to warm it the last time I'd been admitted, but no one wanted special requests to remember or a patient fussing with hospital procedures. I didn't say anything this time. I just gathered up the blankets around me.

When the nurse left, my roommate turned on a football game rebroadcast on one of the sports channels, then he completely ignored it. He called his wife and asked her why she wasn't here yet. I found myself wishing that I had someone to wait for, someone who could walk through the door at any moment and bring flowers or a newspaper and gossip about friends. I'd been too sick for too long to keep up many friendships. My closest current relationships were with my doctor and the staffs at the pharmacy and the food bank. My little sister lived in Minneapolis and she might call, I thought. If I let her know I was in here, she might call. His wife arrived before any of our doctors made rounds. I heard her kiss her husband, and they murmured a few words. Then she stepped around the curtain and smiled a little nervously at me. She carried a small bouquet of lilacs arranged in a dill pickle bottle she had washed the label off. She set it on my dresser.

"Thank you so much," I said, and the tears set in. AIDS was making my brain shrink, among other things, but the only effect I'd been able to notice so far besides the headaches was the constant crying. I could not control my emotions. I'd cry if I ran out of shampoo or if the electric bill arrived one day earlier than usual. I couldn't help it. I sat there with tears in my eyes over this lady's unexpected kindness, and I did not dare blink for fear the tears would run down my cheeks and she'd see.

"I hope you're well soon," she said, and she patted my knee and stepped back around the curtain to be with her husband.

I leaned back and wiped my eyes. I inhaled the fragrance of the lilacs mixed, oddly, with the lingering smell of dill which you can never quite wash out of a jar. I hadn't been able to ask her name, and she had not asked mine.

My doctor made quick rounds. She prescribed a higher dose of Tylenol to bring down my fever, then she was off to her clinic. The resident interns on the floor made their rounds. About an hour later, Mr. Schumberg's doctors arrived, three of them. We were in a teaching hospital so it was not unusual to see teams in a room -- but these were all doctors. There were no interns among them as far as I could tell. They turned off his TV and pulled the curtain completely around his bed. I lay back and closed my eyes.

I couldn't help but overhear everything. After a while, I realized they weren't asking him regular questions. It was all about his work, not his condition.

"I was in the research and development end," he said. "Masked and gloved and in a damned hot bodysuit."

"You couldn't have breathed them in?"

"Through the biohazard glass and the steel shield between them and me? Through my suit? I don't think so." He stopped and coughed and coughed. "It wouldn't have hurt me if I had," he continued when he could talk again.

"My husband is always very careful," his wife volunteered.

"He's not responding to treatment, and we're trying to determine whether something we've overlooked could be the reason why," one of the doctors said.

"How did you work with them?" another asked.

"You suit up before you enter the research area, then you fit your hands into white, pressure-sensitive gloves that control the movement of robotic arms in a hermetically sealed room you never enter. Those robots do all the actual work for you. You strap on goggles that let you see what you're doing. You never come into physical contact with the projects."

He coughed again and again.

"Could you lean forward, please?"

They talked on like that while they listened to his lungs. I was too fevered and chilled from the cold IV to pay them much attention then.

They took sputum samples from both of us. They came back for another from him at noon, then another from him at four o'clock. They took him away in a wheelchair to x-ray his lungs. His daughter Ann came to sit with him in the evening and to spell her mother. Ann kept going to the sink to freshen cool washcloths that she put on her father's forehead.

My fever spiked again in the evening, despite the increased Tylenol. I'd been trying to drink liquids all day on top of the saline drip to do what I could to help my body fight the pneumonia, but it wasn't conquered yet. I'm impatient when I'm sick. I want whatever it is -- cold, flu, PCP pneumonia -- to be over now. Progress always seems slow. But it's especially troublesome when all you have to do is lie in bed while your doctor and teams of nurses concentrate on your condition. It's impossible not to focus on it yourself. All your little aches and pains seem magnified. You watch yourself for the slightest signs of improvement. If there aren't any, you wonder why. You wonder what's happening. You start worrying about what you've left undone and unsaid. Living with AIDS as long as I have, you'd think I'd have said it all and prepared everything long ago. Most people would think that someone like me would have had plenty of warning to get ready, but you never have plenty of warning. There's never enough time. You always need more.

Night came, and all the visitors left and most of the TVs finally went off. Still I could not sleep. Neither could my roommate. We lay there taking turns coughing. His cough seemed much worse. He'd cough and cough, then gasp for air, then cough some more. He did not try to hide it now. He started moaning between coughs.

"Do you need something?" I asked him through the curtain. "Do you want me to call a nurse?"

"I just need to catch my breath," he said. "I'll be all right."

But he could not catch his breath, and his coughing fits lasted longer and longer. His coughing seemed to come from the depths of his lungs. After one long coughing fit, I heard him throwing up.

