Earth, Omaha, Nebraska

  Katharine Miller, Medical Microbiologist

  As Kat exited her brother’s walkout basement through the side door, the assault on her senses was immediate and intense.

  The sunlight stabbed at her head, and her eyes filled with tears. Her nose itched from the blooming flowers, and the scent of exhaust was sickening.

  Had birds and insects and lawnmowers and children always been this noisy?

  These days, the world always seemed to claw at Kat’s brain, and she wondered if it was a symptom of Syndrome Q or if she was just more irritable than she used to be.

  She pulled out a pair of giant Audrey Hepburn-esque sunglasses and her Bose noise-canceling headphones. It wasn’t exactly safe for her to block out the world while walking, but it couldn’t be helped.

  She turned on the last track she had been listening to, the new one by Hayley Jo, and even though it was an upbeat EDM piece, something that she would expect to grate on her senses, the heavy beat and repetitive sampling were shockingly soothing.

  Kat usually hated angsty love songs, but this one was catchy, and ... well, she just liked it, so she mouthed the words as she made her way to the coffee shop to meet with Claire.

  The hunger ~

  Gnawing, clawing, gaping, aching,

  Searching, hoping, needing, breaking

  Oh, the hunger ~

  Do you feel it?

  Oh, the hunger ~

  Do you feel the hunger?

  Find me, save me, love me, take me.

  She set the song on repeat, allowing herself to sink down into its hypnotic beat. Her sore body loosened up as she strolled through the suburban streets, heading toward her favorite coffee shop.

  She almost felt normal in the relative comfort of her sunglasses and headphones. The spring air still held a refreshing crispness at this time of day, but it wasn’t cold, just invigorating.

  This had always been her favorite time of year, when the world was suffused with hope, life, and new beginnings.

  The ping of a text message interrupted her reverie. Kat pulled out her phone and saw a text from Beth Ann.

  Beth: Can you just confirm that you’re still alive? I wish you would tell me what’s going on with you. Besides, Daniel told me you’ve been sleeping at his place.

  Beth: You know his basement is full of old baseball cards and vintage Hustlers. Vintage. Hustlers. Think it through and tell me it isn’t gross. Anyway, love you, sis. Call me.

  Kat smiled despite herself. She knew she needed to talk to her sister, but didn’t know what to say.

  She couldn’t understand her own feelings right now, let alone explain them to her twin.

  Her sister only wanted to help, but that was the crux of the problem. It didn’t feel like talking about it would make any difference. But if she kept ignoring Beth, she’d think Kat was mad at her, which wasn’t true.

  If anything, she was pissed at herself.

  Kat: Ew, I had no idea our brother collected old porn. Could have happily gone the rest of my life without that little nugget, jerkface.

  When she hit send, she saw the three little dots showing her sister was replying, so she waited.

  Beth: Who, me? I’m just looking out for your health. ;)

  Kat: Har har har. Hope your classes are going well. Love ya, sis.

  There. Kat had let her sister know she was still alive, and that she even still had a sense of humor. Hopefully, that would buy her some time to figure things out.

  Beth: You, too ... I wish you would come home.

  Kat frowned and put the phone away. Beth wasn’t trying to guilt trip her—that wasn’t her style—but Kat felt guilty all the same. There wasn’t a good solution here.

  If she had stayed in that apartment one more day, she would have snapped at her chipper and sweet sister for no good reason. But staying away was obviously making Beth worry.

  The guilt gnawed at her stomach. Why couldn’t she just be happy for her sister?

  Everything was so messed up. Beth had done nothing wrong. She was only ... being happy.

  But every grin, every little dance, every time she had acted overjoyed about some mundane thing, had been yet another among a thousand tiny paper-cuts. After years of being sick, Beth deserved to be in love with life.

  The problem was Kat.

  If she couldn’t be happy for Beth, she needed to stay away.

  Kat was still stuck on those melancholy thoughts when she plopped herself down across from Claire in their favorite booth at Zen.

