OLIVIA THOMPSON is a seventeen-year-old living a comfortable middle-class life in the Newland Settlers Confederation. After developing unusual symptoms, she receives a horrifying diagnosis. She is V1 positive, slowly turning into a vampire. The ‘Three-day Law’ gives her two options: Present herself within seventy-two hours at the border of the Vampire Union or submit to summary execution. If she fails to do either, the government will hunt her down.
Desperate to survive, Olivia undertakes the arduous journey north by any means necessary. But the government and a ticking clock aren’t the only danger. Religious fanatics with little regard for the ‘Three-day Law’ hunt down and murder anyone they see as corrupted, and they have a bead on Olivia.
With a once in a decade blizzard bearing down on her, can Olivia evade her pursuers and make it to the border alive?
OLIVIA THOMPSON is a seventeen-year-old living a comfortable middle-class life in the Newland Settlers Confederation. After developing unusual symptoms, she receives a horrifying diagnosis. She is V1 positive, slowly turning into a vampire. The ‘Three-day Law’ gives her two options: Present herself within seventy-two hours at the border of the Vampire Union or submit to summary execution. If she fails to do either, the government will hunt her down.
Desperate to survive, Olivia undertakes the arduous journey north by any means necessary. But the government and a ticking clock aren’t the only danger. Religious fanatics with little regard for the ‘Three-day Law’ hunt down and murder anyone they see as corrupted, and they have a bead on Olivia.
With a once in a decade blizzard bearing down on her, can Olivia evade her pursuers and make it to the border alive?
The examination room was small, cold, and clinical. Cheap-looking turquoise tiles adorned the walls. The floor was the same shade but made of hard, worn linoleum. A small wooden desk with an old computer and telephone sat in the corner for the doctors and nurses to use. Light from the early morning sun spilled in through the cheap metal blinds, making sharp lines on the floor. The place smelled like all hospitals do, of harsh disinfectant masking the smell of blood and feces.
Olivia Thompson sat on the edge of an examination table in an ugly patterned gown, her long brown hair framing the sharp features of her face. Expression blank, she stared across the room at nothing, nervously swinging her long legs back and forth as she waited for her results.
Come on. What the hell is taking so long? It’s gonna be something minor. The other thing is rare, super rare, one in a million rare. Nothing to worry about.
A nurse entered the room wearing a blue surgical facemask and latex gloves, a clipboard of documents under her arm. She shut the door with her leg. Olivia sat up straight at her entrance, eager for news. A quick glance at the nurse’s nametag read ‘Ramirez.’
Short, with jet-black hair streaked with gray, to Olivia’s eyes, the woman looked a little younger than her mother, late thirties or early forties. Although most of her face was obscured by the mask, the bags under her eyes told a tale of a thousand nightshifts.
“Olivia Thompson, seventeen years old. Is that correct?” the nurse's tone was flat, businesslike, nothing resembling emotion.
“Yes,” Olivia responded.
"I'm Nurse Ramirez. I'll be taking over for Doctor Clark. She's busy.”
"But you're just a nurse," Olivia's voice was slightly condescending. The nurse either didn't notice or didn't care.
"Yes, well, some patient care tasks are delegated to nursing staff," the nurse answered through her surgical mask.
"Oh, OK…that's cool…it's not an STD," Olivia blurted out without much explanation.
The nurse's eyes looked a little surprised at Olivia's unusual declaration. "Ah, yes. I've read through your file, and we've ruled out that possibility."
"Good. I had to say because the nurse at school always assumes it's an STD, even if you just go in with a damn cold."
"You haven't been sleeping well. Poor appetite, significant nausea, and some vomiting. This is all correct?"
"Yeah, but I barely eat anyway. I'm not anorexic or anything, I'm just not hungry most of the time," Olivia rambled. "My mom says I need to put some meat on my bones, that I'd look better—"
"But this recent loss of appetite is more aggressive, is that correct?"
"Yeah, but don't worry, I'm not pregnant or anything. That's another thing the nurse at school always assumes."
"Yes, we've also ruled out that possibility."
"The eating thing is fine. As I said, I barely eat anyway. I just need the nausea and vomiting dealt with."
