From the author: A small-town doctor notices something is amiss with the local pizza joint. CAUTION: PIZZA HORROR.
Doctor Adam Malak set his slice of Capriotti’s Family Pizza Kitchen pizza back down on its grease-stained plate and drew in a slow breath. This was it. Capriotti’s was the first pizzeria to move to Harmony Point, Iowa since the last joint closed down three years ago. Its premiere was the talk of the town, constituting the residents’ unofficial proof that their 400-population town really wasn’t going the way of the horse-drawn carriage and debt-free American. The wait for opening day was agonizing for Harmony Point, and citizens were lined out the doors when it finally opened.
Even Malak had found himself getting his hopes up. Having grown up in New York and received his doctorate in psychology from NYU, he had (when budget allowed) treated himself almost exclusively to savory big-city slices. He hadn’t been amongst the throngs waiting with bated breath for Capriotti’s to open, but he had still secretly held out some hope that the chain would give him a decent outlet for his cravings - the nearest decent pizza joint was about an hour and a half drive north to Mason City.
Unfortunately, the food was wretched.
The cheese was gummy and somehow stuck in his teeth. The tomato sauce was so impotent that it may as well have been red mayonnaise, and the selection of toppings was shorter than Malak’s thumb on the greasy laminated menu. Malak might have had cravings, but he was far from desperate. He was a New Yorker. He had standards, for Christ’s sake.
Malak pushed back from his table and stood to leave, casting a weary eye at the blisteringly kitschy rural pastiche coating the restaurant’s walls. Trying not to spoil the fun for the rest of the townsfolk, he slipped his plate into the nearest garbage can and quietly turned to the door.
“Was the meal not to sir’s satisfaction?” As Malak turned, he was met with a pale face barely six inches away from his own. He gasped and staggered backward a single step.
Malak had never seen the guy around before, which was no mean feat in a town like Harmony Point. Even more miraculously, he had never heard the man mentioned by any of his clients, which seemed impossible considering the gossip that a thin, sallow-skinned, dark-suited man in sunglasses must have churned up. Nothing got small town folks talking quite like an odd-looking newcomer - Malak could attest to that personally.
“Sincerest apologies if I startled you, sir,” the man said, his wide, thin mouth contorting to form drawling syllables. Malak noted that, despite his sincerest apologies, the man still refused to move out of Malak’s personal space. “I simply wished to inquire as to your satisfaction with our services.”
“Yeah, uh, sorry,” Malak said, nodding stiffly to the garbage can behind him. This cryptkeeper creep must be the owner. “You guys didn’t have sausage. Tried the pepperoni, but it’s just not the same.”
The man’s wide lips curled upward into a U-shaped smile. “I understand your disappointment, sir. Supply chain management is difficult in this neck of the woods, you see, and some products are more easily obtainable than others when so far afield of the city.”
Sure, Malak thought. Blame the town for your shitty pizza. That’ll really earn you fans. But Malak looked at the crowd of couples and families stuffing their faces, and realized he wasn’t so sure. These poor saps might eat rat meat if it was triangular and covered in cheese. He sighed inwardly. After all this time waiting for a taste of authentic American pizza, all the people of Harmony Point got was a fast food chain gasping for breath outside the safety of the city. And these poor folks would never know the difference.
“I’ll come by again sometime, maybe try something different,” Malak said, smiling and biting back the urge to congratulate the man for his nomination in the world’s best-dressed pedophile contest. Even as the temptation faded, he felt a surge of guilt at his own hostility. Disappointment had affected him more than expected, he supposed.
“Of course, sir. Please do come back soon,” the manager said with another rubbery smile.
Malak reached behind him to pluck his coat from the back of his chair, shrugged his arms through the sleeves, and headed outside.
“And I mean, do you think that Geigersfield got a Capriotti’s movin’ in? Forget about it,” Tim Grimoskas said, waving one hand dismissively and leaning back in one of Malak’s office armchairs.