  Claire was rocking scrubs and tennis shoes, but the look was offset by a diamond tennis bracelet and what was undoubtedly the latest designer bag. Her makeup was pristine, and her brown hair shined with fresh honey highlights.

  With a perfect French manicure, she looked more like a supermodel doing a photoshoot as an OB/GYN rather than the real deal.

  Kat glanced down at her own outfit—ratty band tee, yoga pants, hoodie, baseball cap—and cringed. Next to Claire’s polished perfection, she felt like a hobo.

  The two friends couldn’t have been more different. If Kat and Claire hadn’t bonded during med school, they would never have spoken to one another, let alone become besties. But Kat was glad that they had.

  Claire slid a steaming paper cup across the table at Kat as she stuffed her sunglasses and headphones into her bag.

  “Jesus, Kat, what’s with the getup? You look like you’re on the lam.” Claire gestured at Kat’s disheveled appearance. “And you look like shit.”

  “Gee, thanks. Love you, too.”

  Claire leaned forward, slamming a hand down on the table. “Omigod—everything makes sense now. You’re on drugs.”

  “Keep your voice down.” Kat hissed. “This is my favorite coffee shop, and I’d like to show my face here in the future.”

  Claire leaned in, reaching a hand across the table, “It’s okay, Kat—lots of people—”

  What the hell? Was this an intervention?

  “—Geez! I’m not on drugs, Claire, I just haven’t been sleeping well. You know, on account of my life imploding and everything.”

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  “Ugh,” Claire rolled her eyes. “Don’t be dramatic. It’s just, you know—” She made a dismissive gesture. “—a bump in the road. It’ll all work out.”

  Then she leaned closer, studying Kat like a bug under a microscope.

  Kat resisted the temptation to squirm in her seat.

  “You’re sure you’re not on drugs? Because I know this great program—”

  “Oh. My. God. I’m not on drugs, I’ve never done drugs, I barely even drink. I’m a boring person who spends all of her time reading technical papers and working in the lab—”

  She cut off and looked down at her coffee.

  “—well, I used to, anyway.”

  Awkward.

  Kat pasted on a smile and tried to change the subject. “So, how’s your practice faring after—well, you know.”

  “The cryospore?”

  It was Kat’s turn to roll her eyes. “I wish that stupid name would die already. I swear, one guy comes out with a theory that it came from polar melt, and now we’re stuck with ... I mean, how hard is it to call it by its proper name? ‘Microbe X’. Until we manage lysis and can do a proper DNA analysis, the responsible—”

  She noticed Claire shaking her head and chuckling.

  “—What?”

  “It’s just nice to see that my best friend is still in there somewhere. I barely recognize the morose sack of self-pity you’ve turned into.” Claire smiled, and there was no malice in her words. “Go on—educate me. What’s new in the exciting world of Microbe X?”

  Aaaand ... now she felt silly for nerding out.

  Claire made a rolling gesture for Kat to continue. “No, seriously. I’ve been so distracted by the changes in my practice that I’m barely keeping up with the research end of things.”

  Kat shook her head and chuckled. “I can’t. You made it weird. So, what’s going on with your practice?”

  Her friend leaned back and took a gulp from her latte.

  Kat noticed that beneath her shiny facade, Claire looked tired. No, more like exhausted.

  “Well, of course, there’s everything that changed since now there’s no cancer or STDs, but we sorted out most of that.”

  Kat laughed. “There’s more? I do not envy you, trying to keep a medical practice up and running right now …”

  The words died in her throat when she noticed the serious look on Claire’s face. “What is it?”

  Claire lowered her voice and leaned in to ensure they weren’t overheard. “Okay, so this is all just speculation right now, but ...”

  “But what?”

  “Okay, so a couple of months ago, my periods started getting irregular. But they’ve always been like clockwork.”

  “Yeah, mine have been messed up, too. I thought it was just stress,” Kat said.

  Claire shook her head. “Yeah, I thought so, too. And I figured the same thing when I noticed a small uptick in patients seeing me for amenorrhea a couple months back. But more and more patients are coming in now—you know how we tell them not to worry unless it’s painful or they miss three periods in a row, right? Well, that means there’s already a lag effect here.”