"I understand."
The nurse took a deep breath as if to say something important, but Olivia cut in before she could open her mouth.
"Doctor Clarke said it's something viral, probably something minor, but still worth checking out," Olivia told the nurse before joking, "So, what did the blood tests say? Am I a vampire or something?"
The joke hung in the air. No laughter came from the nurse, no sudden denial, nothing. She just stared at Olivia in silence, a silence that continued for an uncomfortably long time. Olivia's face lost its chipper expression. Her lips tightened, mouth dried up, and a sudden fear rushed through her with a wave of heat. The nurse's eye widened in pity for a moment. It was just long enough for Olivia to know the truth even before the words were spoken.
"You tested positive for both genetic mutations of the HMBS gene, and blood analysis shows evidence of V1 prion disease."
Delivery of the news in a somber and respectful tone didn't make it any easier to digest. Olivia opened her mouth to speak but couldn't form any words. Frightened and confused, like nothing the nurse was saying made any sense as if she referred to some other person who wasn't in the room.
It’s a mistake. This doesn’t happen to good people. It’s a mistake, It’s a mistake. Dr. Clarke will know, she knows me.
"Now, I must inform you at this point—" the nurse eventually spoke.
"I wanna speak to Doctor Clarke. She knows me, this is a mistake,” Olivia’s voice shook as she spoke.
"There's no mistake—"
"Yes, there is, and if you don't get Doctor Clarke to come down here, I'm gonna call my father, and he's gonna have your ass fired."
Olivia’s voice steadied as she barked the instruction at the nurse. The woman was clearly taken aback by her sudden transition from deer in the headlights to cornered dog. The nurse rolled her chair back toward the desk and reached her hand underneath it.
"Olivia, I'm trying to help you."
"Just call Doctor Clarke then."
Jumping onto the floor, Olivia approached the nurse with a snarl on her face. It clearly wasn't Nurse Ramirez's first rodeo, not the first entitled demand from a possibly violent patient.
"I need you to take a couple of steps back, Olivia."
Cold, clear, concise, it was a demand not a suggestion. It was only then Olivia realized the nurse reached for a panic button. She looked at the woman with utter incredulity. How could a grown woman be intimidated by her?
"Please," the nurse insisted, hand hovering under the desk.
Olivia laughed at what she perceived to be an utterly comical situation. She backed away from the nurse by about four steps, holding her hands out in mock surrender.
"Better?"
"Yes, thank you," the nurse answered. "Now, I need you to understand something, I'm here to help you and, right now, I'm the only friend you've got."
"Then please call Doctor Clarke. She can straighten this whole thing out."
The nurse paused for a moment before responding, "Even if I call her, she won't come. She's the one who offloaded your case to me. It's procedure."
Olivia was shaken by the revelation. Her face lost its color. She stumbled backward unsteadily and fell into a small plastic chair like a ton of bricks, face expressionless.
"Procedure? My life is fucking over, and you wanna talk about procedure." Olivia's voice had lost its anger. Now, she just sounded broken.
"This topic is supposed to be covered in your health education classes at school."
"I go to a religious school."
"They're still supposed to teach you, it's the law."
"There was pressure from a parents committee at school," Olivia said in a faraway voice.
Nurse Ramirez pulled her surgical mask down. Her face was soft, rounded, and friendly, not the sharp features Olivia had pictured in her head. The nurse suddenly seemed more human. A small smile cracked in the corner of her mouth and her dark eyes widened a little in sympathy. Olivia offered a sad little smile in return.
"So, you know nothing about how this works?" the nurse asked her.
"Only what I see on the news, and the only news my family watches says all the vampires should be burned along with the peace treaty."
Nurse Ramirez ran her hand down her face in exasperation at the information.
"And you've never read any of the information online?"
"Why would I?"
The nurse took a small pause before speaking, "OK, look. Once a patient receives this diagnosis, doctors are prohibited from treating them. It's the law. Doctor Clarke would lose her license."
"So, why are you able to talk to me?"
"Every hospital has a designated nurse with special training for these situations."
"How did you get the shitty end of that stick?"
"I volunteered."