I hit the "call nurse" button, but no one rushed in. No one came at all. Damn them, I thought. I unhooked my IV, took off my oxygen feed, and got out of bed. I pulled back the curtain, thinking I would at least hand him his plastic vomit bowl, but the sight of him shocked me. His vomit was bloody. It was all over his bed and had splashed onto the floor. He was choking for air.

I headed out the door. "Mr. Schumberg needs help!" I called to a nurse in the hallway. "He's choking in vomit."

That got attention. She ran into the room, and another nurse soon followed. I sat in a chair in the hallway while they worked on Mr. Schumberg. After a few minutes, his choking stopped, but he kept coughing.

The elevators at the far end of the hall soon opened, and a short Mexican woman stepped out pulling a cleaning cart behind her. They hadn't wasted any time calling housekeeping, I thought. I did not envy this woman's job. She pulled on gloves, and the nurses asked her to mop the floor first so they could walk around in there. After that, she carried clean bedding in and came out with the soiled. She went back in to keep cleaning. I waited until one of the nurses had left before I walked back in.

The smell of disinfectant was strong in the room. They had raised the back of Mr. Schumberg's bed to a 90-degree angle, so he was sitting straight up. A nurse was increasing his oxygen flow. When she left, he sat there with his eyes closed, so I didn't say anything. I was certain he did not feel like talking. I started to climb back into bed, but I saw blood on the floor between our beds. The woman from housekeeping was mopping around the sink. I stepped over to her.

"I'm sorry," I said, "but there's still blood between the beds."

"Ai!" she said. She went out to her cart for a different mop. After she had cleaned up the mess with that mop, she came back in with another mop dripping with disinfectant. She mopped vigorously under both beds.

"Gracias," I said.

She smiled at my Spanish. "Nada," she said.

I got back into bed from the other side. She finished her work, then she pulled off her gloves, thew them in the trash, and washed at the sink. I saw that her nametag read "Maria."

I had the first of the odd, frenetic dreams that night. In it, everyone I knew rushed around carrying rocks and furniture and sandbags to a wall we were tying to construct around the downtown highrises. No one would tell me why we were doing it, just that we had to work faster and faster. All the buildings we were attempting to protect were lit from floor to ceiling, and that's what I remembered most from the dream when I woke at 2:00 A.M.: the oddly lit buildings burning gloriously bright while the rest of the city was dark and apparently without electricity.

I pulled the covers up around me. I could feel the fever hot inside me. The ice had melted in my pitcher, but the water was still cool. I poured another glass and drank it. The blinds were pulled over the window so I could not look out at the city lights in the valley, but I was sure they were there. It took a while for me to go back to sleep.

THE INTERNS WERE very worried about the blood in Mr. Schumberg's vomit, and I was certain the doctors would be, too. The head intern sent him for more x-rays before breakfast. When my doctor did her rounds, she ordered a follow-up x-ray of my lungs. When the nurse wheeled me back into the room, Mr. Schumberg was sitting on the side of his bed in conference with the three doctors. His breakfast lay untouched on his table. He had his feet over the side of his bed, and he was trying to sit up straight. He was entangled in IV lines and the oxygen feed to his nose. The doctors pulled the curtains around his bed while the nurse helped me back up into mine.

"There are anomalous structures forming in the lower third of each of your lungs," I heard one of the doctors say to him.

"How do you mean 'anomalous'?" he asked, and then he coughed.

"They are right-angled or curved, not irregular as would be the case with cancer. We have to biopsy the structures to see what they are, then remove them if necessary."

"When?"

"Now. Today. We have the biopsy scheduled for one o'clock. Don't eat breakfast."

They were quiet while Mr. Schumberg signed the consent forms for the biopsy.

"We also need you to sign this form allowing us to contact your employer. If the biopsy confirms our guess, we have to talk to them about what might be forming in your lungs and how best to proceed."

"Lungs are too wet for my projects," Mr. Schumberg said. "Human tissue is too wet. They can't be growing inside me. This is something else probably a malfunctioning x-ray machine."

"We're having that checked."

He signed the consent forms, and they left and the nurse left. I did not hear Mr. Schumberg settle back into bed. After a time, I could hear that he was crying. That surprised me. I wondered if this was the most serious diagnosis he had had to face. I remembered crying after they'd told me I was HIV positive all those years ago. I'd managed to wait until I'd made it to my car where I'd been alone. I'd known that nothing in my life would ever be the same. Maybe he was thinking similar thoughts.

Listening to him cry made me teary, but that was just my shrinking brain. I wished that his wife were here to comfort him. I did not feel comfortable trying. Blubbering hospitalized AIDS patients can do a lot of things, but cheer up other patients is usually not one of them.

I wondered what was going on.

His wife came soon enough, but so did officials from his work. They grilled Mr. Schumberg about lapses in procedures I could not make sense of, and he claimed there had been none. His wife said again that "he is always very careful." I started to wonder just how careful he had been or, if he were the careful man his wife claimed, whether his company had set up adequate procedures to protect him in the first place.

