That international flight saved my life. Or it killed me. I’m not sure which yet.

I distinctly remember the man two rows back hacking his lungs out. It made it impossible to sleep well on the twelve hour flight back from my Asian business trip. I paid for headphones, eventually, but not a face mask. I didn’t see the need.

When I developed a chronic cough, the doctor tested me. It was . Actually, it was worse – it was drug-resistant tuberculosis. They called it XDR-TB, extra drug-resistant TB. I wasn’t going to be allowed to sit in quarantine at home taking antibiotics each day. I was locked in a bubble and driven by armed soldiers to a top notch quarantine facility.

I thought my life was over. I just didn’t think it would have ended this way.

The funny thing about the hospital is the way it feels like a sterile lab. In some ways, it is. I’m in a small room that feels like a hospital room. The double or triple airlocks keep my pathogen in. The little door they use to send me pills, drinks and food is another double airlock. The toilets and shower send wastewater through a multi-layered sterilization process. I can control an infotainment center by voice. I can listen to podcasts, order it to play music and tell it to play movies on the TV screen. I can dictate emails and play games via sensors that feel like a second rate Kinect game. It isn’t fun, but it isn’t boring. As long as there is power.

Dr. Nokomura, the supervising physician, Stacy, my head nurse, and others suit up as if they’re going to an alien planet. In reality, the few times they come into the space with me, my pathogens are considered as dangerous as an alien plague. Dr. Nokomura said that the last time we really spoke. Then he laughed at it. He didn’t stop laughing.

I have a single modest, triple pane and unbreakable window. Some psychologist said you have to give them a window to keep them sane, though security ensures I’ll never get out of it. I always hated the thought that they made sure you can’t escape via fire escapes and other tech here. I get the impression the designers wanted to be able to burn this place down with the patients inside as a last resort biocontainment measure.

I hardly saw the alien craft when they streaked through the atmosphere, though everyone heard them. I expected the news to show alien craft hovering over major cities. The news showed what looked like strafing runs with contrails. They did multiple passes over the cities, but they flew over Siberia and Nunavut, too. Then they warped out of the atmosphere, disappearing in shockwaves. Maybe they self-destructed. We couldn’t tell, since the electromagnetic pulses they made fried most electronics.

I was able to talk to a few nurses as the backup generators struggled. They’d been shielded against EMP more out of fear of radiation from nukes than alien invasion. What were the contrails? Everyone stayed inside the facility as best they could, though we were now left with the air, water and food inside. As the days passed, people left to go find their families, seek fresher food as what we had ran out, or decided they just couldn’t stay here.

Stacy left to go home. Dr. Nokomura talked about her returning. He asked my advice on quarantining her in a room like mine. Was I still able to breathe in there, though every flush seemed to decrease the pressure? While I was bored, was the temperature habitable? Was the water still flowing to the tap? How did I feel? He passed me my meals as she paced around outside, dazed and confused the few times she passed my window. He clearly wanted to get her into quarantine to take care of her and, in his mind, give her a chance.

He ended up passing a biohazard suit to her through the doors to let her put on. She donned it, and they worked the doors mechanically to let her enter. She went into a unit next to mine, though I can’t really see her. They tried to respect our privacy, so I can’t talk to her without her permission and certainly can’t do so without screaming, since the phone system died with the generators. I think water and sewer just work because of gravity. Dr. Nokomura gave me a lot of food and bottled water to hold onto in case he ended up breaking quarantine when he opened the outer doors. He wasn’t sure how it all worked when the whole system reverted to mechanical if it wasn’t totally in lock down. So he locked me down, then went to get her.

He put her in the unit, and she seemed amused by the whole thing. She took off the biohazard suit in the airlock, then went into the unit. Dr. Nokomura was talking to her about it, and then he started screaming at her when she took all her clothes off. I heard his yell that he only said take the biohazard suit off, not all of them off. I don’t know what she did, but he shouted her name, I’m a married man, and this isn’t what you asked for. She started giggling, this high-pitched girly sound. She shouted that it is too late, anyway. He angrily said that’s right, because I just closed you in quarantine so there’s no chance of us touching until there’s a cure and help and – she started laughing. The giggling rose to hysterical laughter, and it didn’t stop. His voice dropped down to a conversational tone, words I couldn’t make out. Then he went silent in the face of her laughter. He stormed off angrily, boots slamming on the floor. I knew that sound from when I initially refused to take 20 pills a day. I had 400 now, my regimen to keep up until help came. Or food ran out. I don’t know.