“That’s a pretty good point, Tim,” Malak said. “It’s probably pretty good for the town. Might help with your anxiety, right?” Tim was one of Malak’s oldest clients, crippled by hopelessness and stress over the deteriorating state of Harmony Point. Tim’s eyebrows raised and he crossed his arms.
“Hey, yeah,” he said. “I never thought about that. Guess the place is helping me in ways I didn’t even realize!”
Malak gave a struggling smile. “Now, how are things going with your wife? Last time we talked about her, you two had-”
“Oh, Betty loved the place, too. She said she wanted to buy a whole pie and take it home so we could have it for lunch tomorrow! Can you believe that?”
Malak crossed one leg over the other and tried to smile. “I really can’t.”
“Yeah? Why’s that?” Tim narrowed his eyes and cocked his head, his voice suddenly low. Malak grimaced. Something about Capriotti’s completely bypassed his extensive training in the venerable art of watching his goddamn mouth. He held his hands plaintively up to Tim and shrugged.
“Just not the kind of pizza I’m used to, I’m afraid.”
“Oh!” Tim said, relaxing his gaze and leaning back again. “‘cause of like, what you are, right?”
It was Malak’s turn to squint as he tried to figure out exactly what his client meant. Tim, as if in explanation, pinched the skin on the back of his hand between two fingers and waggled it. Malak looked down at himself, and at the dark brown hands reaching from beneath the sleeves of his suit. Did Tim actually think...
“I’m not Italian, Tim.”
“Oh!” Tim said again, jumping as though electrocuted. “Then, uh... what are you?”
“My family on my father’s side is Egyptian and my mother’s parents were Scots-Irish.”
“Egypt! Like with the pyramids?” he paused. “But you speak American so well!”
There were still fifteen long minutes before Tim’s hour was up. Malak drew in a deep breath.
Tim chuckled a few heartfelt apologies as he shuffled out of Malak’s office and the next appointment made her way through the doorway. Trinity Torres looked up at Malak and gave him an exasperated smile as only a teenage girl can give, which Malak returned as best he could. Tim gave them both a cheerful goodbye as he departed.
Trinity dropped into Malak’s client chair with a sigh and slumped into the cushion, relaxing luxuriously as she had begun to in their past few sessions. She nodded, smiling, and opened one eye.
“Mr. Grimoskas said something racist, huh?” she asked.
“Can’t confirm or deny. Client confidentiality. You know the deal,” Malak said.
“Well, he’s doing the same thing he did when my mom told him that not all Mexican women know how to make tamales. He hurries to leave but his steps get really small so he just kinda shuffles away.”
“Tim means well. He’s a good man. There are just some things about small-town living that I’m still having trouble getting used to,” Malak admitted.
“Same,” Trinity said. Her father was an emotionally-distant civil engineer whose job had brought him to Harmony Point to aid in restoration work which the town could scarcely afford. The move from Phoenix had been hard on her and strained their already difficult relationship, until Trinity’s father decided to work through their conflict by sending Trinity to therapy.
“Is there anything you wanted to talk about today?” Malak asked. “Did you manage to talk to your dad?”
“Naw, dad’s been in a really good mood lately. He’s been smiling a little more. It’s nice, you know? I don’t want to ruin it.”
“I can understand that, certainly. But he might be easier to talk to this way, won’t he? He may be more receptive if he’s in a good mood.” Malak was thankful that Trinity was the type of teenager he could use the word “receptive” around.
“That’s true. But you should have seen him. We were at that new pizza joint, right? He was going on and on about how glad he was finally living in a place with its own pizza joint. It was weird seeing him get so hype about something that dumb.”
Malak managed not to say anything, but he was unable to avoid wincing when Trinity mentioned Capriotti’s. Trinity raised her eyebrow.
“Yeah? Not a fan?” she asked.
“This is your therapy session, Trinity, not mine,” Malak said with a laugh.
“No worries, man. Not to burst your bubble, but I do agree with my dad. Oh! That reminds me, look at this-” Trinity shifted forward in her armchair and began rolling up the sleeve of her sweatshirt. To Malak’s shock, her arm was covered in three red, circular welts. Malak drew in a shocked breath through his nose.