For the first time, Olivia looked at the nurse with some degree of respect and nodded in recognition. The woman had put herself forward for this work, work most people wouldn't touch with a ten-foot pole. The kind of work that made your neighbors stop talking to you and your kids friendless at school.
"OK…OK. So, what happens next?" Olivia asked.
"Do you know about the three-day rule?" the nurse asked.
"Yeah, I know about the three-day rule. Everyone knows about the three-day rule. You don't need a health-ed class to know about that."
The nurse looked at Olivia's file. "Good. It's Thursday the 20th, so, you have until 8 AM on Sunday the 23rd to present yourself at the border of the Vampire Union, or—"
Olivia raised her hand to silence the nurse. "I know what the or is."
"Either way, I need to explicitly say it."
"Let me guess, it's the law," Olivia said.
The nurse nodded in grim confirmation and took a deep breath before speaking. "Or…you present yourself for euthanization at any of the sanctioned medical facilities."
Olivia's face was now a pale white. She looked gaunt, hollowed out. A torrent of thoughts splashed around in her head. She had a thousand questions, and they all seemed pointless, but she asked one anyway.
"And if I don't do either?" she asked.
The nurse’s face sharpened, warmth seemed to drain out of it, like a sunny day suddenly turned dark. "Then they'll come for you and bring you to a facility by force."
"To murder me," Olivia could barely speak the words. Her voice broke as she uttered them.
"They wouldn't see it that way but, yes, that's what it is."
Olivia broke down and sobbed uncontrollably. Tears rolled down her face and made soft pattering sounds as they hit the fabric of her hospital gown.
"How will they know?" Olivia asked through tears.
"Once your results came back positive from the lab, they got put in a medical database. After three days, the data gets uploaded to a law enforcement database automatically. If you're not already over the border, they start looking, and they don't stop."
"But can't you—" Olivia started.
"The databases are read-only from our side. Once the initial entry is made at the lab, not even a judge can overturn it. It's to stop the very thing you were about to ask me to do."
"Oh…" Olivia looked dumbstruck. The last sliver of hope her father's connections might have been able to save her had just been extinguished.
"I'm sorry," the nurse only spoke to fill the void.
"I'm supposed to go to college next year. I was gonna apply to Lakeshore," Olivia rambled. "My grades might not be good enough, but my dad went to college with an admissions officer there, and he was going to put in a good word for me…"
The nurse tried to break into Olivia's rambling by holding out a tissue to her. She barely noticed.
"Olivia."
"…and I have to go to a party at Sara's on Saturday night…" Olivia continued through the tears.
"Olivia!" the nurse shouted at her.
She was broken out of her babbling story. The nurse stared directly into her eyes with conviction.
"Forget about all those things. Get them out of your head, they don't matter anymore. Focus on the next three days," the nurse told her.
"Why, what's the point?" Olivia asked, body slumped, face ashen.
"Because you could still have a life. But first, you have to make it through these next three days."
Olivia took the tissue from the nurse and wiped her eyes dry. The brash young woman who walked into the examination room was gone. Only a frail-looking frightened girl remained, hunched over in a chair like some creature. Olivia looked into the nurse’s eyes, big and brown, warm, reassuring, like a mother’s. Olivia searched for some kind of comfort.
As she stared into the deep brown cauldrons of Nurse Ramirez’s eyes, Olivia wondered how many people she’d had this conversation with over the years. She'd clearly danced this dance before, Olivia could tell. Her words well-chosen, practiced.
Maybe the others had different questions, maybe they took the news better than her, or maybe some couldn't accept it at all, became violent. It would explain the panic button. Olivia wouldn’t become violent. She couldn’t afford to. She needed information more than anything.
"What kind of life would it be up there?"
The nurse spoke, her voice softer than before, "In truth, I don't know. They're a closed society. From what I do know, it's certainly not the horror show they portray it as on the news."
"Amber at school says they have forced marriages, and you have to kill a child before they accept you as one of their own."
Nurse Ramirez cocked her eyebrow at the dubious story.
"I don't think those stories are true. The vampires are like us…more or less."
The words more or less caught Olivia's attention. She looked at the shafts of sunlight pouring in through the window blinds, illuminating dust particles before they hit the green laminate floor.
