This is one of a collection of stories that are like “Final Destination” meets “The Monkey’s Paw” (W. W. Jacobs, 1902). As such, they are tragedies more than either mysteries or horror, and would appeal most to readers who enjoy the inexorable pull of a story arc that leads to doom. In each story, a protagonist makes a wish that comes true with fatal results for someone, often the person making the wish. Nothing supernatural, but just how things work out. (Or is it?) The technical details surrounding the fatal (or near-fatal) event are drawn from real cases in the US OSHA incident report database or similar sources and are therefore entirely realistic, even if seemingly outlandish. The plots draw lightly from cultural beliefs around actions such as pointing at someone with a stick or knife, wishing in front of a mirror, or stepping on a crack.
Nothing in her training as a vet could have prepared Shania for breaking the law. She was under no romantic illusion that her job as a rural vet was going to be all kittens, puppies, and bunnies. She knew that most of her daily work would be early starts, rough roads, and late nights far away from the city lights. She knew her patients would be mainly livestock, working dogs, and only the occasional fluffy pet.
What she hadn’t considered was that nearly a third of her patients would be the owners, and that she would be taking over the role as the local ER when the only hospital closed. It had started 5 years ago when she was stitching up a working dog that had run into a fence and noticed that the owner was dripping blood on the floor. She did what any first-aider would: She cleaned the gaping three-inch tear on his shin that he got while disentangling his dog from rusted barbed wire. Knowing that the nearest hospital was a 2-hour drive, and at her client’s pleading, she also stitched up the wound and gave him a tetanus shot. The Australian Shepherd needed antibiotics, and since she was pretty sure that the owner would share the prescription, she doubled up the number of tabs and added a dosage by weight table. The word that the lady vet would patch up cuts spread through the social network, and Shania faced countless tiny decisions about whether to deliver care and knowingly break the law or go by the letter of the law and know that people would try to treat themselves. She had heard plenty of stories of locals skipping treatment and relying on social media and gossip to treat injuries and illnesses that got progressively worse. When the choice was traveling 2 hours and paying uninsured rates at the nearest hospital, or DIY and prayer, many doubled down on prayer. Shania slowly but surely became the local urgent care and OB/GYN. Her calls to farms almost always involved looking at more than one species, one of which insisted she take some eggs, slices of bacon, or vegetables.
Travis was not a cynical or suspicious man by nature, but there were two things he had learned about life. If anyone was making a ton of money, they were likely cheating someone, and if government were eager for you to buy something, it meant they were in someone’s pocket. He knew all about how big pharma made money by milking the average working stiff. One of his cousins had the sugar sickness, and the drug maker had pushed the price up every year, to the point where Mary sometimes had to choose between the drug and paying the rent. Another cousin needed a drug that had always cost about seven bucks a month, but new management pushed the price to over a thousand. The CEO had even been pulled in front of Congress, but he just smirked at their questions. It was crystal clear to Travis that for all their smart words, the Congress critters weren’t going to do squat about the prices. It was also clear to Travis that the pharma CEOs were funding re-election campaigns, slipping cash directly to politicians, or that the politicians owned shares in the pharma companies. Travis knew when he was being lied to and he had no doubt that when pharma and government were speaking with one mouth, their hands were trying to slide into his pocket. It all got to him, and he sometimes self-medicated with barbiturates: “Pink Ladies,” “Blue Heaven,” or “Yellow Jackets.” They helped him to calm down when panic swelled up inside his chest and threatened to paralyze his heart. They also helped him to get to sleep instead of worrying in the darkness about government plots and murky schemes.
Hot tears of frustration trickled down Dawn’s cheeks and hung on her clenched jaw for a ticklish moment before dropping to her desk. As the only remaining public health employee serving three adjoining counties, she had played the role of Cassandra for several years. She had issued warning after warning about overcrowding and abuse of antibiotics on the poultry farms. She had written memos about the lack of proper segregation between wild fowl and factory birds. She had penned imploring letters about the lakes of waste from the pig farms that could easily spill into waterways that were for irrigation and personal use. With a tiny budget, no staff, and a muted voice in the state government, Dawn did what she could with what little she had. She still regularly baited and set a dozen traps out in the field, got blood and scrapings from the wild fowl and scavengers she caught, and did the analysis and lab requests as if someone, somewhere, somehow would pay attention. She had trimmed her focus somewhat over the years and had given up reporting the bubble of gut-wrenching stench that hovered over the lagoons of pig excreta and the wall of stink that billowed from the slaughterhouse and engulfed the small town and its sparse inhabitants. There was no way to measure stink, jobs and revenue trumped any complaints anyone might have, and those affected had either moved long ago or just learned to live with it. There were three issues that really did occupy her time: the overuse of antibiotics in crowded bird and pig populations, the risk of spillage from waste dams into drinking water, and the co-mingling of rodents and wild fowl with the pigs and chickens in the factory farms.
A month ago, she had reported a spill from a pig farm lagoon. Heavy rains had swollen the river and added to the waste lagoon, which had been overfilled to begin with and poorly maintained. What started as a small over-topping quickly eroded more of the earthen wall and thousands of gallons of raw pig excretions had flowed into the river. The factory owners did manage to avoid a complete breach of the wall by making some repairs, diverting to an emergency depression and pumping to the other lagoons. They were uninterested in the sewage that was now entering the freshwater supply, the fish kills, or the potential for pathogens to spread. The state government was likewise just not all that bothered and it drove her mad. There was, however, something smaller as an event, but that worried her more. A few weeks before the sewage spill, she had found a dead wild fowl in one of her traps. She saw no injuries that explained its death, and it had clearly been in reasonably good health before being trapped. She lacked any sort of genetic testing, but she had ample access to embryonated chicken eggs, a few canine kidney plates, and some blood plates. Over several days she saw clear signs that a virus had colonized the eggs, so she used up some of her precious kidney and blood plates.