One of the doctors came in to ask questions of the company officials. They all studied Mr. Schumberg's lung x-rays. The company officials asked for copies and left quickly. Nurses arrived to take Mr. Schumberg away for the biopsy. His wife walked down to the waiting room, but soon she was back in the chair by his bed.

"Do you mind if I turn on my husband's television?" she asked. "The waiting room is so crowded and all anyone is watching is football. I'll wait here for Bernie."

I told her to go right ahead. She turned on a cooking channel which she completely ignored. She called Ann to tell her about the biopsy and possible surgery, then she leafed through an issue of Good Housekeeping. After an hour or so of Northern Italian pastas that I at least watched, she walked back down to the waiting room.

The room was oddly quiet after she left. I turned off the TV, but it was more than that, of course. Being around Mr. Schumberg and his family made me think, too much probably, about what my life lacked. Mr. Schumberg had other people in his life. The quiet hospital room would be like my quiet house when I was well enough to drive myself home again. It was time to make some changes, I thought. Time for some improvements. I knew that hospital resolutions were like New Year's resolutions -- seldom remembered after discharge. But I'd remember this one. There were people I could call, old friends who'd maybe want to see me again, new friends to make. I'd even leave here with pasta recipes to cook for them.

My chest ached from all the coughing, and I could not stop. They gave me a liquid medicine to control the cough, and it seemed to help for about half an hour. My fever was higher, not lower -- 103.5 now, and that in the daytime. I was chilled. I asked a nurse to bring me another blanket to wrap in.

My doctor surprised me by coming back to my room around three o'clock, hours before evening rounds. She pulled on gloves before coming over to me, which she would never normally do.

"How do you feel?" she asked.

"Sick," I said.

"Lean forward," she said. "I need to listen to your lungs."

I did as she asked, then she percussed my back and chest, asking whether any of the taps hurt. They all did.

She excused herself and walked out to the nurses' desk. I could see her through the doorway. One of Mr. Schumberg's doctors walked over and talked to her. He opened a chart and showed her a series of x-rays. She held an x-ray she was carrying up to the light for him to look at, and he shook his head. The head intern walked over to look. I could see that my doctor was getting angrier by the minute, though I couldn't hear what any of them was saying. A nurse at the desk hurried to hand her a form, and she walked back into my room with the head intern.

"I'm getting you out of this room," she said.

"What's wrong?" I asked.

"Where do I start? With the health-care system in this country? With free-enterprise capitalism that thinks it can chew up people and spit the ones it damages into hospitals unequipped to handle them?"

She was filling out a form for the room transfer. I'd never seen my doctor this angry.

"You might have picked up what Mr. Schumberg has," the intern said.

I leaned back and closed my eyes. "But they assured me he was noninfectious," I said pointlessly.

"They told me the same thing," my doctor said. "They used to have an AIDS ward in this hospital. If they'd kept that going, as I'd advised them, we wouldn't have this problem."

"What does Mr. Schumberg have?" I asked.

The intern looked at my doctor.

"That's the million dollar question," my doctor said.

When she was through with the form, she handed it to the intern and walked to the window. She held up an x-ray in the light. "These are of your lungs the day you were admitted," she said. She pointed out the areas affected by the pneumonia. "Now here's your x-ray from this morning. It came to me just half an hour ago."

She held the new one up in the light. There was a small dark rectangle in the lower portion of my right lung.

"What is it?" I asked.

"I don't know," she said. "But apparently it's not organic."

"What do you mean 'not organic'?"

"It's metal."

"How did it get there?"

"That's what we need to find out. I'm heading down to see what the biopsy discovers in Schumberg's lungs. In the meantime, you're getting your own room and isolation."

She left in a hurry. The intern was leafing through Mr. Schumberg's chart.

"I don't get it," I said. "How do you catch 'metal rectangles' in your lungs?"

The intern shrugged. "We don't know yet. Mr. Schumberg developed symptoms of pneumonia two weeks ago, but all standard treatments failed, first antibiotics at home, then in-hospital treatment. He apparently works for the research arm of a telecommunications company. Yesterday after each successive x-ray showed the anomalies in his lungs changing and growing we started wondering if something from his workplace could be causing his condition."

"And you left me in here with him?"

I was furious.

"We weren't putting together all the pieces. Until three hours ago, we still thought there might be something wrong with the x-ray equipment. But the technicians assure us it's functioning perfectly."

I just sat there, stunned, not knowing what to do or expect with a metal rectangle of some kind growing in my left lung.

"You might have a million dollar lawsuit on your hands," the intern said. He seemed to think that would brighten things up for me.

WHEN YOU CONTRACT a disease like AIDS, you think that that is what is going to kill you. With AIDS, I had any of ten or fifteen opportunistic infections either singly or in combination lurking as my executioners and time to imagine facing them all. You never think that your end will come in some unexpected way like a bus hitting you in a crosswalk. That's what I felt like alone in that room again. I felt as if I were standing in the headlights of a Greyhound bus.

