Book Review: Doctors and Friends

Synopsis:

Hannah, Compton, Kira, Vira, Georgia, and two other women have been close friends since they met in medical school. They’ve reunited each year to enjoy a much-needed vacation. But this year, just as four of them travel through Spain, an outbreak of a fast-spreading virus throws the world into chaos.

When Compton Winfield returns to her job as an emergency room doctor in New York City, she finds a city changed beyond recognition — and has suffered a personal loss so gutting that it reshapes every aspect of her life.

Hannah Geier’s career as an ob-gyn in San Diego is fulfilling. But she’s always longed for a child of her own. After years of trying, Hannah discovers she’s expecting a baby just as the disease engulfs her city.

Kira Marchand, an infectious disease doctor at the Centers for Disease Control and Prevention (CDC) in Atlanta, finds herself at the center of the American response to the terrifying new illness. But her professional battle becomes a personal one when she must decide whether her children will receive an unapproved experimental, but potentially life-saving drug.

Review:

Kimmery Martin, a former emergency medicine physician, is the author of The Heart of the Matter and The Antidote for Everything. Readers may be surprised to learn that Doctors and Friends was not inspired by the COVID-19 pandemic. Martin was actually motivated in 2018 to pen the novel by her father, a man she describes as “brilliant, MacGyver-ish . . . innovative and scientifically minded,” and imbue her protagonist, an infectious disease doctor, with those characteristics. She studied the 1918 influenza epidemic and 2014 Ebola outbreak in Western Africa, and drafted an essay outlining her planned story. When her editor liked the idea, Martin proceeded with further research. In the process, she discovered Crisis in the Red Zone, a nonfictional account by Richard Preston of two physicians who contracted a strain of Ebola in 2014. The medical director was in possession of an untested, experimental drug — but only enough of the medicine to treat one patient. That physician faced an ethical conundrum: whether to treat either of two colleagues and, if so, which one. That incident compelled Martin to have one of her characters face a similar ethical quagmire and the consequences of her decision in Doctors and Friends. But she upped the ante: “What if those two people had been his children?” she asked herself.

Martin completed an initial rough draft of the book in January 2020, ironically, just as “the real novel coronavirus was just beginning to worm its way into our collective consciousness – and our bloodstreams,” she recalls. “We were all still running around with naked faces, blissfully ignorant of what would befall us in 2020.”

The fictional virus she devised bears no resemblance to COVID. Rather, she made up its virological characteristics and transmissibility long before a real pandemic took hold of the world. Martin’s virus is even more terrifyingly deadly — and strikes without warning. As the story opens, physicians Kira, Compton, Hannah, Vani, and Georgia, Martin’s protagonist in The Antidote for Everything, are vacationing in Spain when news of a potentially deadly new virus begins filtering in. They first encounter and attempt to aid a little girl who is inexplicably burning up with fever and struggling to breathe. With the World Health Organization involved, they debate whether to continue their journey. Kira has no choice but to proceed to Seville where her fourteen-year-old daughter, Rorie, and son, Beau, age six, are staying. They decide to forge ahead and while sailing the Strait of Gibralter, a young woman suddenly falls to her knees, gasping for air. Sweaty, coughing, her gaze unfocused, and in obvious respiratory distress, the woman’s nailbeds are bright blue, an unusual and telltale symptom. Kira springs toward the woman without thinking. She is seconds away from death and begins seizing. Compton urges Kira to step aside because it was Compton who held the little girl in an effort to stabilize her breathing and if the little girl had the virus, Compton has surely been exposed to it. Compton is unable to save her, and Kira knows what she has risked by not canceling the trip.

At the center of the story, Kira relates, via a first-person narrative, that she began her career in internal medicine with an aid organization. After her husband died suddenly of an undiagnosed illness, she then returned to the United States and completed a fellowship in infectious disease and specialized training in battling pandemics. She is a single mother in a relationship with Declan, whose biopharmaceutical laboratory is targeting the same virus that Kira studied at the Centers for Disease Control (CDC). For him, everything is riding on the lab’s upcoming request for a clinical trial.