  Kat felt a chill run down her spine and leaned in to whisper back. “Are you saying what I think you’re saying?”

  Claire ran a hand through her hair. “Right now, all I have is data from my practice, and similar anecdotes from my OB/GYN friends. At first, it didn’t seem so bad—patients with lifetime dysmenorrhea, or PCOS, even hormonal acne kept coming to my office to get taken off medication. We thought it was just the cryo—sorry, Microbe X—healing them. But now lighter periods are turning into no periods in a lot of young, healthy patients.”

  Maybe there was a positive explanation. There had to be. The alternative was ... too alarming to think about.

  “Maybe it’s changing our biology, removing our need to shed the uterine lining every month? Aren’t humans one of the only species that doesn’t just reabsorb it?” Kat offered, her mind whirling with the implications.

  “That occurred to me, too, but then I looked at my monthly stats for new OB patients.”

  Kat’s stomach tightened. “And?”

  “It was gradual, and there was so much chaos with everything else, so I didn’t notice at first.”

  “Mhm ...”

  “But my number of new OB patients has been declining over the past three months. It’s now under 70% of last year’s average.”

  “But that’s just your practice—it could be a coincidence, or maybe people just don’t want to have kids because the economy is such a mess ...?”

  “Except when some of my friends looked over their records, they saw the same thing.”

  “How is no one talking about this?”

  “They are—well, some are—some random social media groups, a couple of those big data period and fertility tracker apps have blogged about it—but you know how it is. No one wants to talk about ‘female stuff.’ People only stop cringing again when we’re talking about babies. And that data won’t be collated by the CDC until ... well, it’ll be over a year before the drop in live births starts to show in the vital stats.”

  Kat sat back, stunned. This was going to cause a shitstorm. The world had barely got its bearings, and this—she didn’t want to think about it.

  She realized Claire was still talking. “... I’m not sure what it will mean for my practice. I’m thinking of taking a research job.”

  “You should—we need people like you working on this to figure out a solution.”

  “Well, yeah, that—but also, I had Jillian remove my IUD last week. Erik and I have been fucking like bunnies. A research job would have much more stable hours.”

  Kat wanted to be annoyed with her friend. She was a bit annoyed with her for focusing only on how this situation affected her personally rather than the bigger picture—human fertility might be dropping precipitously.

  But that was just Claire. She cared deeply for the people close to her, but ‘didn’t overburden herself with the weight of the world,’ as she put it.

  “I thought you wanted to wait a few years before having kids.”

  “I did. But if this is my last chance to be a mother, I don’t want to miss out. So we reassessed our priorities.”

  “Um ... congratulations? Good luck? I’m not sure what to say in this situation.”

  Claire smiled. “Thanks. We’ll see how it goes, I guess. I stopped taking new OB patients, so I could phase out of practice, so now it’s just fingers crossed that I can get knocked up. Everything’s been so weird since all this happened. Anyway, I’m bored of worrying about all this. Tell me what’s up with you.”

  Kat shrugged. “Not much to tell. Just taking some time to regroup.”

  Claire narrowed her eyes at Kat. “Regroup, hmm?”

  “Yep.” Kat popped the ‘p’ as she said it and looked around the coffee shop. It was only about half full at this time of day. There was a guy on a laptop in the corner armchair, bobbing his head to music only he could hear. A woman sitting at a window table, jotting something down in a Moleskine—

  “Oh, no, you don’t—you don’t get to check out on me. Fine, if you’re not going to tell me what’s going on, then I’ll tell you. You are a fixer, Kat, and I mean that in the nicest of ways. But sometimes you focus on other people’s problems, so you don’t need to figure out what you want. Your whole life revolved around fixing Beth Ann, fixing her illness. And now you don’t know what to do with yourself, so you’re moping—”

  “—but—”

  “—Not finished yet.” Claire used her ‘doctor voice’ and held up a hand. “The way I see it, there are two ways to fix this. One, you find some new lost cause to devote your life to, or you finally focus on figuring out what you want in life.” She gave a curt nod and smiled. “Okay, now I’m finished.”