I know I had trouble sleeping because of her laughing all night. It turned into strangled coughing that night. She seemed to struggle to get a breath in as her body tried to expel it in peals of laughter. Mercifully, the next dawn, she was unconscious. She stopped laughing because she’d passed out. She slept a few hours, as did I. Then she started to wake up, started laughing again, and tried to go through her motions. At one point, she dropped something and gagged around the laughter. That’s when Dr. Nokomura came to me for the last time.

“What’s going on?” I asked.

“She’s infected.”

“With what?” I asked.

“Whatever those ships dropped, it seems to be an airborne virus. And she has it.”

“What is happening to her?”

“It interferes with the executive function of the brain and emotional processing system at the same time. Everything seems to be seen as hilarious. Once the physiological circuit for laughter is engaged, they can’t seem to stop.”

“She stopped when she couldn’t breathe.”

“Yes, and like a seizure, it re-engages as soon as she can breathe.”

“That’s hilarious.”

“No, it isn’t. She just choked on water, coughing it out her nose, because she can’t hold it back long enough to drink. She certainly can’t eat.”

“Death by dehydration. Sounds swell. And here I thought she might suffocate slowly due to her difficulties getting air into her lungs.”

“I wondered about that as well.”

“You’re the doctor, not me.”

“You’re the only XDR patient,” he said.

I blinked in confusion. “I don’t understand how that’s relevant.”

“You’re the only patient in the highest containment unit from before this outbreak.”

“There are other patients here.”

“Yes, and they’re slowly starting to succumb to the disease.”

“Did she bring it in?” That was obvious. “How could you let her spread it to others?”

“Stacy clearly brought it in with her. That is proof it is outside. Some of the patients here had started falling to the illness before she became severely symptomatic.”

“I hadn’t heard anyone maniacally laughing like that.”

“You underestimate the sound-proofing. It is designed to prevent a patient screaming in pain or protest from disturbing others.”

“The other patients,” I said.

“Or the staff. Remember, we don’t want to hear more than we have to, either. I wanted to talk to someone who might outlive the rest of us, someone who could remember. A few are as bad as her and have been for a while. I’m guessing her walking home and back not only exposed her but wore her out, speeding up the condition’s progression over what you’d experience if healthy.”

“I don’t think anyone but staff here is healthy.”

“That has a measure of truth to it. Most of the advanced HIV patients died within minutes of exposure. It must be a pathogen if the speed depends on the state of your immune system.”

“That must have been tragic-comic.”

“No. They suffered seizures and died rather quickly. That suggests the disease normally takes time to cause the classic laugh until the body can’t even try to fight it off.”

“I have XDR TB.”

“Yes, you do. And it was caught early. You have a nearly fully functional immune system.”

“I hate to think that means I’ll take longer to suffocate if I get it.”

“Your quarantine system seems so well designed that it should keep out this pathogen longer than anywhere else.”

“Is there anywhere else?”

“She talked about preppers on ham radio giggling as they discussed the end of the world, truck drivers driving to safety while joking about the apocalypse. I don’t know who she saw or what really happened given her attempt to lace puns into every phrase.”

“Hell of a disease.”

“Yes, it is. And she didn’t run into anyone immune but me.”

“You’ve been here suited up, not taking drugs to protect against it.”

“I don’t know if any drugs protect against it, but I am trying to defend against it.”

“Do you have any leads on the disease?”

“My most informative source is gagging on her own saliva in the cell next to you.”

That explains how I could hear her if no one else. “Now we’re back to it being a hell of a disease.”

“It has been a week. I don’t think help is coming.” His face was sympathetic. “And utilities aren’t back on.”

“How can you tell?”

“When I sit in my office at night, the cityscape is going dark but for a few solar powered traffic lights.”

“Damn. Any people?”

“The city is going dark and dead.”

I sat down, feeling winded from pacing. “Did you have a family?”

“My divorce was bad, and we never had kids. I used to think that was a bad thing.”

“I used to think that this infection was a bad thing.”

“It still is. I’m terrified of your infection or the HIV infected patients and our suspected ebola case ever getting out. That’s why I stayed and supervised as all my subordinates slowly drifted away, literally or more literally.”

“Stacy came back.”

“I think she’s resistant. She was more coherent than the others.”