Kira is the subject matter expert on artioviruses in the Viral Infections branch of the CDC and it is that type of virus that is fast spreading around the world. After quarantining, the women barely make it back to their respective homes and medical practices before travel is restricted. Martin’s depiction of the impact of the disease is uncannily and eerily akin to what actually transpired in 2020. New York City becomes a ghost town and tragedy strikes more than one of them. Martin devotes successive chapters to each character, relating, from their perspectives, their feelings, struggles, and the gut-wrenchingly heartbreaking decisions some of them must make as the pandemic sweeps the world and the number of fatalities climbs. The virus leaves few survivors and within a few months many of those who manage to survive their initial bout with the disease meet a horrific fate: rapid-onset dementia. Scientists scramble to develop and distribute an effective vaccine.

Through it all, the women keep in touch with and support each other, as some of them continue practicing medicine and some are forced by their circumstances to pivot. Hannah, who specializes in obstetrics/gynecology in San Diego, has been unable to conceive her own child. She must care for her patients while the virus rages with no knowledge of its long-term impact, if any, upon a pregnant woman who contracts the disease . . . or the unborn child. Hannah’s previous efforts to become pregnant via invitro fertilization have failed, and she ponders the wisdom of one more attempt. Georgia revealed her own pregnancy while the women were in Spain and must take steps to protect herself and her baby. Meanwhile, Compton, who practices emergency medicine, is overwhelmed by the number of patients she treats and her inability to save them. She must carry on in spite of tremendous personal loss for the sake of her three children, but is profoundly and irrevocably changed by what she and her family go through. And Kira faces the aforementioned ethical conundrum, despite her vigilant efforts to keep her children safe.

Hindsight demonstrates that Martin’s portrayal of the pandemic is starkly accurate and chilling, particularly her descriptions of a world in lockdown and the toll the disease takes on medical personnel. And the fast-paced story is riveting, keeping readers engaged to see who will survive and whether Declan’s company will conduct a successful clinical trial. Likewise, Kira’s plight is emotionally gripping and suspenseful. Martin admits that the “scenario in real life would be hellish beyond anything I can imagine” and, in fact, writing one particularly emotional scene “turned out to be such a wrenching process, I almost quit.” Luckily, she didn’t, because it is one of the most effective aspects of the story, told with just the right tone by capitalizing on but not unnecessarily enhancing the plot twist’s inherent drama.

Equally credible is Martin’s portrayal of the friendships that were forged years ago in medical school and have endured. Can they withstand the challenges each character faces? Their interactions are believable and endearing, imbued with familiarity, empathy, compassion, and stubbornness. They support each other even when they must do so from afar, and Martin’s dialogue is crisp and witty. She “tried to inject humor and sweetness and hope whenever I could,” and succeeded spectacularly.

Unfortunately, Martin contracted COVID in 2020 and suffered long-term symptoms, including parosmia, low blood pressure, and fatigue. She says she has given a “lot of thought to the irony of writing a novel based on a bizarre side effect during a new pandemic, only to promptly develop a bizarre side effect during a new pandemic myself.” Perhaps art imitated life a bit too perfectly. She adds, “For my next novel, I think I will write about world peace.”

Whatever topic she decides to tackle, if her next effort is as compelling and emotionally resonant as Doctors and Friends, it will also be well worth reading.

Excerpt from Doctors and Friends

One balmy evening near the end of a balmy winter, a man sidled up to me in a corner of an Atlanta mansion.

He had a request.

