As we crossed the atrium, she nodded questioningly toward the women’s room. “Okay, honey,” I said, “I’ll be up in the office.” She peeled off as I kept walking with a spring in my step. I was pleased how we’d just beaten back a hepatitis flare in Brazil. En route to my office I detoured past my favorite section, deeper in the building. To me it was the heart of the CDC: the laboratories. I paused to peer through one of the double-thick biosafety windows that looked into BSL-4, the highest security lab, Biosafety Level Four. I knew the vital protocols by heart.
Excerpted from CDC Lab Safety Protocol Link
Why laboratory safety is important
Laboratory safety cannot be achieved by a single set of standards or methods. What is an acceptable workflow in a lower biosafety-level lab may expose workers to risk if used in a higher biosafety-level lab. All levels of biosafety are needed to allow scientists and researchers to work with specimens to identify new health threats, stop outbreaks, and gain new knowledge.
Biosafety—the science of working with risk
CDC has the expertise to operate laboratories at all levels of biosafety. All laboratories require special training and equipment, whether lab staff are working with relatively safe materials or extremely dangerous pathogens. There are four biosafety levels (BSL) of labs at CDC:
BSL-1—these labs handle agents that pose minimal risks and are not known to consistently cause disease in healthy adults
BSL-2—these labs handle agents that pose only moderate risks to lab staff or the environment
BSL-3—these labs handle agents that can cause serious or lethal disease
BSL-4—the highest level of lab safety in the world, these labs handle the deadliest pathogens for which there is no known cure or treatment
Courtesy CDC
Dr. Susan Perry. . .
I saw a pair of CDC laboratorians working inside the all-white, state-of-the-art chamber that was BSL-4. The two scientists wore bulky, blue isolation suits very similar to space suits. They smiled through their helmets and waved, as pleased to see me as I was them. One gave me a big thumbs-up. I was happy to be back. The CDC had been home to me for the last five years, since I’d completed my postdoc work at Stanford.
I took the elevator up to the third floor and stepped out into a bureaucratic corridor cluttered with stacked file boxes and occasional file cabinets, which had migrated out of overstuffed offices. Approaching me from the opposite direction was Dr. Prashant Sidana, a rail-thin, birdlike Mumbai native with floppy brown hair parted carefully on one side. He was carrying a half-eaten jelly doughnut. I grinned. “What, you didn’t bring me one, Prashant?”
He recognized his error as he licked his finger. “Ah. Ah. Most sorry, Susan, but welcome back to you nevertheless.” I noticed that his eyes darted nervously around. This was not unusual. Prashant was often stirred by various low-grade paranoias. Today he seemed particularly preoccupied about something, but was determined to get through the appropriate greeting and pleasantries first. “I heard that you bedazzled them down in Sao Paolo,” he said in his delightful Marathi accent. “Even more than in Vietnam last month. Or in—”
“Whoa, whoa.” I chuckled. “You’re much too kind. But that won’t get you off the hook for not bringing me a doughnut.” While I was certainly very proud of all our recent successes, dear Prashant could often go over the top. “The most important thing is that we stopped the hepatitis.”
“Yes, yes indeed. You kicked its buttocks.” Prashant often made me smile when he used a catchphrase. Though he’d been in the States for a few years, his grasp of our colloquial linguistics was still a work in progress. He leaned slightly closer. “And the rumor is you are next in line for promotion. Be right up there on Lauren’s level.”
“Well”—I raised both hands slightly to quell his enthusiasm—“I certainly haven’t—”
He snagged my sleeve to interrupt, and I realized he was finally getting to the point of what was disturbing him. He blinked nervously as he leaned closer still, speaking more confidentially, “And speaking of Lauren, he’s here again.”
I frowned, confused. “Who’s here?”
“I’ve seen him more than once since you’ve been gone,” he whispered as he slowly guided me to rotate with him 180 degrees so that we had switched positions. “Mitchell. I heard his name is Mitchell. Look over my left shoulder. The tall man down there talking to Lauren. See?”