  Claire had a point. Without her work and without needing to dote on Beth Ann, Kat felt like a boat without an anchor, tossed about. But lame as it sounded, all she wanted was to get back into the lab. Her voice was quiet when she responded.

  “What I want is to work on Syndrome Q.”

  “Then do it! You’re the perfect woman for the job. You love studying weird diseases and germs and shit.” Claire shuddered.

  Kat had always found it amusing that her friend could deal with abdominal surgery, all the fluids in the delivery room, baby barf—but mention the flu, and she was dousing herself in hand sanitizer and backing out the door. She wondered if Claire still used hand sanitizer now that no one got sick anymore.

  Kat huffed and continued, “Claire, I want to work on Syndrome Q, but there’s no way anyone would hire me. Have you looked around lately? The job market is flooded. It’s just,” she shook her head, “it’s never going to happen. I need to be realistic and figure out a Plan B.”

  Claire wrinkled her nose. “So it turns out I’m not quite finished yet—that bullshit about the job market is a cop-out, and you know it. How many jobs have you even applied for?”

  Kat stared down at her coffee cup. “I haven’t gotten around to it yet.”

  “That’s what I thought. So I got you an interview.”

  Kat leveled a stare at her. “You what?”

  Claire got a sheepish look and picked at the sleeve of her coffee cup. “So ... one of my old sorority sisters is the daughter of the CEO of Hope Pharmaceuticals—”

  Well, shit.

  “I dunno, Claire ...” Kat set down her cup, trying to choose her words at least a little diplomatically.

  “I have complicated feelings about big pharma. And it’s not even a good fit. They manufacture and sell drugs, right? I was studying etiology, diagnostic tests ... things that would help people prove they were sick, actual cures ...” She let out a frustrated sigh. “You know how I feel about bandaid medicine.”

  But Claire would not be deterred. “Hope does in-house R&D, too.”

  Then her perky friend took a deep breath and said the following sentence so fast Kat could barely make it out. “And so I reached out to Aubrey and told her your background and how you’re great at programming, and she’ll be here in ten minutes to interview you.”

  “Claire! What the hell? I look like a bum today!” Kat gestured at her disheveled appearance.

  Claire scrunched her face. “Maybe a little. But it won’t matter. Aubrey won’t give two shits what you look like—she’s all about hiring people who get the job done. Just be you. Let that geek flag of yours fly, and you’ll be perfect.”

  Kat tried to summon a glare to throw at Claire, but her lips ruined the effect by cracking a smile.

  “I can’t tell if I hate you or love you more right now,” she mumbled into her latte.

  “You’ll be singing my praises when you get the job, because you need this, Kat. You’re a champion without a cause, and I can’t stand to see you like this. The world needs you to be solving its problems again, and you need problems to solve. So, like, go kick ass and stuff.”

  Kat’s mind raced. An interview? Now? She wasn’t prepared, looked like hell, and wasn’t even sure she wanted to work for a pharmaceutical company. But Claire was right ... what other options did she have?

  She took a deep breath, squared her shoulders, and nodded. “Okay. I’ll do it. But if this goes sideways, I’m blaming you.”

  Claire just grinned and sipped her latte, looking far too pleased with herself. “That’s my girl. Go get ‘em, tiger.”

  As Kat mentally prepared herself for the unexpected interview, her thoughts drifted back to the troubling revelations Claire had shared about a potential fertility crisis. First, Microbe X showed up like a miracle, then Syndrome Q, and now this?

  Kat couldn’t shake the feeling that something sinister was lurking beneath the surface, waiting to be uncovered. The world had been turned upside down, and every day seemed to bring new challenges and uncertainties.

  She had to find a way to get back into the game, to be part of the solution. While waiting for Aubrey to arrive, she silently vowed that no matter what happened with this interview, she would stop at nothing to unravel the mysteries that plagued their world.

  The fate of humanity might just depend on it.