Feathery feet and a crepitus body slide across my left eyelid. My palm scrapes blue eye shadow to the creamy pillowcase, plus an inch-long black and gold psychedelic bug which scurries away on jointed legs. A Halloween horror, two weeks early.
Blurry vision of the arresting creature is a clue my debauched night was a disaster. Its larger cousin creeps along my left thigh—while thrusting my leg in the air to dislodge it, I bump the naked backside of the man next to me.
He's pudgy, white, with hairy limbs and a smooth back. A sledgehammer pounds from my eyes to the nape of my neck. Trapped against the copper-hued wall, I slither across him, bare skin rubbing, as my stomach lurches. After tripping over the rug, I crawl into the mosaic bathroom and lose all those glorious salt-rimmed margaritas. Guaymas shrimp—I taste those coming back up, too.
As I crouch on the cool, blue and white flowered tiles, fingers stroke my short hair. My head arches up, and I recognize him.
"You okay?" His bulging, brown eyes are concerned, but meander in his typical, distracted and disinterested way. Under the dark hair, too much minutiae always dances through his prodigious brain. I’m sure he really cares.
"Fred, can you help me up?" After he reaches to grip my arm, I lean over the terracotta sink and rinse the yellow-green bile away.
"Get yourself together.” The deep voice barks from the bed as he tugs on blue boxers and rumpled tan pants. “We're late for the lead poisoning talk."
For him, the Tuesday morning session of the regional border health meeting is more urgent than washing up. We’ll learn about maquiladoras, Mexican factories with insufficient pollution control. But I'm not showing up without a shower.
He's vanished when I towel off from the tepid but reviving spray. I step into a lemon-yellow skirt and pull on the matching blazer. Stand out in a crowd—that's my modus operandi. Although we didn’t make the best decisions last night, I was smart enough to have our reunion sex in my hotel room, not his.
A quick blast from the hair dryer on my mousy, brown locks and I'm ready. After riding the creaky elevator to the first floor, at the front desk I call out, "Buenos días, ¿cómo estás?" to la chica bonita, her head crowned by glossy, black braids woven with white silk ribbon. As I smile, the wrinkles around my eyes reflect almost thirty years of hot Texas sun. She replies, "Muy bien, ¿y tú?" She has a decade before men start seeing right through her.
I'm not late. Dr. Gonzalez, the Arizona State Epidemiologist, hobnobs in the ballroom with his Sonoran counterpart. My position as a public health physician started three months ago, when I finished the Baylor family medicine residency. It’s an inspiring time—President Clinton appointed the first African-American CDC director.
The annual neighbor-state gathering is on the Mexican side this year. Until the difficult dawn, I embraced my first visit to Nogales, Sonora. The temperature hit eighty yesterday, and music spilled out of las cantinas when we strolled for lunch and dinner. Our hosts are relaxed, gregarious, and gracious. The schedule allows time to shop for artesanías—I've a yen for Huichol yarn paintings.
Last month, a highlight of the Puerto Vallarta rabies meeting was the night excursion to capture vampires as they darted in to suck blood from the legs of cattle. Jalisco veterinarians pried the bats out of fence nets and wiped warfarin on their backs. In the roosts, bats rub the paste on their relatives and they bleed out, dying before they can spread rabies. Sounds barbaric, but it reduces vampires feeding on the toes of sleeping people, who suffer horrific foaming-at-the-mouth death.
By the time translators don their headsets and everyone settles down, Fred plops on the empty seat beside me. He's in his Public Health Service dress blues—went to his room to change. At the mid-morning break, he seizes my forearm, steering me away from the snacks and posters.
"Nancy, I don’t regret getting carried away after the banquet. Seven years since we were together, but I never stopped thinking about you."
"We're not going to speak here." I slap his hand aside. Dr. Gonzalez frowns when he sees me—am I that hungover? He might suspect my dalliance, due to our raucous toasting and laughing and singing with the mariachis. Staying glued to the boss's side throughout the remaining presentations is the right decision. Fred can do whatever he needs to, by himself, to slake his thirst.
“1993 Measles. Dr. Fred Grinwold, Epidemic Intelligence Service Program, Centers for Disease Control and Prevention.” Final listing on the Friday schedule. After his presentation and questions, he corners me, and I lead him to the elevator. He's taller and heavier—I can't force him to come, but he follows like a pining puppy. Probably shouldn’t boss around an officer, but I'm not ceding control again.
Inside the antiquated hotel room, I perch on one of the equipale chairs and gesture for him to do the same. No evidence remains of our carnal tryst. A bracing breeze ruffles white lace curtains and the enticing, warm aroma of corn tortillas floats in.