I looked across Prashant’s shoulder toward the far end of the cluttered corridor. The man he’d called Mitchell was a hale and hardy sort, over six feet, probably midforties. I sensed a commanding presence and got an immediate impression of power.
Waiting quietly nearby Mitchell and Lauren were two other men, one in a conservative gray suit and tie, the other in more casual clothes with a windbreaker. They were each subtly scanning in different directions. Watchdogs? I noticed that they each had a tiny earplug in one ear with a wire discreetly disappearing into their collars. They lent an added touch of importance and mystery to this Mitchell person. He was conferring with my immediate superior, Dr. Lauren Fletcher, typically elegant and carefully groomed in one of her creamy Donna Karan suits.
Prashant whispered, “I will bet you dollars to a great many doughnuts that he is military intelligence.” As I sized up Mitchell and his entourage, Lilly was shuffling past us, engrossed in reading her iPad. Her cardigan was hanging a bit unevenly, as usual. She had that normal vacant look in her downcast blue eyes.
Lilly had overheard Prashant’s words about Mitchell. She glanced up absently toward the man, eyed him blankly for an instant, then walked into my nearby office.
I said to Prashant, “Okay. I see him. But why do you think he’s military intelligence?”
“Are you kidding? Look at those CIA types with him.” I smiled patiently at Prashant’s paranoia and followed Lilly into my research office with Prashant right on my heels. “And I am most certain I remember seeing him here three years ago. Among some military people. And he definitely has that ‘intelligence’ look. Surely you must see it, Susan?”
I really liked Prashant. His constant apprehensiveness and OCD attention to detail made him an extremely careful laboratorian. He was exactly the person you wanted by your side when you were in the level four lab, dealing with a hot virus. I drew a breath and turned to him. “Now Prashant,” I said, trying to be gentle, “the last time you thought something shady was going on, it turned out to be plumbing repair.”
“Yes, yes. I know, but this is different,” he urged emphatically.
I tried not to roll my eyes and instead glanced over to our friendly CDC custodian, Joseph Hartman, who smiled back knowingly as he emptied my trash. “Joseph, I think you better do some serious praying for this guy.”
“Oh, I do, Dr. Susan. All the time. For all y’all.” He tilted his gray head down and gave a pointedly cautionary look over the top of his wire-rimmed glasses. “Particularly when y’all out there in the field.” Joseph was a caretaker, in every sense of the word. A gentle, self-effacing white man with thin hair. An Atlanta native, he’d been a fixture at the CDC many years before I came along. We’d often have conversations about his daughter, Claire, who was a respected nurse and “the light of his life.” I’d had the pleasure of getting to know Claire when she’d come to several CDC family events. Her natural empathy made it clear to me why patients were so fond of her, as Joseph had told me. Other times a more disheartened Joseph would lean against my lab table and sigh to me with concerns about his prodigal son, James Joseph, who was bent on calling himself Jimmy-Joe and doing everything he could to go down the wrong track.
Joseph was wonderful with Lilly. He was one of the people Lilly was completely comfortable with. That day she was sitting on her tall stool as usual with her iPad resting on her special corner of my lab table. Though most of my office was generally cluttered, Lilly’s corner was always organized and neat. Obsessively so. Her head was bent so low over her iPad that when Joseph tried to lean down t
o catch her eye, he almost had to get on his knees. “S’cuse me, Lilly?” He waited for her millisecond glance of awareness. “Can I get at that trash can, honey?”
Lilly was already intent again on her iPad, but she responded without looking at Joseph, “Uh, okay.”
Joseph carefully eased it out past her, then headed to his cart outside my door. He had to dodge around Prashant, who had continued to pace in the central area between my computer desk, bookshelves, lab table, and window. He was gesturing with the last remains of his jelly doughnut. “Susan, surely you remember those rumors about the military pressuring CDC to develop biological weapons. I will bet you that Mitchell is just the type to be at it again.”