I unhooked myself from the IV and oxygen feed and packed the few things I had brought with me to the hospital so I'd be ready to move to the new room. Then I hooked everything back up and waited. After about twenty minutes, they wheeled Mr. Schumberg into the room. Mrs. Schumberg followed his bed in, and she had tears in her eyes. Mr. Schumberg did not look good. I just looked at all of them, wide-eyed. I knew room transfers could take a while, but I'd expected to be gone when they brought him back. They pulled the curtain while they moved him onto his own bed, but I could hear him wheezing and coughing and moaning. The two nurses who brought him in were coughing, too. Add my coughs, and it was a noisy room.

Ann soon arrived. I was surprised to see her in the daytime since I knew she had a job. She stepped over for a chair from my section of the room. "They're taking Dad into surgery as soon as possible," she told me. "I took the afternoon off to come sit with Mother through this."

"I'm sorry," I said, "but I hope the surgery helps your dad get well."

It was the least I could say, even under the circumstances. Ann was pulling the chair past the end of my bed. I decided to try to get some answers. "What did your father do?" I asked Ann. "They think I might have picked up what he has."

She stopped and looked at me, then she sat in the chair. "What's happened?" she asked.

I told her about the x-rays of my lungs.

"Dad designs ultrasensitive communications equipment," she said.

"I don't understand," I said. "How could that affect his lungs and now mine?"

"Let's ask him," she said. She stood and pulled back the curtain. She explained the situation to her father. No one said anything for a moment. None of us even coughed for a time.

"I design machines that build -- " Mr. Schumberg said, then he started coughing again. "That build themselves from the molecular structure up--nanotech. Our nanomachines carry the plans for communications devices. They process local materials and build our equipment in hours. We wanted them for emergency situations, military patrols. People could carry a telecom center in a matchbox."

I lay back and looked out the window. It was starting to make sense. Nanotechnology and the marvelous machines it would supposedly create had been in the news for years. His nanomachines had somehow escaped from the lab to the wider world -- or at least to our lungs. I imagined microscopic nanomachines eager to build radios and handsets coughed out in a fine spray from Schumberg's lungs hour after hour for the days that I had lain next to him.

"What were your machines supposed to grow from?" I asked.

"Dirt or sand. Start the process and my little machines fan out to find what they need in the local environment. Lungs -- human tissue -- were supposed to be too wet for them to grow in."

"Apparently they weren't," I said.

He looked appalled. So did Ann and his wife.

"How do you turn them off?" I asked.

He thought for a moment. "High-dose radiation would do it.

Extreme heat." He looked back at me. "Basically, at this point, you don't turn them off. We were still trying to design decent shut-off mechanisms."

Hence his rushed surgery and, I imagined, my own to follow shortly though how they would operate on lungs sick with pneumonia I didn't know. At least I was finally able to make sense of what was going on. Apparently the wetness of a person's lungs just slows down the nanomachines, and apparently each microscopic automaton carries the plans for the entire finished set of equipment. They are programmed to work together if they encounter others of their kind, but all you really need is one of them. It just takes longer if you start from such a small beginning. Still, at the rate things were going, Mr. Schumberg thought I could look forward to a satellite uplink and all the necessary receivers and transmitters in my own chest by Thursday noon unless they could cut the damn things out.

I watched nurses set up a table with disposable plastic gowns and gloves and masks, just outside the door to our room. The head nurse soon walked in covered in protective gear. She asked Mrs. Schumberg and Ann to step out to gown, glove, and mask, too.

"What's the point now?" Mrs. Schumberg asked. "I've been with Bernie every day since he took sick."

"Gown and mask now or leave the room," was all the nurse said. She stood in the middle of the room until Mrs. Schumberg and Ann had stepped out to do as she ordered.

I stopped the nurse before she could leave. "Ma'am," I said. "My doctor said I would be getting a different room."

"I'm afraid not," she said. "Administration ordered us to quarantine those of you with this problem in as small an area as possible. You'll be staying right where you are."

The nurse pulled a large trash can into the room and positioned it by the door. She pulled off her gown and gloves, threw them in the trash, and left quickly. Ann and Mrs. Schumberg came back in dressed in the hot plastic. Ann told Mr. Schumberg and me, her voice muffled through the mask, that they'd taped a contamination warning next to the door and hospital policy about the use of protective gear when entering the room, instructions on how to take it off when leaving the room so as not to spread what might be inside, and warnings to visitors and staff.

"Will plastic protect people from your nanomachines?" I asked Mr. Schumberg.

Mr. Schumberg hit his call nurse button. The head nurse stepped back to the doorway.

"Plastic is no protection," Mr. Schumberg told her. "You should use cotton. The hydrocarbons in plastic will attract the nanomachines much faster."

"Your company advised us that this was a possibility," the nurse said. "But who has disposable cotton gowns anymore? I'm not sure we could even buy them. None of us will wear the gowns or masks very long. We'll take them off and leave them in the trash in your room, which Sanitation will remove and burn each hour. Fire will apparently destroy any nanomachines on the plastic. The masks at least are cotton. It's the best we can do."