“Trinity... did your dad do this to you?” Malak managed to ask. Trinity gave a long, sputtering laugh, and Malak’s tension evaporated.
“Dad would never hit me! I told you already, he’s not that kind of guy. I got these after I ate that pizza. I think it’s an allergic reaction or something,” Trinity said. Malak leaned closer and grimaced. The welts were solid red and flecked with specks of gray that gave them an almost necrotic look.
“Did you see Dr. Harris about this?” Malak asked.
“My appointment with him is right after my appointment with you, man. I just wanted to show you, not freak you out. Anyway, they don’t itch or ache or anything. I don’t know why, but when I look at them, they make me hungrier for the stuff.”
“Can’t imagine why that would be. They’re not exactly appetizing,” Malak said, forcing a smile.
Trinity tugged down the sleeve of her jacket, shrugged, and smiled back. Malak struggled to focus for the rest of their session. He couldn’t shake the thought that ever since Trinity had pulled up her sleeve, the air in his office smelled like meat.
That afternoon, after the last of his patients left, Malak stole out the door of his office and made his way across the street to see Doctor James Harris. Harris was the town’s sole family medicine practitioner, and a damn fine one at that - like Malak, he was an import, shipping out for Harmony Point after graduating at the top of his class from Northwestern University in Chicago. His expertise and work ethic helped tremendously to shoulder the caseload of an entire rural town.
Harris ushered Malak into his office with a smile, and the psychologist sidled guiltily past the waiting room full of patients. Harris picked absently at his nails as he found Malak a seat.
“Your patients won’t shut up about that pizza joint, too?” he asked before Malak had a chance to speak. Malak’s face brightened.
“Thank you!” Malak sighed, rolling his eyes. “It’s complete garbage, right?”
“You kidding? No way could that cardboard compare to a deep dish. It’s offensive.”
Malak laughed, his relief carrying his laughter a little longer and a little shriller than it should have been. “God, I thought I was going crazy,” he said, massaging the bridge of his nose.
“A little crappy pizza driving the resident shrink insane? That’d be a case for the textbooks,” Harris said. He leaned back against his examination table and ran a hand through the wispy hair on his balding scalp. “Now, what brought you to my office, Doctor Malak? Not too much time to talk, but I always appreciate the excuse for a break.”
“Have any of your patients been complaining about welts?” Malak asked. Harris grunted, bobbing his head and staring into the middle distance.
“One or two, yeah. Why, any patients of yours talking about them?” As two of the more reliable healthcare professionals in Harmony Point, Harris and Malak often attempted to collaborate. It helped smooth the wrinkles of patient care, and didn’t violate any confidentiality guidelines as long as they kept their records straight.
“The young Miss Torres.” Malak paused, an image from earlier in the day coming to mind. “Come to think of it, Tim Grimoskas had a bad rash on his neck, too, just under his collar. I was wondering if you might have any insight about what they might be.”
Harris winced. “I had a hell of a time removing Trinity’s. Painful. I’m no dermatologist, but I managed to make it work. As far as I can tell, the welts were just an allergic reaction. Bad response to over-processed dairy. Not common, but it’ll happen more often out here in the sticks ‘cause they’re not as used to fast food.”
“So it’s normal?” Malak asked. He was partly relieved, and partly disappointed that he didn’t have an excuse to run Capriotti’s out on a rail with its creepy manager clapped in a stockade at the fore.
“As normal as it is for fast food chains to use shit ingredients. They’ll be fine,” Harris said with a laugh. Malak nodded and looked up. He hadn’t noticed while they had been talking, but during their conversation, Harris had shifted from leaning on his exam table to sitting on a mini-fridge set into the counter next to the office sink.
“Business been going well?” Malak asked.
“Hm?” Harris asked, blinking.
“The fridge,” Malak said, pointing. “That’s new, right? Dunno if I’ve seen this office change once in the two years since I moved here.”