I sifted through some files, my attention already elsewhere. Prashant got annoyed. He sat on the other stool near Lilly’s end of the table and leaned his arm on her neatly organized section, trying to needle me. “I would think you’d worry more about the possibility of biological weapons. After the way BioTeck Industries developed that Agent Orange–type killer stuff out of Chris’s DNA research.”
His statement sparked exactly the effect he wanted. I glanced sharply at him as I chafed at the memory. Prashant knew very well how deeply I missed Chris Smith. And on much more than just a professional level. My eyes drifted over to a photo pinned on the wall near my desk. It was of Chris and me, laughing and hugging in New Orleans’s Lafayette Square two years ago, after we’d finally curtailed that city’s West Nile outbreak. Chris was a handsome, midthirties man with thick red hair and multihued, intelligent eyes. Extremely intelligent. The photo was taken the day he’d bought me the little opal ring I’d worn ever since. Just three weeks after that day, he went away. Loving memories remained, but so did the sadness. I sighed, acknowledging what Prashant said. My voice was lower. “Of course I care, Prashant.”
Lilly glanced from her iPad to her small portion of the table, which Prashant still leaned on. She was uneasy, but spoke flatly to him. “Ooopsie. You m-messed up my pencils.”
Prashant stood up from the table, politely understanding his error. “Oh, I’m so sorry, Lilly.” He carefully realigned the pencils. “There. All fixed.” Lilly stared at them as Prashant went on to me, “Now, Susan, think about it for just—”
“Got j-jelly on one,” Lilly interrupted.
Prashant exhaled a puff of irritation. “Sorry, Lilly.” He wiped the pencil carefully. “There. Okay?”
Lilly stared at the pencil. “. . . But it’ll be s-sticky.”
Prashant was getting frazzled, his voice took on an edge. “Shall I go and wash them for you?”
“Don’t worry, Prashant,” I soothed him, “I’ll take care of the pencils. But do you have any proof about this Mitchell?”
“Wellll . . .” Clearly he hated to admit it. “Not yet, but—”
I was relieved when a fresh and very healthy-looking new face appeared at my door. “S’cuse me, ma’am. This Epidemiology? Dr. Perry?”
“Yes. Susan. Hi.”
“Howdy.” The tall visitor reached out a naturally tanned hand. The hairs on his wrist were sun-bleached white. “I’m R.W. Hutcherson. Folks call me Hutch.” Of the classic Westerner Butch Cassidy tradition, I registered immediately. With his late-thirties outdoorsman good looks, sun-streaked, light-brown hair, charmingly crooked smile, and seasoned snakeskin boots below his Levi’s, the prototype was impossible to miss, and I didn’t.
But I also didn’t miss a beat as I returned his firm handshake. “Of course. Lauren’s been raving to us about you and your work. Very unusual for her, believe me.”
Given his impressive physical persona, his general attitude was in pleasant counterpoint: he seemed unexpectedly shy. “Mighty glad to hear that, ma’am. I sure paid her enough.”
I smiled. “Montana U and Berkeley, right?”
“That’d be right, ma’am.”
“Welcome. And that’d be Susan,” I insisted, as I grinned, privately appreciating his interruption of Prashant’s intensity. “Very welcome.”
Prashant picked up my little barb and smirked, “All right, all right. You are wanting some proof. I will get you some.” He glanced toward Hutch, grasping his hand. “Hello, Prashant Sidana.” And then before Hutch could respond, Prashant went on to me, “Then perhaps you will listen?”
I looked at Prashant with the patience of a true friend. “Have I ever not?”
Prashant nodded pointedly, making clear how he intended to hold me to it. He started out, but paused, pulled out his cell phone. “Oh, Lilly? ‘Lymphocyte Irradiation Studies’?” I saw him click on his cell to record her answer.
Without looking up from obsessively wiping her pencils clean, and without stuttering, Lilly rattled off, “Favero, Martin. Article in The Journal, 1989, Volume 4, issue 13, page 37. Also Knight, David C., Microbiological Journal, 2007, Volume 2, issue 7, page 19, including photomicrographs. Also Locke, Matthew—”
“Yes, yes. That is plenty. Thank you, Lilly,” Prashant said as he clicked his recorder off. Then he gave me a last, huffy look and flitted out.