The nurse left, and the room grew suddenly quiet as the air-conditioning went silent. They apparently did not want the air from this room recirculating.

Mr. Schumberg reached out for his wife's hand. She stood up and put her gloved hand in his. "Get out of here," he told her. "You and Ann -- go now and pray you don't already have them."

"I'm not leaving you, Bernie," she said.

"No," he said. "There were other projects, more dangerous. If my nanos escaped, so did theirs. If all those nanos work together, God knows what they'll build. This is a level ten."

Mrs. Schumberg put her hand over her mouth when he said that.

"What's level ten?" I asked.

Mrs. Schumberg looked at me. "Possible contamination not just of the local area, but of the entire world."

Oddly, I didn't feel tears in my eyes over any of this. I was starting to get very, very angry. "And there's no reliable way to turn off your machines?" I said. "You built something that could contaminate the world -- and you did not first design a way to turn it off?"

"There's a way," he said. "We always kept a failsafe. We never thought it would come to this."

Ann and Mrs. Schumberg were gathering up their things.

"Hydrogen bombs," he went on. "You can only stop a level ten in the early stages. The military observers back in the lab must know what happened." He looked at his wife with tears in his eyes. "Get out now."

But it was already too late. Hospital security turned back Ann and Mrs. Schumberg at the elevators. No one was leaving the hospital, or at least this floor, for now. Ann and Mrs. Schumberg regowned and gloved and masked and sat quietly back in their chairs. None of us talked. They did not even turn on the television. In that quiet, I could hear nurses and other patients coughing. Granted this was a pulmonary ward, but it seemed to me that I was hearing more coughing than before, especially among the staff. Ann and Mrs. Schumberg both coughed a little now, too. It was impossible not to imagine Mr. Schumberg's nanomachines fanning out to find what they needed in the local environment, a determined little plague gobbling up the dust between the tiles and the dirt tracked in on people's shoes and when that wasn't enough looking for what they needed in other places. They had clearly learned that they could find what they needed in human lungs. Mr. Schumberg's and my lungs had taught them that.

A team of nurses arrived to prep Mr. Schumberg for surgery. They untangled him from all the IV lines, but not the oxygen feed. That would go with him. He looked over at me. "I'm sorry," he said.

I did not know what to say. He'd worked on a project that could contaminate the world and that only hydrogen bombs could control, but he was sorry. His apology rang a little hollow to me. I ended up not saying anything in reply.

The nurses pulled a transfer bed alongside Mr. Schumberg's bed.

"Can you sit up?" one of the nurses asked.

He tried, but he could not sit up. Apparently he was suddenly too weak to move. "It hurts to move," he said, and he coughed and coughed.

Nurses walked to either side of the bed and tried to lift Mr. Schumberg forward, but they could not do it. They could not budge him from the bed, either. He coughed and coughed and moaned.

One of the nurses pulled back the blankets. There were no restraints, if that was what she was looking for, but there was blood slowly seeping out from around Mr. Schumberg's back.

Mrs. Schumberg gasped, and Ann stood up. The head nurse went for towels to staunch the blood with. They tried to turn Mr. Schumberg onto his side, but they could not move him.

"Stop!" Mr. Schumberg said. "Just let me lie here for a minute."

"We have to stop the bleeding," the head nurse said. She started feeling underneath Mr. Schumberg's back. "Call Dr. Adams!" she said after a moment. "Stat."

Adams was one of the three doctors I'd seen conferring on Mr. Schumberg's case. He came on the run, as did the resident intern in charge of the floor that afternoon.

"For God's sake gown and mask first!" the head nurse shouted at them when they rushed into the room.

They went back out and did as she asked, then she had them feel under Mr. Schumberg's back. "Something's hooking his back to the mattress. It's gone through the sheets and into the plastic padding."

Dr. Adams felt under Mr. Schumberg's back. There was more and more blood oozing onto the bedding. Dr. Adams knelt to look under the bed. "Just wheel him to surgery in this bed," he ordered. "Now. I'll call the OR to advise them."

AFTER THEY LEFT, I lay alone again in the darkening room. But I did not lie there for long. I sat up so that my back could not touch the bed. I looked behind me for signs of blood on the bedding, but there were none.

Yet.

I felt around my back for odd bumps, but there were none, either. Still,

I did not lie back down.

I sat there, thinking. If what Mr. Schumberg had said were true, there were people I needed to warn to get out of the city. It being late afternoon on a Tuesday, I reached lots of answering machines. I left messages telling my old friends to leave town -- to call me for details if they wanted, but that they had better trust me on this one, especially if they couldn't reach me at the hospital for some reason. The only person I found at home was my cousin Alyson in Magna.

"Why didn't you tell me you were in the hospital?" she asked.

"That's not important," I said. I tried to explain what was happening and that she should take her kids and leave now.

She was quiet for a time. "Look," she said. "Are you all right? I mean, this isn't making sense."

She probably thought my dementia had gotten worse. "It will make sense," I said. "I just hope it's not too late for you when it does."