Harris looked between his legs at the refrigerator beneath him, as if noticing it for the first time. “Oh! Yes, ah, yeah. Being the only business in town’s finally paying off.”
“Drink up, man, I’m glad to hear it.” Malak trailed off, offering the silence as invitation to Harris to continue. He hadn’t expected such a strange reaction from the doctor, but something about his tone had put Malak on his guard. When Harris gave him nothing, Malak stood from his chair and held out his hand. “Thanks for the insight, Doctor Harris. I’ll get out of your hair. Let me know if you hear anything else, okay?”
Harris took Malak’s hand and shook it. “Of course.”
“I might call you sometime in the next few weeks to vent about Capriotti’s, too. You’ll have to forgive me.”
“Of course. City boys gotta stick together, right?”
“Right as rain.”
A few days later, Malak saw Tim Grimoskas heading home in six inches of snow carrying a steaming Capriotti’s pizza box, beaming from ear to ear. Malak hadn’t needed to look too close to see the baseball-sized welt clinging to Tim’s flabby neck. Tim waved hello to the Harmony Point sheriff as he crossed the street, who waved back with an ungloved hand burdened by a lump growing between his forefinger and thumb.
Tim passed the Angstrom family as he rounded the corner, whose children sported matching growths on their rosy pink cheeks. The youngsters saw the pizza box and reached for it, grabbing at Tim’s clothes for better leverage to reach for the steaming pie.
Tim pulled away, quicker than Malak had ever seen him move, in an effort to shake them off. Before Tim rounded the corner, Malak thought that he saw the man bare his teeth. Worse, he thought he saw the children snarling back. But that couldn’t have been right.
Malak had considered calling Harris about what he’d seen. The population was, shockingly, still gorging itself despite obvious health issues, necessitating some kind of intervention by Harmony Point’s underpopulated healthcare community. Passing Harris’s swollen parking lot forced him to reconsider, however - bothering the overworked physician again seemed unnecessary. There was no way that his colleague didn’t already know.
Since then, the weather had only gotten worse, burying the town in periodic snowfall. Malak had elected to stay indoors and keep to himself, needing distance from the town and its obsession with terrible pizza. The busy streets outside began to empty of people as they piled up with snow, and, Malak noticed with a grimace, more empty Capriotti’s boxes.
But now, a half a week later, Tim wasn’t showing up to his appointment. No calls or texts. Nothing to let Malak know that Tim would be late. A missed appointment wasn’t unheard of in a small town, particularly in the snow, but a missed appointment without a panicked but sincere midwestern apology was cause for concern. Malak waited out the remainder of the hour to no avail.
When Trinity failed to show, Malak pulled on his overcoat and headed outside.
The streets were scarcely populated when Malak walked to his office that morning, but now, at noon, they were completely empty. He felt a surge of unease twisting in his gut. He wanted to blame the silence on the weather, but he knew better. He had seen the citizens of Harmony Point go about their days just as cheerful and industrious in blizzards as they were in sunshine.
“Harris!” Malak shouted as soon as he stumbled into his colleague’s waiting room. Like the street outside, Harris’s office was completely empty. Malak held his breath, afraid that Harris, too, would be missing, but the exam room door swung open and the doctor’s balding head popped into view.
“Malak, where is everyone? I’ve been making calls all day, nobody’s picking up!”
Malak wasn’t sure what to say. Part of him had been hoping that everyone in town would be in Harris’s office, too sick to trudge through the snow and meet their therapy appointments. This was all wrong.
“Call Mason City, then get your coat. We’re gonna need to make some house calls.”
The windows of the Grimoskas residence were dark. Malak had knocked several times since pulling up, after nearly slipping on the unplowed, half-frozen sidewalk. He tried peering through the closed window blinds, but to no avail. He bit his lip, wrapped his hand around the doorknob, and wished for the hundredth time that he hadn’t left Harris at his office to call for help.
Malak turned the handle and the unlocked door swung inward. Score one for small-town comforts, he supposed.
“Tim? Tim, I called you four times and nobody’s picked up. Is everything alright?”