Before I go into detail about the repellent nature of the man’s proposal, I should temper your expectations. I know very well how my voice comes across in person, let alone in the recounting of a history. I have a sense of humor, but it’s sometimes mistaken for condescension. Similarly, to my dismay, my sense of compassion during tragedy has occasionally been misinterpreted as judgment. Throughout a mass calamity in which millions of people died, we were hobbled by fear and grief and hardship and isolation, yes; but at the same time, we learned humanity is resilient beyond all reckoning. We shared a mutual hope. Women still gave birth, nurturing tiny new humans first inside and then outside their bodies. We still created art and music and literature. Our scientists continued to innovate, our doctors to heal, our educators to teach.

On a lighter note, we still extracted comedy from tragedy, finding new ways to laugh at ourselves. We swapped pandemic jokes. We watched late-night comedy routines. We captured funny snapshots, wrote pithy quips about them, and flung them into cyberspace. If a society can’t meme itself out of a disaster, what hope is there?

But this is not our collective story as a society. This is my story — and also Compton’s story and Hannah’s story and a little bit of Georgia’s story — and it represents the most difficult circumstances of our lives. For my portion, you’re stuck with my voice, such as it is.

I hope you can forgive me.

For the last fifteen minutes, I’ve been hovering at this party clutching my drink-a Manhattan-trying to act as if I were interested in the beads of condensation crawling down its beveled-glass surface. Earlier, I’d attempted to infiltrate the nearest knot of people but found myself largely unable to secure any purchase in the smooth waterfall of words. Every syllable I uttered ended up the same: an aborted reach, followed by a slide back down the conversational slope.

Twenty minutes before, I’d been rolling along the streets of Buckhead as they became wider and posher and leafier, navigating past Hummers and Land Rovers and various other luxury vehicles until the huge home hosting tonight’s event floated into view like a glowing mother ship at the top of a hill. Ten thousand watts of incandescent bulbs burned brightly against the night sky, illuminating a pair of cream-jacketed valets trying to wave me down. I ignored them. No one drives my truck except me.

My truck! My truck is really an economy hatchback from which I’ve removed half of the back seat. This vehicle, which I’ve named Herman, has been with me for twelve years over multiple continents, so he doesn’t exactly boast the latest technology. He also looks like ass, having sputtered through monsoons and deserts and, in the worst of times, literal wars. I’ve replaced and rotated his tires, changed his brake pads and calipers, swapped out his filters, substituted his belts and hoses and batteries, and flushed his radiator and transmission. There are more than two hundred thousand miles on this sucker, and there’s no way I’m getting rid of him until the tragic day when he finally and irredeemably croaks. As always, driving him makes me happy.

In the house, though, I’ve lost a bit of my composure. I can’t control my fidgeting; of its own accord, my body yearns toward the door. My foot taps, a relentless, skittish beat. My face too is a failure: I can feel it settling into the kind of gritted-teeth smile produced by young kids who are being forced to pose.

Part of this reaction is physical. Even though the room, a grand, high-ceilinged sweep of space, has been cleared of furniture, the air circulates poorly. Flames roar in a ten-foot-high fireplace anchoring one end of the room, its mantel heaped with drying pine boughs and berry-encrusted twigs. The beribboned garland is clearly meant to invoke a festive yuletide spirit, but in me it produces a burning desire to figure out where the fire extinguishers are stored. Whoever decorated the mantel didn’t hold back elsewhere either; even without furniture, the room appears to have been fluffed by a herd of manic elves. There’s red and green shit everywhere: glass stars, hunks of mistletoe, human-sized nutcrackers standing sentinel in the corners, all of it somewhat shimmery from the radiance of the fire.

But my discomfort stems not just from the ostentatious decoration, or from the oppressive warmth, or from the perfumed but acrid scent of other people surrounding me, shooting up my nose like a chemical weapons attack. It’s not only the sound, the chittering and cackling of too many voices straining to make themselves heard.

It’s the bodies.

Even if I close my eyes and block my ears, I can sense them. Mere feet from me, they span all directions, appropriating space, emitting sound waves and social urgency and, without a doubt, respiratory particles.