"More or less? When does the more or less kick in?"
"The physical transformation takes about twelve weeks, give or take," the nurse began. "Your symptoms and bloodwork indicate you're in the early stages. The nausea should ease up soon. You shouldn't have a serious aversion to sunlight till about midway through the process."
Olivia paused for a moment to digest the information. Again, the words seemed alien, as if they were for someone else who wasn't in the room, some girl from the next town over you heard rumors about in school.
“Is it contagious?” Olivia asked.
“No, not in the sense of it passing from person to person, and there’s a wealth of research on the subject. I wouldn’t have lowered my mask if it was a risk,” the nurse responded.
“Then why bother with the mask at all?”
“There’s plenty of other things you can catch around a hospital, Olivia.”
“Guess I don’t have to worry about things like that anymore,” Olivia said.
“No, I suppose not.”
"The other thing," Olivia asked, voice trembling. “You know…”
Olivia couldn’t form the words to finish the question, but the nurse correctly guessed where she was going.
"If you're lucky, you won't need to…feed in that manner for another few weeks yet. You should try to continue to eat regular food as long as you can keep it down."
The nurse explained the horrors of Olivia's new existence in as simple and straightforward a fashion as possible, like she described something mundane, as though how to take a medication or maintain good hygiene habits.
"If I'm lucky, if I'm lucky…"
Numb now, some of the grim details of her new existence laid bare, her new existence sounded more like that of an animal than a person. A disgusting creature living in the shadows of a frozen shit-hole country far to the north. An unspeakable abomination you saw snatching children from their beds in a horror movie. A monster, unholy, irredeemable.
The nurse broke through Olivia's thoughts. "I understand they give you more detailed information on these subjects when you cross the border into the Vampire Union."
Olivia couldn't listen to much more. "Oh, that's good. Look, I'm gonna be late for school."
The nurse looked at Olivia with concern but not surprise. Perhaps she'd seen this unusual reaction in others before. Panic, then flat nothingness.
"You're going back to school?"
"Yeah, I only have a sick note for the morning. If I don't show up, people will think something's wrong."
"I understand. This is a natural reaction I've seen in others before, but remember, time is not a luxury you have much of. We live about as far south as you can get—" The nurse tried to give her advice, but it was cut off.
"I know…I know," Olivia said, clearly becoming exasperated.
"OK, I understand your frustration. I can't imagine what you're going through, but you need to be gone by early tomorrow morning at the latest, or you won't make it."
"OK, OK. I understand. Can I call my dad to have him come pick me up, at least?" Olivia asked.
Pausing for a moment, the nurse looked at Olivia. Her dark brown eyes surveyed the young girl hunched forward in the chair, clearly trying to get the measure of her, trying to see if any of the information she provided was truly getting through.
"You mentioned you go to a religious school," the nurse began. "What are your parents' opinions on this…subject?"
Olivia was upset at the suggestion her father would be called into disrepute.
"My dad's my dad. He'll understand," Olivia responded, trying to convince the nurse but also herself, doubt creeping into every facet of her mind.
"And your mother?"
There was a lengthy pause, clearly long enough for the nurse to sense the danger even before Olivia had a chance to open her mouth.
"She's a bit over the top on the religious stuff…but I mean…"
The nurse had heard enough. "I strongly recommend you do not tell your family."
"But…"
"It's illegal for them to help you get to the border anyway, and you need to get there under your own steam. It's the law."
Confused and frightened, Olivia was overwhelmed with information. Could she really not speak to her family? Her first port of call if she was ever in any real danger would be to go to her father. He'd always understand, even if it was serious, even if she'd fucked up beyond belief. Her father could fix things. He was that kind of man.
"But if I told them, they can't stop me from going, right?" Olivia asked.
"Legally, no, but…"
Olivia looked vulnerable in her little plastic chair.
"Well, I have to say goodbye at least."
Nurse Ramirez stood up and walked over to Olivia. She hunkered down so she was at eye level and stared deep into Olivia’s blue eyes like she was trying to stare into her very soul.
"Olivia, listen to me, and listen good," the nurse began in a deadly serious tone. "There are people out there, maybe your family included, who will do everything in their power to stop you reaching that border alive. Do you understand?"