“Dr. Malak?” Tim’s voice called from somewhere inside. Malak exhaled.
“Jesus, Tim, you scared me half to death. What’s going on?” Malak took a step inside and felt the dull crunch of glass beneath his feet. His breath caught in his throat. The Grimoskas home lay in quiet disarray, a dim menagerie of toppled furniture and torn pastel wallpaper.
“Oh, sure, we were just havin’ us a family pizza party, here, doctor. Couldn’t get enough of that Capriotti’s, could we?” Tim said, his voice muffled. Malak took another step inside, his loafer crushing more broken class, and nearly gagged. The air was thick with the stench of meat and rotting food. Dr. Malak carefully rounded a corner to follow Tim’s voice, a part of his brain telling him that there was a chance that he was simply assuming the worst...
Tim Grimoskas looked up from his dining room table, a stretched string of muscle fiber trailing from his clenched teeth to the unmoving body of his youngest son, Howie. The growth at Tim’s neck had grown exponentially since Malak had seen it last, jutting outward so as to force his head at a permanent angle. Several more growths had blossomed across the surface of his skin, causing his clothes to bulge and tear. The growths on Howie’s body had been picked clean, torn away and replaced by the grooved scoring of teethmarks.
“So whaddaya say, Malak?” Tim asked, the strings of his son’s flesh snapping and falling against his swollen chin as he spoke. “Wanna slice?”
Malak was dully aware as he turned that Greg, Tim’s youngest, sat slumped against the kitchen sink. A bloody tangle of Betty Grimoskas’s hair lay in the hallway. Something wet slipped under Malak’s foot before he was fully conscious that he was running, and he tripped out the open front door with a gasp. He slammed the door behind him, climbed in his car, and had sped away before he was fully aware that Tim had not followed him out.
The Torres house was devoid of life. Malak knew that he should have headed back to Dr. Harris after what he had seen at Tim’s, but he had to see if Trinity was alright. He was greeted by the same scent of blood and meat, and an absence of human life other than a partly-clean femur on the floor. Malak decided not to stick around any longer; he needed no more questions answered. Even in his car, the stench seemed to follow him.
Harris wasn’t answering his phone now, either. As Malak’s modest sedan rounded the corner to Harmony Point’s sole physician, he looked in his rear view mirror and saw a pillar of smoke rising to join with a curtain of gathering clouds that wreathed the setting sun. Malak parked curbside and stepped into Harris’s office.
“What do you mean you won’t take them? I need to get these out of my office!” The door from the waiting room to the exam room hung open. Malak couldn’t see Harris, but he could hear him.
“We no longer need them, obviously. This branch was a failure. You could not contain-” A dim memory of a voice heard a week ago. Sallow skin and wide lips. The Capriotti’s manager. Malak stepped as quietly as he could to the wall parallel the exam room door.
“I failed to contain this? You contracted me to collect the samples and observe growth rates from your compounds. You didn’t tell me there was a chance that these people would turn feral!” Harris said.
“Side effects were a non-zero probability, to be sure, but they’re far from feral. Customers simply consumed our product at much higher volumes than initially projected, toxicity buildup was not purged at normative rates, and they became addicted to our compound. The easiest way to absorb more of the compound is through the ingestion of more material. A perfectly natural response. If anything, your inability to notice these psychoses speaks to your shortcomings as a clinician.”
“I - that’s not my job!” Harris sputtered. Malak winced. It had been his.
“Of course,” the Manager said. “Well, I simply came by to remind you of your nondisclosure agreement for your help in our supply chain management.”
“Like hell! I need you to pay me for these so I can get out of town!”
“First you want me to take incriminating evidence, and now you’re demanding payment? In light of recent events, I might accuse you of overestimating my sense of charity.”
“Take my advice, Harris.” Any sense of decorum had evaporated from the Manager’s voice, giving his voice an edge that raised Malak’s hackles. “Find a rag, light it, and shove it somewhere where the flames will spread. There’s nobody left to put out the fire. Only happy, happy customers.” Malak heard footsteps and ducked behind the waiting room desk as the Manager’s thin profile whisked past and out the door. As soon as he left, Malak rounded the corner to face Harris.
