The previous night

Victoria Yu stood at the soft shoulder of Highway 20, her thumb in the air, shivering and fighting to stay upright. Rain dripped from her coat's hood, cinched tight around her round face. Please please please let there be someone soon, she thought.

A set of headlights approached and slowed. An old couple in a truck looked Victoria up and down, and then sped up and drove away. Victoria started to cry. Her eyebrows knit together, and she shook with big, heavy sobs quickly swallowed by the wind and rain.

Another set of headlights approached, and sped by without slowing. The old sedan's tires splashed through a puddle further down the road and threw a rooster tail of water into the air. Then, nothing. Victoria rubbed her face with cold, damp fingers. This is it. No one is coming. I have nothing else. No other options. She sat down on the gravel, fought to stay steady while the world spun around her, and then lay down on the shoulder.

Then she heard the sound of tires again, and saw the glow of distant headlights. She hauled herself up to stand, and brushed pebbles from her shoulder. She stuck out her thumb again, her arm shaking. The headlights slowed, and the shape of a big diesel pickup took form out of the gloom. The engine clattered and rumbled. To her disbelief, they stopped. She laughed out loud in surprise. The driver, a thin man with a patchy beard and a trucker hat, rolled his window down and spat a stream of chewing tobacco. "Where y' headed?"

"West. To town, hopefully." Victoria hugged her shoulders against the rain.

"All right. I'm heading to Burlington. Hop in."

He unlocked the doors with a loud clack. Victoria walked slowly around to the passenger side, and hefted the tall door open. She wrapped her hand around a small grab handle, stepped onto the high running boards with shaking legs, and then hauled herself into the cab. She swept her feet in and her hiking boots collided with a small pile of empty energy drink cans and beef jerky bags.

The man locked the doors again, and started down the road. His big diesel engine clattered and rumbled somewhere far in front of them under the massive hood. His tires splashed through a deep puddle and sprayed water over the shoulder. He eased around the next bend, and then turned to Victoria. "What brings a woman like yourself all the way out here, and this late at night?"

Victoria shook her head as the world kept spinning. She heard the man talking, but he was far away. A layer of television static sat between them, and she fought to hear him. She coughed once, and pain shot through her chest. "I just need some..."

He looked out at the road, stretching out ahead in a long ribbon. The worn center line reflected back, glowing yellow. "Sorry, you need some what?"

She blinked slowly. "I... I need to get to the... town."

He nodded. "Okay. I think we covered that. You doin' okay?"

After a pause, she shook her head slowly, deliberately. She whispered, "...no."

He said nothing, his face lit by the glow of the dashboard. She might be drunk, he thought. They continued down the highway, his large tires humming as they settled into silence. Victoria's head nodded, and she fell asleep with her temple against the door sill.

A few minutes later, they crashed over a pothole. Victoria awoke with a gasping inhale, and snapped her head upright, her eyes wide. "Oh no. No no no." She scratched her shoulder furiously.

The man turned. "What?"

"Do you see them? They're everywhere. You can't drive here!"

He slowed down, scanning the road in front of them and seeing nothing. "What's everywhere?"

"They just... came here like that." She said, her eyes drooping again. "The flames. You can't get rid of them. It's like rats... see one, you have a dozen. See?" She pointed to the empty shoulder. "It's. It's a problem. They're jumping all over the place. It's the beginning of the end. The end of... the world."

She leaned forward, fumbled for a jerky bag, and then wretched and vomited into it. Her vomit was thin and clear-yellow. The truck cab filled with the acrid, sour smell.

"Jee-zus." The man shook his head, and rolled her window down to let in the cold damp fall air. "Could you fuckin' not? I don't care how high you are."

She shook her head, her voice low and garbled. "Nope. Not high. I'm just... on fire. You can't put me out. Not this kind of fire." Her eyes slowly closed, and she slumped lifelessly against the door.

The man stared straight ahead for a moment, in thought. She was itching like a tweaker, but I've never seen a tweaker act like this before. The trees flashed by in his headlights, one after the next. He looked over, and the hitchhiker looked too still. He couldn't tell if she was even breathing. The hairs on his neck raised and prickled. Something is really wrong.

He took a long breath, and thought about a plan. He rolled down his window and spit out a long stream of tobacco. The thrum of his large tires filled the cab, then he rolled it back up again. He picked his phone up from a cupholder, and saw no signal. He reached over and shook her shoulder, her damp rain coat crinkling. "Hey, wake up."

No response. "Hey, wake the hell up. Seriously. You're freaking me out." Nothing. I have to get her to a hospital, he decided.

He sped up with a loud clatter of diesel sound and smoke. He took the next bend in the road with a squeal of chunky tires, the truck leaning hard right on its long, soft springs. The hitchhiker stirred and mumbled, "the end is almost here. It's... here for everyone. No stopping it." Then she settled back into a lifeless stupor.