"We were infatuated—nuts about each other—during your last semester in Texas," I acknowledge with a faint smile.
Then I take charge—rigid posture, tanned face mask, toneless voice. "But you graduated and headed to Albuquerque for med school. You didn't contact me. Now you're the EIS Officer assigned to the New Mexico Health Department.”
Putting a coda to the recollection, I salute. “Congratulations."
He bobs his head, vibrating the double chin. Although he's gained weight since we were lovers at Baylor, his I.Q., and a few other talents, still attract me.
"Medical training was important to both of us." He pushes the black-framed glasses higher on his bulbous nose. "Now that we're working close-by, can we repeat last night, sometime?"
Only a when-it's-convenient sort of thing—my faith says no way, Jose. I already need to take Confession, and won’t rewrite my life for him. Phoenix is fabulous, including Saturday Camelback Mountain climbs at dawn. As a native Houstonian, Arizona’s dry heat doesn’t faze me.
I shift position while changing the topic. "When we woke up Tuesday, I found ginormous, gross insects on my eyelid and thigh. Both areas itch and I’m woozy, even with cooler temps today."
His full lips twist. "My residency was preventive medicine, not clinical practice."
Thick, short fingers trace my eyelids. "Your left one is inflamed. Want an assessment of your leg?"
"Not necessary—checking that myself." No touching there, now that I'm sober, in my right mind.
Another vivid insect scampers across the floor, heading for a crack in the whitewashed bathroom wall. "Hey, that’s it—"
He drops a plastic cup over the bug.
He acknowledges the compliment with a thin smile, and stuffs tissues over the insect. "Is this what you saw before?" After my nod, he stomps for the door. "The manager needs to hear about this."
"Triatomino—el chinche." The forty-something male summoned by the receptionist ducks his head. "Lo siento, doctora."
Fred rubs his pale, balding forehead. "‘Chinche’ is used for bedbugs, which are much smaller. This might be similar—sucks blood while you sleep."
Like a vampire bat. But I’m lucky—insects don't transmit rabies. My skin starts to tingle.
"Creepy to envision it biting me, especially on my eyelid."
"Tape this up, so it won’t escape," Fred directs the manager. I'm not used to him being so organized. When the bug is secure, he turns on me. "Meeting’s over—you're riding with me to Phoenix."
Darned if he’ll order me around like the hired help. "I came with the boss, and will go back that way."
His skin blazes brick red—pretends to be taciturn but his emotions are clear. The manager's and the receptionist's inky eyes dart between us. Probably wondering who will win out in this gringo battle. After achieving simultaneous agreement not to be hotel entertainment, we migrate toward the ballroom.
"You’re on my route to Santa Fe.” He lifts his glasses and scrubs his eyes. “I can't remember if bites from this bug carry any health risk."
I'm embarrassed, too. "Guess we're both green—let's ask Dr. Gonzalez." But everyone's disappeared to the farewell brunch. The blood-sucking insect skittering in the cup kills our appetites.
"Leave him a message," Fred tells me, "and you’re going home."
A white vintage Corvair idles near the sliding door when I drop off the note summarizing the change of plans, and check out. Despite the brisk draft through the lobby, hot flashes prickle my skin while I whisper a sentimental adiós to dozens of rustic whiskey barrels overflowing with spectacular, multi-colored annuals. After tossing luggage into Fred’s back seat, I can’t avoid needling him—"Unsafe at any speed."
"Ralph Nader can say what he wants—this is my baby. Named her Ethyl.”
At the border, the American officer glances at Fred's license and waves us through. Crossing south on Monday morning, the Mexican guard hesitated until my boss pulled out a twenty to cover both of us. La Mordida—the bite. Price to avoid a lengthier inspection.
"Any guess when we'll get to Tucson?" The interstate isn’t finished and travel is slow in spots. I'm flushed and faint. Nobody on the planet gets more car sick than me—that’s all it is.
As I doze off, I discern an answer, but it doesn’t register.
Fists of hail strike the front windshield and rock me out of my reverie. Fred swerves over to an ocotillo-thatched ramada protecting a concrete picnic table. Wind whips the thin green Palo Verde branches and the thicker dark mesquites.
"We're close to Tubac and Presidio ruins, but today's not ideal for sightseeing. How are you doing?"
Although tucked off the road, the Corvair frame is light, like Nader warned, twitching with every gale gust. Through the car vents, bursts of chilly air waft my favorite bouquet of desert-after-a-rain, but my epidermis breaks out with goosebumps and my limbs shake. Fred reaches back and unhooks the latches on the sparkly pink hard-covered suitcase. He rumples through everything, including underwear, until he discovers my bulky Irish wool sweater. Before pulling it over my head, he caresses my neck and forehead.