A party, it should be obvious, is not my thing. By now, you’ve gleaned a few more facts about me, or you think you have. Socially awkward, you’re thinking; oversensitive. Insecure. Or maybe this: too introspective.

I feel the need to defend myself from your assumptions, even though they are logical. Despite my earlier warning, I’m actually good with people. My people, anyway. I like my people. I’m not a hermit or overwhelmed by sensory stimuli either; I can state without any exaggeration that I’ve endured some of the harshest conditions the planet has to offer.

I’m just not great around a lot of people. Especially now.

To my left, a blond bejeweled woman in her fifties gazes with rapt attention at an older man at her side, her fingers stroking the green circular pin at the top left of her long, floaty dress. His suit sports a corresponding pin, also on the left, at his lapel. Next to him, another couple, a beefy white man and a rail-thin, much younger woman, display their respective pins in the same spots. I reach for my pin, securely attached to the right side of my blazer. There’s no mandate regarding pin placement-you can put it anywhere on your torso you like, as long as it’s easily visible-but to me it’s come to serve as a signal for handedness. Right-hand-dominant people tend to pin theirs on the left, and vice versa, making it easy to keep a running tally of the lefties.

I’ve spent little time in society over the last several months, but still, I’m amazed at the ease with which these people have adapted to the fear that first gripped the world not even two years ago. The acute sickness caused by the artiovirus is rare now, vanquished by an army of public health servants, and, ultimately, a vaccine, but our world still bears the ghostly imprints of the lost: children who live with grandparents instead of parents, schools without qualified teachers, and above all, hospitals still in crisis mode because of a lack of doctors and nurses and cleaners and techs. There are, however, still plenty of hospital administrators.

Despite our losses, merriment shines on most of the faces here. Please understand: I don’t judge them, these people who are trying to return to the past. I understand the urge to repress the memories. Everyone lost someone. The particular hell of the artiovirus was its precise targeting of the otherwise young and healthy. It turned our immune systems against us, generating not a cytokine storm but a cytokine tsunami, sometimes felling people in a matter of hours. You could feel fine in the morning and be dead by evening.

But, as everyone in the country now knows, the virus harbored an even more terrible secret, one we would not suspect for months.

When a hand brushes my shoulder, I expect one of the three friends who are meeting me here tonight, or possibly somebody I know from the time when I worked at the CDC. Instead, I encounter a ferrety bald man who’s made the unfortunate decision to groom his mustache into a pencil-thin line. The effect is reminiscent of a cartoon villain or, perhaps, a weasel.

“Artie Smert,” he says, offering his hand in what appears to be a misguided reflex. Even before the pandemic I wasn’t big on shaking hands, so I ignore his outstretched arm. Batting his eyes, the man attempts to execute a face-saving maneuver by raising the hand to smooth back his hair, which might seem a tad more natural if he weren’t bald. After a brief awkward slide along his scalp, the hand drifts back down to his side.

I hadn’t intended to make this guy look stupid, so I offer him an elbow to bump. Unfortunately this doesn’t go any better, as he’s grabbed a business card from his pocket and apparently mistakes my gesture as an invitation to deposit the card on my elbow. I retrieve it with my other hand and study it.

“You’re Dr. Kira Marchand,” says the man. “I’ve been wanting to meet you for some time.”

The voice rings a bell. I read the card again. “Artie Smart?”

“It’s Smert, actually, not Smart. Are you familiar with the Midwest? The Dakotas, maybe?”

I blink at the non sequitur. “I was raised in Kentucky. I bounced around the world for a while and now I live here, but I’ve never lived in the Midwest. Why?”

“My friend in the Dakotas pronounces smart as smert.”

This line of conversation is of such confusing irrelevance I do not know how to respond. No wonder I always go mute at parties. “You left a bunch of messages with my office last year,” I say finally. “You’re a television producer.”