The next few miles felt like an eternity. The man threw the huge truck around each bend, then surged forward with a clatter and thrum of diesel. Finally, he spotted a blue 'H' sign by the roadside for a hospital ahead, with an arrow. He pulled off, and sped down the side road. Finally, he saw the glow of a small hospital building. He followed a sign for the emergency room, and pulled under a small lit porte-cochere.

He left his truck running, jumped down from the drivers' seat, hiked up his loose jeans, and walked around. He paused to think for a second. If she's slumped against the door, is she going to fall out when I open it? He reached out with one hand to open the handle, and held the other hand out catch her. Or at least slow down her fall.

"Can I help you?"

He turned around to find a nurse in blue scrubs, a mask, and a surgical cap standing by the automated sliding door. She saw the pained expression on his face and jogged over. "What's wrong?"

He pointed up to the door, and realized that his hand started to tremble from the adrenaline. "I... picked up a hitchhiker. She threw up and then passed out in my truck. I think she's still out."

The nurse nodded. Drug overdose, she thought.

He continued, gesturing at the drop from his door to the ground. "I think if I open the door she might fall out. She was leaning against it."

"Was she breathing? Could you tell?"

He shook his head and wiped his face with his shaking hands. "I... couldn't tell. She looked too still, like she wasn't. Something looked really wrong."

The nurse pulled a small radio from her pocket. "Possible code blue outside the emergency entrance. Repeat, possible code blue at emergency entrance. I need a doctor and a cart."

Seconds later, two nurses walked quickly out of the sliding doors, rolling a gurney toward the truck. A doctor followed in a white lab coat. The nurses stood in a tight circle with the driver, discussing the situation. One climbed into the driver's side of the running truck, unclipped a flashlight from his pocket, and looked the hitchhiker up and down. He grabbed her arm, and gestured to the other two nurses through the window. They opened the door, and the nurse inside the truck kept her upright. Then he slowly eased her down. The two nurses on the running board held her, and lowered her down into the waiting gurney.

The hitchhiker stirred and shook her head. "No. No no no. You can't..."

They turned the gurney and started walking back into the hospital. One nurse held his fingers on her wrist to feel for a pulse. "Pulse weak, slow, and thready."

The first nurse slid a Narcan nozzle into her nostril, and sprayed it. "Administering Narcan. Be ready. If she OD'd, she'll wake up angry."

Nothing happened. The second nurse continued holding her wrist. "Pulse is no change."

The doctor looked her up and down as she bumped over the concrete. The wheels of the gurney creaked and crashed over the driveway. Dry, cracked lips. Sunken eyes. Blotchy hands. She called to the nurses. "We need IV fluids, she's severely dehydrated."

They passed under the white lights at the entrance. They lit up the hitchhiker's face a vivid shade of yellow. "We need to screen for kidney failure. Patient has jaundice." The doctor rolled up her sleeve and noted her swollen wrist, then pressed and held her thumb against it for a ten-count. She released her thumb and saw a deep pit. "And significant edema."

The driver followed behind. "Is... is she going to be okay?"

A nurse turned behind her. "We don't know yet. We'll need to stabilize her first."

The nurses wheeled the hitchhiker into the closest patient room. One attached an automatic blood pressure cuff, the other a pulse oximeter. The third nurse left and returned with an IV bag of saline. She cut away the hitchhiker's rain coat and fleece jacket with a pair of medical shears, and pushed them out of the way. She searched for a vein, and hooked up the IV.

The hitchhiker winced, and her eyes opened. She contorted her face into a grimace, and gasped. She spoke barely above a whisper. "You can't stop it. It's going to happen. It'll be... beautiful."

The doctor noted the blood pressure of 70 over 40 and blood oxygen at 78%. She noted that the hitchhiker responded to the IV placement. She reached forward and pinched the patient's hand, and saw motor movement and eye response. "I'm calling this a GCS of 10, possible coma. We have hypotension, edema, jaundice, and oxygen desat."

The driver stood by the door, peeking in. The doctor pointed and waved him in with her gloved hand. Her voice was muffled by a mask and face shield. "You found her?"

"Yeah."

"Tell me about her symptoms. What happened after you picked her up?"

He blew air through his lips and looked at the drop-tile ceiling. "Uh. Let's see. She was itching real bad, and she threw up."

"Was she talking? Was she confused, or was she making sense?"

He shook his head. "She was a mess. She kept talking about fires on the road. She said that she was on fire, and... uh..."

The doctor nodded.

"She said the fire was 'coming for everyone.' She said it was the end of the world."

The doctor looked back at the patient, then to the nurses. "Let's get blood samples to the lab. You might need to wake up a few lab techs to get it done quickly. I want CBC, toxicology, and a metabolic panel. Get a pathology check, too; HIV and Hepatitis." She paused and looked at the puIse oximeter, climbing slowly. "Her oxygen is coming up, but if she gets any worse I think she needs to be intubated. If that happens, we should call a Life Flight and get her to a level 1 trauma center." She looked at her black digital watch, then back out at the quiet hallway of their small hospital. It might be a really long night. What is her story?