“The others? You never spoke about others.”

“I’ve been supplying food, water and medication to a dozen remaining patients, documenting the declines and deaths of twice that many. When exactly do I have time for conversation?”

“You seem to now.”

“Now. Yes, now, because most of the others are dead from this unknown disease or their own condition for a variety of reasons.”

“I’m not dead.”

“Without medication, the TB will become more active. It could kill you in weeks without medication. You had an aggressive strain, and that’s why we immediately locked you in here.”

“How much longer do I need medication to cure it?”

“Three months.”

“I have three weeks’ worth of meds in here with me now.”

“Given the erosion of quarantine with every mechanical cycle of the seal, I don’t know if I can safely give you more. Every time I open that door, I shorten how long you’re safe.”

“If there are aliens here, is anywhere really safe? If I do survive an alien invasion, I don’t want to survive with a super-tuberculosis plague in my lungs. No one would rescue me if they knew.”

“You’re right. You’d be a danger to any survivors you encountered, and that’s aside from how this alien pathogen may affect you in your condition.” He shook his head and chuffed. It was like a suppressed cough.

“Are you sure it is alien?” I asked. Part of me wished it was Russian biowarfare, Islamic terrorists, or something else I could comprehend. That would mean there were military or intelligence agencies holed up somewhere, safe, fighting it, coming to save us somehow.

“Yes. I’ve seen it in the lab in samples from Stacy.” He winced and huffed again, a strong sigh. It was a reflex akin to trying not to sneeze but fighting a tickle in your nose.

“I hope you had good quarantine protocols with it,” I said. “I need you alive.”

“I don’t think it matters.”

“Oh, it matters.”

“I used to be afraid that a disease like XDR-TB was the worst thing humanity faced. I considered your pathogens as dangerous as an alien plague.” He laughed heartily. “Oh, I was so wrong.” He laughed again. He started laughing, pausing only to mutter words like “irony” and “terrible” before crawling off. A part of his mind must have held onto his dignity, because he ensured I never saw him in that state. But the rest of his mind was fading, because he never again uttered an understandable word or did anything useful.

I heard him for another two days, petering off over time, before falling silent. I wondered if he had soiled himself while dying of dehydration and if that’s why he wanted to make sure I couldn’t see him. I tried not to think of other patients who died the same way. I can only guess that the drugs he was taking had slowed down the disease, since Stacy had died within 24 hours of her giggling fit that started and never stopped. Or she was already dehydrated and irradiated. How was I to know?

I’m down to 13 days of meds. The water is still going, I guess pulled down by gravity from the tall water towers. The sewer still flows away from me. The doctor was right in that my cell is designed to keep me and my pathogens in. I’ve dreamed of hiking through a post-apocalyptic land, alternately seeking survivors and fleeing them. This utter isolation, though, is worse.



I read the medical warnings on pill boxes to the point of memorization. Twenty pills a day is what keeps the infection under control. Twenty at once is dangerous. If I take 3 days’ worth of pills at once, it should kill me. That gives me four more days for help to arrive or continue trying to write out my story in the hope someone will arrive. I don’t want to die in here. Please, God, don’t let me die alone like a specimen in a cage. That there are aliens that might appreciate such a specimen roving on the horizon almost makes it worse. Almost.



I stopped taking the pills. My four day supply of meds is now my suicide reserve. I may be the last man alive on Earth, and I’m going to hold on as long as the protein bars and tap water do. The alien ships are flying through the sky again, unimpeded. But I still rarely see their ships through the window, and I never see them at all.


It is hard to describe the sound except like a plastic shell being broken, and the pressure change was like a hurricane. My ears popped, the artificial wind whipped me, and I could smell things I hadn’t before. The lights, the sounds, everything else defied description. All I could be certain of was the ripping of walls and structural degradation. Whatever else happened, I wouldn’t die in quarantine.

When the aliens sauntered through, I think they seemed surprised at seeing me alive. Or that’s what they normally look like. That’s a rather funny thought. I glanced at my pill pile, finding it hilarious they’d stopped my suicide attempt. Freedom, blessed freedom, I never thought I’d live to see the day.

I went up to meet them, hoping to tell them thank you for saving me from the worse ways I could die. And a small corner of my mind, a voice in rising hysterical tones hoped that that I’d share my germs with them, all of them, before they blasted me.



Photo by Peter-Lomas (Pixabay)

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