She said nothing.

"It must be making news," I said. "Is there anything odd on the channels about Salt Lake?"

We both turned on the same twenty-four-hour news channel. Five minutes later they ran a story about the closure of the Salt Lake City International Airport. An early spring heatwave had buckled so many of the runways, they claimed, that no flights could take off or land. Since Salt Lake is a Delta hub, this was big news -- hundreds of flights had to be rerouted. Officials did not know when the problem would be resolved, especially if each runway had to be resurfaced. Of course, the day's high temperature had only been sixty-seven, but they interviewed an expert who explained why sixty-seven degrees Fahrenheit was high enough on a sunny day to buckle runways.

"Oh my God!" Alyson said slowly as she read between the lines.

"Go now before they close the roads," I said.

We wished each other luck and hung up. Maybe they had already closed the roads, I thought. I'd have to wait until five o'clock and the local news for cleverly disguised stories about that. The airport story, however, made it clear that somebody was quarantining these valleys. I realized, of course, that no responsible government could let people fly all over the world and spread Mr. Schumberg's nanomachines. Still, I was surprised that it was happening so fast. It was almost as if they had had a plan for this in place. On a whim, I pulled the telephone book out of the top dresser drawer and looked up the number for the bus station. I called them just to see if buses were moving. I asked if I could buy a ticket to Denver that night.

"I'm sorry, sir," the attendant said. "We are unable to book any tickets at this time. Please call back in the morning."

She would not give me a reason for her inability to sell tickets. I could only get a recording at the train station.

Oh, we were good people, I thought. Everybody was doing what he or she had been told to do, at least for now. I wondered how many people in Salt Lake really knew what was happening. There were three million people in the connected valleys along the Wasatch Front. It would not take long before lots of them were asking questions. I wished Alyson and my friends luck out on the roads.

The head nurse phoned me to ask for the names of everyone who had visited me in the hospital.

"Just my doctor," I said.

"No one else? No friends came by? No family?"

I hated answering those questions. "No," I said. "I have one sister, but she's in Minneapolis."

"All right," she said, and then she coughed. "Sorry to call you like this. I just didn't want to pull on one of those hot gowns again. Saves time and gowns."

Oddly, after the phone calls, I slept for a time. When I dreamed, I found myself helping to build the wall around the downtown highrises again. The entire cityscape was weirder in this dream. Large sections of the valley seemed to have been flattened to the ground, while among the towers lacy filaments strung with lights danced on the evening breezes. It was so hot down where we were working. Everyone's shirt was wet with sweat. I wished that I could be twenty stories up to feel the breeze. We could not feel a breath of air where we worked and sweated. I tried to wipe the sweat off my forehead.

I woke with a start. My doctor was holding my wrist in her gloved hand, taking my pulse.

"You can still feel a pulse through these gloves," she said. "Sorry to startle you."

"It's so hot in here," I said.

"I asked Housekeeping to bring in a fan. They should be on the way with it. Your temperature's up. One-oh-four now. Pulse is high, too."

I could feel my heart racing.

"We're taking you into surgery in two hours."

"That late in the day?" I asked.

"None of us is leaving here, so it's easy to round up a top-notch team.

The entire hospital's under quarantine. Meantime, the police are tracking down everybody who might have come in contact with Mr. Schumberg or his company, and they're bringing them here to be checked. Apparently they've already turned up six other cases among the people who've been calling in sick at his company. Their HMOs were treating them for everything from bronchitis to asthma. They have them down in the ER now as the initial intake area, but they'll be bringing them up to this floor for care."

"How is Mr. Schumberg?"

"Still in surgery. I'll be heading down to see what they bring out of him before we start on you. But what you have is much smaller. It will not be so hard to remove."

"How do you know that surgery will get it all?" I asked. "Apparently a radio tower can grow from just one nanomachine. How do you know that you won't have to cut this out of me today, then repeat the procedure again four days later, then again four days after that?"

"We don't," she said. "All I know is that what we can see now must come out. We'll cross other bridges if and when we have to."

I turned my head and covered my mouth to cough and decided to tell her the rest of what Mr. Schumberg had said. "It might be too late for all of us anyway," I said.

"Hang in there," she said. "We've been through a lot together, you and me. This is just the latest challenge."

"No, you don't understand. Has anyone told you how the government would control a level ten contamination, and that this might be a level ten?"

"I've heard," she said. She pulled up a chair and sat down. She looked mostly tired now, not angry. "The rumor mill is working overtime in this town, as you can imagine. We've got maybe a quarter of a million people trying to walk over the mountains since every other way out of the valley is closed. The police and the National Guard on the other side are just rounding them up and taking them to camps when they come down through the passes."

"But you didn't try to get out? Surely some are making it through. How can you stay here?"

"I have patients to care for and more on the way."