"Those are just stories people tell to frighten kids," Olivia responded, looking straight into Nurse Ramirez's gaze.
Unflinching, the nurse responded, "Sadly, those stories are all too real Olivia."
Bowing her head in despair, Olivia sobbed again. The nurse used her hand to hold the girl's chin so she looked directly at her again.
"You tell no one, and beg, steal, or borrow, you make your way to that border. Do you understand me, Olivia?" the nurse's soft warm voice was completely gone, the instruction given like a drill instructor.
She released Olivia's chin. It didn't drop. The two remained staring at each other, eyeball to eyeball.
"Yes…I understand," Olivia responded with as much resolve as she could muster.
The nurse finally looked relieved, like she'd finally gotten through to Olivia the seriousness of her situation. She stood up, walked back over to the desk, and sat down.
Her voice returned to its warmer, friendlier tone. "I have some pamphlets you can take with you if you want them."
"Are they any use?"
"Not really. They're government-issued, but I have to offer them anyway," the nurse responded with a clear hint of disdain for the pamphlets.
"Then they're just evidence that could give me away."
"Good, you're being smart. Keep it up, and you'll survive this." The nurse looked pleased Olivia had passed this small test.
A tiny laugh burst out of Olivia at the direness of her situation. "Yeah…maybe. Look, I better get to school."
“I really have to advise you again, that is not a good idea,” the nurse said.
“If I don’t show up for evening roll call, I’ll be missed. Nothing serious but enough to raise questions. And if I go home straight away my mom’s likely to be there, that leads to even more questions. I have to keep up appearance until this evening at least.”
The nurse held her hands up in surrender, clearly understanding the bind Olivia was in.
"I understand, I'll leave you to get dressed."
Getting up from the desk, the nurse walked toward the door. Olivia watched her as she went.
"I'm guessing I won't see you after this?" Olivia said.
"You're right, this is goodbye. But good luck, Olivia. I'm rooting for you."
"Thanks." Olivia offered the nurse a small smile as she walked out the door.
The door clicked shut, and Olivia sat perfectly still in silence for a time. Her mind was a void again, numb, too much information to process, so it processed nothing, then reality sank in. A wave of panic washed over her, and she cried loudly. The rage she couldn't let out during the meeting with the nurse now sprayed out in a short, sharp scream, then there was silence. She wiped the tears from her face and stood up with purpose.
Olivia Thompson lives the perfect life in the NSC - the Newland Settlers Confederation. Her parents are rich, she holds rank in the popular group at school, and even her mediocre grades won’t stop her from getting into the college of her dreams when her father has all the right connections. Nothing can stop her from continuing the life she’s taken for granted. Nothing, except a simple diagnosis.
When a blood test reveals that Olivia is V1 positive, her worst nightmare becomes reality. She’s transitioning into a vampire. The law states she has three days to make it to the NSC’s northern border to the Vampire Territory before the government hunts her down and executes her. Suddenly her family’s connections are worthless as she faces her new existence as an outsider, an enemy to her people. She can’t trust her parents, her friends, or even a friendly face on the bus. Anyone could turn her into the Purification Squad, a radical religious group dedicated to exterminating “unclean” monsters like herself. Anyone could want her dead, and the clock is ticking.
The Diagnosis was a fast paced and thrilling read, full of suspense, deception, and redemption. As a vampire novel enthusiast, I love reading different takes on the creation of vampires. While a genetic mutation causing a normal person to transition into a vampire isn’t unique to this story, it is a creative rendition that I greatly enjoyed reading about. The idea of a Vampire Union full of vampires living peacefully and separate from normal humans was, however, new to me. I think the details given to us on the NSC and the Vampire Union barely scratched the surface of the world building the author has up his sleeve. I can only hope Murray offers us a sequel to reveal the secrets and questions I developed regarding the vampires in this story.
Overall, I have to say I absolutely loved this novel and will probably read it again. If it wasn’t for the grammatical errors I couldn’t ignore and the use of certain cringey words, I would have awarded this book five stars. I would recommend this novel to anyone who loves action packed chases and a strong female lead who’s willing to do anything it takes to survive.