"You've got a fever and the inflammation of your left eyelid is expanding."
No joke—my vision is narrowed. So I don't catch him reaching for my skirt before he yanks it up. "Damn, hell of a rash."
I glance down at my baby’s-flesh upper thigh. The discolored area is extensive, round, and pearlescent red. "Guess I need to brush up on bug-borne diseases." My pronouncement slips out, barely audible.
He twists the ignition key and burns rubber back to the highway. "We're stopping at the University of Arizona Hospital."
As he carries me into the E.R., my eye is swollen shut and my head vibrates like our morning after. I’m short of breath when adjusting my position on the gurney. And my heart’s racing—I hate being out of the loop while Fred pulls out el chinche and discusses it with the lab attendant. After they take blood and urine specimens, and run an EKG, a compact Native American stops by.
"Dr. Bingham? I'm Louis Lopez, chief resident. Dr. Grinwold gave us the triatomine from your hotel. People call them kissing bugs, because they bite faces. Arizona Poison Control gets more calls about them than anywhere in the country. Pima County is the hotspot—about forty percent of the bugs here have Trypansoma cruzi, which causes Chagas Disease.”
Fred’s voice is tentative. “Wouldn’t you feel the bite? We were, um, together when Nancy found them on her.”
Lopez is professional and doesn’t remark on the personal reveal. “They suck blood for half an hour if someone is a heavy sleeper or somehow impaired.”
Yeah, somehow impaired.
“Human cases are a mystery in the U.S. You'll be the first I’ve diagnosed, if confirmed."
My synapses kick in. "Protozoan parasite, squiggly little worm. Sorry. Not you Fred. The parasite.”
From the grim expressions, I notice neither is amused. “Anyone looking at my blood smear?"
Lopez nods. "Eye swelling is called Romaña sign. Can happen from the bug bite, without T. cruzi transmission."
His fingers rub my neck below the ear, and I flinch. Doctors shouldn't show pain.
"Left superficial cervical lymph node is enlarged.”
He must be afraid I’m not sufficiently worried because his voice turns harsh. “Ten to forty percent of cases develop cardiovascular and gastrointestinal complications. Repeat bites can kill instantly from anaphylaxis.”
Fred plonks down, clutching my hands. Basset hound eyes - comforting. I tilt in his direction, easing the left-sided discomfort. My right eye closes to match the other one, and I drift away.
Lopez reappears, with a gray-haired woman trailing. "Bad news—your bug has the parasite and you have Chagas.”
Fred's massive dome jerks up. Huddled at the bedside all night—what a sweetheart.
I locate Lopez with my operational eye. “Transmitted through the bite?”
“Grosser than that—the bug contaminates bite wounds, or conjunctivae of the eyes, with its feces.”
The older lady steps forward. “I’m Deborah Nichols with the Arizona-Sonora Desert Museum. We want to compare with Sonora our Pima County insects and animal hosts, like armadillos, opossums, or wood rats. Did you spy any of those species on the hotel grounds?”
“Your point.” Fred is rude and impatient—what else is new?
“Our bugs are springtime—warmer temps, drier—but the weather’s been similar this month, unusually hot. We research climate change on species, and want to be in synch with President Clinton’s Climate Change Action Plan.”
Fred’s weight shifts—he emanates intimidating vibes. Ms. Nichols glances at her watch and reaches out to him. “Here’s my card.”
After her exit, Lopez reviews my chart. “You’re a big deal—scientists are fascinated.”
“I’ll handle the Museum.” Despite the disheveled uniform, Fred maintains his no-nonsense CDC persona. “What’s the treatment plan?”
“Dr. Bingham has some early anomalies, including sinus tachycardia. A cardiologist is coming to consult. We’ll start nifurtimox for ninety days—not FDA-approved, but we have no risk-free options.”
He hands me a xerox. “Medication side effects include depression, insomnia, and memory loss. Take this seriously—chronic neurologic and cardiac complications could show up in twenty years, and be fatal. Ten thousand deaths a year worldwide—that’s the estimate.”
He scrutinizes Fred. “One more thing.”
Then the black eyes pin me. “I could order a pregnancy test—fetal transmission can cause microencephaly or death."
If Chinche isn’t a Spanish swear word, it should be. I’m a semi-good Catholic girl and responsible doc—we used protection, didn’t we?
Millicent Eidson is a retired veterinary epidemiologist for the Centers for Disease Control and Prevention and state health departments, currently residing in beautiful Burlington, Vermont. This story received honorable mention in the 2020 Jim Martin Mystery Story Contest sponsored by the Arizona Mystery Writers. Bienvenue au Danse, Millicent.