She stepped to the window and looked out at the city. "I don't think they'll drop bombs just yet," she said. "The medical community in these valleys is working furiously to discover how far the contagion has spread. Surely the government will wait till we've at least answered that question. Besides, they won't let me leave. No one can leave. Plenty of the staff has tried. This place is sealed tight. Believe me, if I could have had you and my other patients evacuated to the hospital in Cheyenne, I would have."

Having part of your lung removed is no fun. But having it cut out when you have pneumonia is the equivalent of medieval torture. Pneumonia makes you cough, and each cough after my surgery was agony. They kept me heavily sedated, so I did not know much except the pain until the day after the surgery. They had my bed positioned at a ninety-degree angle, so I was sitting when I woke up. There was a different man in the bed next to mine.

"Who are you?" I asked him, and he told me some name I can't remember.

When my doctor made rounds, I asked her what had happened to Mr. Schumberg. She was quiet for a time, then she took hold of my arm. "He died during surgery," she said. "I didn't want to tell you till after your own surgery."

I did not know what to say. I looked at the lilacs Mrs. Schumberg had brought me.

"Aren't you afraid of catching this?" I asked my doctor.

"Of course. But if I were afraid of catching my patients' troubles, I would never have become a doctor."

I wanted to send Mrs. Schumberg flowers. I imagined that she was still here in the hospital, quarantined like the rest of us. I wondered if the gift shop could find her and deliver them to her, but I felt too sick to call the gift shop then. At least Mrs. Schumberg and Ann were together.

My doctor showed me a picture of what they had cut out of my lungs. It looked like a black metal rectangle with a knob forming on one end. They'd had it incinerated.

I knew the hospital had become more crowded -- it was much noisier outside my room --but I did not realize just how crowded it was until they took me to Radiology to x-ray my lungs. We could hardly move down the hallways. There were people sleeping in every available chair and others sleeping in sleeping bags on the floors. They had apparently quarantined the entire day and night shifts of doctors, nurses, and interns because many of the people I saw were medical personnel. But there were lots of other people as well just wandering the hallways. They all looked bewildered and tired.

They took my x-rays, then wheeled me back up to bed. After about an hour, my doctor came in with the x-rays in hand. She looked grim.

"It's growing back," she said. "Surgery is backed up, but I was able to call in a few favors and schedule you for surgery at four o'clock this afternoon."

"It won't stop it," I said. "You know that now."

She sat in the chair next to my bed. "What do you want me to do?" she asked. "We can't leave it inside you."

I thought for a minute. I imagined all of us with nanomachines consenting to euthanasia and having our bodies burned, but then I remembered something Mr. Schumberg had said. "High dose radiation might stop it," I said. I told my doctor what Mr. Schumberg had told me.

"How high is high?" she asked. "Wasn't he referring to hydrogen bombs?"

"Who knows?" I said. "But don't they use radiation in cancer treatment? The equipment must be here to expose me to it. What do we have to lose? Use me as a guinea pig. Find a way to stop this before they do something drastic."

She left without saying another word.

Early the next morning, they covered my head and lower body with lead, then they shot my chest full of radiation. Afterward, back in my room and bed, I had never felt so sick. My body was rigid and hot. For a time, I could not even blink my eyes.

"He's going into shock," I heard my doctor say. "Get more blankets in here. Hurry!"

I sat there waiting for the blankets, but the very first time I was able to blink my eyes again I threw up. It went everywhere. It was bloody like Mr. Schumberg's had been.

A team of cleaning ladies eventually came in, but Maria was not with them.

"Where's Maria?" I asked.

"Who's Maria?" my doctor asked.

I explained about the cleaning lady who had helped the night Mr. Schumberg had gotten sick.

"They've been checking everyone who entered this room," she said. "I'll make sure they've looked at her."

BUT MARIA WAS not in the hospital. She did not answer her telephone. The police found her house empty, some of her things hurriedly packed and gone. She had not come to work the last two days, and even before the quarantine she had not called in to request sick or vacation time.

But by evening, they knew what had happened. Apparently Maria's papers had been forged. She had entered this country illegally. The INS had arrested her the morning after the shift during which she had cleaned this room. They had transported her that same day to the Mexican border and handed her over to officials in Nogales.

"Maria's deportation probably saves us from the bombs," was all my doctor said when she told me about it. "What would be the point now?"

Eventually I dozed off, and for the last time I was working to build walls. They were mostly high now in that dream, surfaced and smooth, and I could see people -- or things, I could not be sure when I looked closely -- walking along the tops of those walls. For some reason I knew not to look too closely or for too long. I held tightly to the rocks in my arms. I concentrated on my work.

When I came to the unfinished part of the wall and after I had handed my rocks up to men working above me, I could see out across the valley if I stood on tiptoe. It lay completely flat now, flatter than it had ever been. It looked paved. There were no buildings. There were no roads. There were no habitations and nothing natural to be seen. The white paving on the valley floor shined brightly in the moonlight, and in the south something was eating at the mountains. I could not see the Oquirrhs. To the west, everything was completely flat and silent. Wind hissed over the smooth paving.