Harris stood holding a plastic tray of the red growths, the lumps of crimson tissue marbled with flecks of dull grey. Behind him the new mini-fridge hung open, holding two wire shelves stocked with more trays of specimens. The samples were cut into small, flat discs and arranged in rows like poker chips.
“Is that... pepperoni?” Malak asked. “Harris, what have you done?”
Dr. Harris looked up at him, his eyes wide and sunken with fatigue. He shook his head. “You could have just left, Adam. You could have just let me live with the secret that I watched this town die.”
“You were using them like cattle!” Malak shouted. “What was your take, Harris? What was the cut?” He didn’t flinch when Harris reached for the tray beside him to grab a scalpel, still red with pepperoni gore.
“Do you really think the cut mattered, Malak? I was meant for more than this! Meant for more than a cramped office stuffed with small-town hicks so miserably uncultured they’d kill themselves for a slice of fake pizza!” Harris lunged at him, and for the second time that day, Malak turned and ran. “Top of my class, Malak! Top of my class and reduced to wiping noses and corporate butchery!”
Malak pulled open the door, but his second step onto the snowy sidewalk flew out from under him as his shoe slid on frozen concrete. He toppled, but not before noticing to his confusion that the back door of his car was open. He turned back to see Harris standing over him, the scalpel gripped between his fingers.
“Can’t you let this go? What do you owe these people, anyway?” he asked. The greasy, spiced smell of pepperoni hung between them, clinging to Harris’s coat and the blade of his knife.
“We’re doctors, Harris. People are going to need our help no matter where they live. The people here needed our help, too.”
Harris snorted. “Self-righteous pri-” Malak didn’t give him the chance to finish, kicking out at Harris’s instep. At the same time, a shape materialized from the shadow of Harris’s office building, lurching toward the looming physician. Malak’s heel struck Harris just as Trinity Torres’s malformed face appeared over Harris’s shoulder, biting down on the physician’s neck. Harris was torn away from Trinity’s teeth as his leg buckled, tearing a chunk away from his neck with the force of his fall. Malak scrambled backward as Trinity descended upon Harris, tearing pieces from him and gulping them down.
“Oh, hey, Doctor Malak,” Trinity said between bites, over the sounds of Harris’s fading cries. Her voice was relaxed, just as casual as Tim’s had been as he ate his son. “I was just thinking about that talk we’d had last week.” Her head descended to take another strip of flesh from the man’s cheekbones while Harris, with the last vestiges of his strength, attempted to stab her with his scalpel. The blade only plunged into the inert red meat growing at her neck and shoulders, and if Trinity felt anything, she gave no sign.
Malak looked away just in time to see a sleek black Tesla emerge from the office parking lot. The driver’s pale face watched the scene on the sidewalk for a moment, smiled, and turned his eyes to the road.
“I was thinking, you know, pizza’s like one of the teen experiences, right?” Trinity said as she slurped down another helping of Harris’s flesh, mixed with the torn fabric of his coat. She looked at Malak, but through him, as though she saw but didn’t recognize him. The growths along her neck and jaw obstructed her mouth, making her speech notably difficult. “Go to the mall, get a pizza. Have a slumber party, get a pizza. Movie night, order a pizza. You know?”
Malak turned back to the road to see the Manager’s taillights fading into the night.
“So it’s a cool that I can finally get that even out here in the boonies, man. Even if you aren’t a fan of the stuff. Maybe you can just... lighten up. Have a slice. Enjoy a part of the American experience.”
Malak pulled himself upright and set his back against the side of his car. He remained silent, and Trinity said nothing more, and Malak wondered if the last of her had escaped with that final sentence. Not far away, a burning pizzeria wafted the smell of roasting meats and cheeses to creatures stirring in darkened houses. Above, the snow fell indifferent on what remained of Harmony Point, Iowa.
This story originally appeared in Do No Harm.