“O-Okay,” Lilly said in her monotone, without looking up.
Hutch stared in amazement at Lilly, who was intent on her pencils. I smiled at his incredulity. “My sister, Lilly.”
Hutch moved closer to her. He sensed her special needs and offered his warm, Montana-bred smile. “Hi there, Lilly.”
Lilly didn’t look up from reorganizing her area. She never looked anyone directly in the eye. Her voice was always colorless and level. “Hello.”
“How can you remember all that?”
Assessing her pencils, she said, “I’m-m exceptional.”
I moved to them and hugged her. “Yes, you are. And here’re some fresh ones that haven’t been uploaded yet, honey.” I carefully laid a handful of new pharmaceutical and medical journals at the edge of her space. Lilly immediately began turning through one, scanning each page in less than two seconds.
Hutch blinked, spoke aside to me, “She’s not . . . reading those?”
“Yes. Lilly’s got an amazing ability for speed-reading and an exceptionally dazzling memory.” I brushed back an errant lock of her auburn hair. “Because of her autism she doesn’t respond much to social stuff. But she’s a savant, aren’t you, honey?” She nodded without looking up.
“I saw a boy like that on 60 Minutes a while back”—Hutch looked at Lilly in admiration—“who could play a whole piano concerto after just listening to it.”
“Incredible, huh? Autism presents differently in each individual. With that boy it was music. With Lilly it’s shapes a little bit—she loves that old Tetris game—but mostly it’s words. She’s read most of the texts and journals in the CDC library.”
Hutch was suitably astonished. “What? Most of—? She understands them?!”
“Oh, not a word.” I chuckled. “But she can recall every detail.” I smiled at his stupefied expression. “Yeah. I know. And what a waste not to use that skill, huh? That’s why I brought her to be with me here after our parents died. Never wanted her in a home. Better for her in the real world. She’s fairly high functioning. Everybody here loves her.”
Hutch laughed charmingly. “Who wouldn’t? A living bibliography!” He smiled at Lilly. “And lots prettier than Google. Nice to meet you, Lilly.”
Lilly had no reaction. She just went on scanning the dense documents at lightning speed. While Hutch contemplated her, I studied him. I’d immediately noted the wedding ring, of course. Now I considered the healthy tan, the cowboy-handsome face with just enough smile lines to give it character. His jacket was old corduroy, the color of my favorite Cadbury milk chocolate. His shirt was a muted blue-and-brown plaid but with a button-down collar. The jeans were well worn in, as was the broad leather belt, which augmented the wrangler feel. He looked up and almost caught my inspection. He smiled shyly, seeming like he felt uncomfortable about saying, “Listen, Dr. Levering told me to work out of your office for a couple days till mine’s ready, but if that’s gonna be
a bother for you then—”
“Not at all.” I smiled.
“Much obliged. He’s got me taking over the list of clinical trial subjects for the new AIDS medication.”
Really? I was surprised. Curious. “That was Lauren Fletcher’s pet project. She must be on something new now . . . or . . .” For a moment I considered Prashant’s suspicion about Lauren and Mitchell, then passed it off. “But you’re welcome in here. I’ll show you how to access—”
“It was r-raining.”
I glanced at Lilly. “. . . What honey?”
“October twenty-sixth,” she said, while still scanning one of the journals. “Thursday. Three years ago. When that M-Mitchell person was here before. Rained all day.”
I was pondering that information when officious-looking, sixtyish Dr. Ernest Levering was passing in the corridor and paused to look in. “Oh good, Hutcherson. You found her.” Hutch nodded, and Levering looked at me. “You get the file I forwarded?”
I glanced at my computer screen, tapped at the keyboard. “I saw it come in, but hadn’t opened it yet.” I did so as he went on.
“About a woman who got attacked by her hogs.”
Hutch looked startled. “What?”
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