The cloudy appearance of her blood plates and the lack of any halo told her that the virus was likely to be transmissible to mammals, but at that point her capability ended. She needed to get a PCR test done and that meant a bite out of her budget and a lot of begging for it to be treated as a priority. She had no ability to safely test on mice, and there seemed no other options open to her other than just being alert and doing more sampling. It wasn’t the first time she had walked this path, and previously the pathogen either retreated into whatever wild reservoir it lived in or died out. She wasn’t just going to trust luck, though, so she set up more traps, ordered more plates, and started sampling at the factory farms.
The next few weeks validated her efforts. The PCR results came back saying that she had found a novel Influenza strain and there was confirmation that it could infect humans. The good news was that the current influenza vaccine was adequate, if not optimal, and likely to have 25% efficacy. The bad news was, of course, that far more people would need to be inoculated than in previous years. In this region, vaccine adoption typically never got above the high teens, and almost never more than 30% of the population got their influenza shot.
Shania’s first visit of the day was at seven, attending to two cows with mastitis. The farmer’s wife also needed attention for fever and aches. The additional combination of congestion, runny nose, headaches, and fatigue seemed clearly to be influenza, so Shania recommended some rest, lots of fluids, and to keep an eye on the fever. Two days later, the first person in her area died of it, and it seemed like everywhere she visited, at least someone in the family was either staggering around with it or knew someone who was sick. The tri-county health department sent out a bulletin and someone from the state government went on the TV to discuss it, recommend getting the vaccine, and suggest social distancing. Because it was such a hot topic on the radio and the online chats used by farmers, it wasn’t long before wild ideas started surfacing. It was a foreign attack. It was killing thousands. It had been created in a lab at one of the liberal colleges. It was all just a hoax. It was also not long before advertisements for the vaccine, natural remedies, and gadgets for supposedly cleaning the air also flourished. Stern admonitions by the governor to get vaccinated sparked furious accusations that he was covering up a lab leak, that he was lying about the severity, and that he was hiding ties to the pharmaceutical industry. She wasn’t sure who started the rumor, but soon she was getting urgent calls to supply a common livestock dewormer.
As the story went, it was highly effective as a preventative and could treat those who were infected, but big pharma and the government were nefariously hiding this. Shania tried to argue that this just didn’t seem likely and spent hours on PubMed, the Cochrane library, and the CDC website to answer the anxious questions that filled her voicemail, email, and phone messages. She reluctantly supplied the dewormer, first to farmers who told her that it was for their livestock, and later to people who were certainly not farmers, but who swore blind that it was for their dog or cat. Eventually, people just came straight out and asked for it to dose themselves against influenza. In her mind, it was a tiny but momentous step to go from supplying a drug that someone had bought previously for livestock or pets to supplying it when it was clear that they intended it for their own use. She had known that sometimes in the past they were doing dual use, using antibiotics or wound care products on themselves that had been bought originally for an animal, but now it was blatant. Shania tried to explain that although in lab tests the dewormer had shown antiviral properties, it was at concentrations that would be impossible or unsafe to reach in a human body. She also emphasized that dosing for this drug was not linear, and that they couldn’t just apply to human weight a dose that was calculated for a horse or cow. From the reactions, it was clear that they just thought she was being evasive.
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Travis didn’t trust doctors, but since he didn’t have access to a doctor, it didn’t much matter. As a clerk for a farmer’s co-op, he had a different way to get product. He passed word around that he could get the same dewormer direct from China if he could get enough buyers to fill a bulk order. It took only a day and he had more than enough commitments to order 10,000 tablets. He felt a sense of urgency because two of his friends had come down with it and one was now in the ICU. Eight days after placing the order, his package arrived, and he felt a huge sense of relief. Opening the plain packaging, he saw that some tabs had been crushed in transit. He used those himself, but generally, he was very happy with his purchase. After dosing himself with the drug, he felt he was safe and could speak from firsthand experience that the drug was safe and effective. Travis got into a production line mode: count out 50 tabs into a packet, lick the flap, seal it, drop it into a basket, and tick off the name on a list. It was almost daybreak before he was done, and his back and neck ached. He had about an hour to sleep, but the dewormer tabs had upset his stomach, and he spent most of the time on the toilet. Puffy and red eyes stared back at him as he shaved in front of the bathroom mirror, and he popped a couple of tabs for his raging anxiety over all these odd symptoms and the pressure of distributing the packets of tablets. He felt a little lightheaded from the lack of sleep, but otherwise ready to distribute the packets.
By lunchtime, Travis had handed out about half the packets and was due for his second dose. He was feeling like he had caught influenza and was grateful that he had already started his course of medication, confident that he would be fine. When the last person came to the co-op for their little brown paper packet at three that afternoon, Travis was feeling decidedly shaky and a bit unsteady on his feet. He took another tab to calm his nerves. Walking with the customer to the front door of the squat brown office block, he collapsed. His colleagues bundled the twitching and jerking man into a pickup truck and took him straight to the vet.
Shania was expecting to see another influenza victim, but Travis presented with additional symptoms that didn’t tally with a diagnosis of influenza. The fever, swollen glands, and muscular and joint pain matched flu fairly well, as did his cough and headache, but the severe skin rash, blurred and double vision, and rapid side-to-side movement of his eyes did not. She did what she could to stabilize him, set up an IV with saline, and then called the hospital. Forty minutes into the 2-hour drive to the nearest hospital, Travis had a series of seizures and lapsed into a coma from the fatal combination of pentobarbital tabs and veterinary dewormer that he had taken by mouth at a dosage far exceeding that prescribed for humans.