“That’s right!” says Smert jauntily, as if responding to even a modicum of positivity on my part. “We’d love to work with you on a show about female doctors during the pandemic. People recognize you from those press conferences where you explained what was happening . . .” Here, his eyes slide to the side. People don’t like to mention the worst outcome that can occur if you survive ART, or if they do, it’s usually in an undertone.

Some months into the pandemic, certain unpleasant truths about the illness began to make themselves known. By then we knew the basics: who was most likely to contract it, who was most likely to die. Like a typical virus, ART targeted the very young, the very old, and the weak. But this particular mortality curve followed an unusual shape when it came to the age distribution of the dead. Like an ongoing M, it peaked and fell and peaked and fell and peaked again; it turned out the virus had a predilection for strapping adults in the prime of their lives. Like a food snob, it cultivated its tastes precisely. It preferred men to women, eastern seaboarders over southwesterners, people with type A blood over types O or B, and so on and so on through a range of attributes. But it would-and did-devour anyone who crossed it, if the mood struck.

What we didn’t know then would turn out to be far worse than the immediate deaths. ART causes a delayed but catastrophic complication in a small but significant percentage of people, brought about by an autoantibody targeting certain proteins in the brain. As of today, we cannot predict who will suffer this effect, or when, although we believe it is likeliest to occur within a year or two of recovery from the initial illness. Now that we’ve conquered the virus, all of humanity is united in the fervent desire to find a cure for its most infamous sequela. Barring that, they want a predictive test. Everyone wants to know who will get the complication.

Artie Smert warms to his pitch. “That press conference you did with POTUS? You’re a natural-born speaker.”

I offer him a glance of considerable skepticism.

“It’d be a limited-run series,” he says, one finger unconsciously tracing the line of his mustache. “But not depressing. We’d allude broadly to the details of the pandemic-the deaths, the morbidity, the cratering and recovery of the financial sector-but there’s no appetite out there for another exposŽ of those circumstances. Everyone on earth’s already familiar with them. And you know, no need to go into detail about the . . . brain thing either: this isn’t a horror film.”

“Then what?” I ask.

“This series,” he says proudly, “will focus on the personal stories of those on the front lines, especially those with an unusual story to tell. In particular, the series would focus on you.”

If Smert considers this approach to be an enticement, he’s mistaken. I don’t watch television. While I have streamed a scientific documentary or two, I’ve never seen a reality show. I am ignorant of celebrity news. I barely even talk to regular people, unless I already know and like them.

Speaking of people I know and like, I spy my friends-Vani, Compton, and Hannah-perhaps twenty feet away, standing together but each speaking to people I don’t recognize. None of them lives in Atlanta; they’re here to support me when I give a speech later tonight. How had they managed to strike up such animated conversations with strangers?

Vani, my closest friend, catches my eye first, but then again Vani generally catches everyone’s eye first. She’s my age-early forties-and infinitely more alluring. Tonight, indifferent to the attention she draws, she’s dressed in an electric-yellow silk concoction with an array of jeweled bracelets crawling up her arms. Even from this distance, I can read her expression, so characteristic of Vani, somehow combining an aura of peace with a ridiculous, endearing sense of humor. She’s like a human embodiment of both Xanax and one of those party drugs that make people giggly.

Compton flanks her, her cap of sleek dark hair set off by an equally sleek black dress. Compton is the Ritalin to Vani’s Xanax; she’s beaming an intense, skeptical look to two chatty blond men who appear to be in their forties. On her other side, Hannah, pink-cheeked and fair, with her shapeless dress and messy bun, might have registered as dowdy compared to the other two were it not for the warmth in her expression, which she’s aiming at an older gentleman who is apparently hard of hearing. He’s got a hand cupped round his ear and I’m fairly certain the entire room can hear him shouting delightedly in her direction.

Oblivious to my distraction, Artie’s still going strong. “We’d want to showcase your particular, ah, style in the show, of course. You were one of the first Americans to contract the illness. You were one of the few worldwide experts on this particular virus before the pandemic. People must wonder: why does a woman want to become an expert on germs?”