The next morning, x-rays showed that the anomaly in my left lung had not grown, and it did not grow the day after that either. The radiation had stopped it. They started treating everyone with it, and soon they found that lower doses repeated over several days worked just as well. I underwent surgery for the last time to remove the dead nano-construct in my lung.

They never did find Maria Consuela de Alvarez. But eventually, of course, the entire world knew everywhere she had gone in her last days, even what she had looked at and where she had turned her head. The bus the INS had transported her in and the bus she had taken to her village south of Nogales had both apparently been hot and without air-conditioning. They had ridden with the windows open. Maria had had a window seat on the right-hand side of the bus all the way from Salt Lake to Nogales, then on the left-hand side in Sonora. We know that, of course, because of all the bizarre machines that grew along the roadsides in Utah and Arizona and Sonora wherever she had coughed out the window. Mr. Schumberg's projects had combined with the other projects escaped from his laboratory to create monstrous machines they had never intended. The army and National Guard had quickly killed, if that's what you call it, the ones in America with radiation and fire.

My sister called from Minneapolis. She had been trying to call me, and had finally reached Alyson, home again after being stuck in traffic on the roads for a day and a half. "Why didn't you call me?" my sister asked. "I didn't want to worry you."

"How can I not worry about you? You're my big brother. You used to take me to parties with your friends and made me feel older and grown up. You read all the Jane Austen novels to me and taught me how to dance. I'm flying out to take care of you as soon as they lift the quarantine."

And she did come. It was my sister who drove me home from the hospital. She was the first person I cooked the rigatoni pesto for.

My sister stayed for two weeks. We had long talks over coffee on the back porch, and we looked at pictures of when we were kids. I slept a lot. She took me to follow-up appointments with my doctor and with specialists from the CDC. One night she invited Alyson and her kids over and cooked dinner. She helped me manage the requests for interviews from all over the world including, of course, the one for this story about how I had met Maria. My sister bought me a new cap after my hair fell out from the radiation treatment.

Lawyers from all over the country were also contacting me. I did not join the class-action lawsuit -- my lawyers felt I had a chance at a huge settlement on my own. The intern had been right. But if I lived to see money at the end of the litigation I wasn't sure what I would do with it. Take my sister to Paris, maybe. Or to Rome.

I had looked up Bernard Schumberg in the telephone book, of course, so I had Mrs. Schumberg's number and address, but I had hesitated to call to offer condolences. I had not sent flowers. Finally, the day before my sister was to fly home, I had her drive me to the Schumbergs'. Their house was on a shady street in a nice neighborhood on the east bench. It was a small turn-of-the-century Victorian. The yard was neat and well kept. The last of the lilacs were blooming in the back yard.

I carried a bouquet of carnations and went alone to the door and knocked. After a moment, I heard someone inside. The door opened, and it was Mrs. Schumberg. Tears came at once to her eyes, and I could not keep them back either. I handed her the flowers and I wiped my eyes and she invited me in. She was wearing a scarf to hide her bald head. Of course she had had to have radiation treatments, I thought. How could she not have picked up the nanomachines?

I told her that I could not stay long, that my sister was waiting in the car. Mrs. Schumberg did not invite her in, so I knew that I had done the right thing by leaving my sister there. It was too soon for Mrs. Schumberg to see people.

We did not know what to say to each other. "He was a good man," she said finally.

"He loved you," I said. "He couldn't stand it if you weren't with him. You were so good to him."

I left quickly.

I bought all the books with photographs of the nanomachines in the deserts, but I keep looking at the pictures of what they turned into in Sonora. We mostly don't know what they were. We have ideas on some. They had longer to work in Sonora, so everything there was bigger and more elaborate. The plans of all those different projects in Mr. Schumberg's laboratory had combined in so many unexpected ways. In their short time, the nanomachines in Sonora had "learned" more than anyone could have predicted. Some of the constructs looked like nothing more than beautiful modern sculpture. Others blended into the landscape and could be found only with heat signatures. Some were enormous, clawed horrors lurking in side canyons that, had they lived, would have begun to walk about the land to hunt and take what they needed. None of them "lived" long.

But the barren white paving over what had once been Maria's village haunts me the most. It concealed an enormous transmitter that had been calling the stars for eight days before they killed it. No one has been able to crack the code of those transmissions. We don't know what it was saying. We don't know what it was calling. We don't know why its transmissions were beamed at only three stars in alternating order. We don't know what will happen because of it.

The world is mostly afraid of the answers to those questions. But I look at the pictures of that smooth paving and wonder. Inside that construct, part of whatever it was, was all that had made up Maria Consuela de Alvarez, a little woman who had found the courage to smuggle herself here to try to better her condition. She had taken a job no one else had wanted. She had come in the night to help sick people. I don't know if any part of her could have survived to influence what was happening to her and her village. I could not have influenced what was growing inside of me, I know that. But if the construct had listened to Maria before it killed her, if it had tried to understand her (if it had had that ability), maybe the transmissions were calling angels to Earth, not devils. I'd like to live long enough to find out.