by Tom Clancy
There were plants, but nothing exotic. They stood in the center of the living room, not touching anything with their gloved hands or even with their green-trousered legs, as they turned around slowly, looking.
“I don’t see anything,” Quinn reported.
“Neither do I. Kitchen.”
There were some more plants there, two that looked like herbs in small pots. Klein didn’t recognize their type and decided to lift them.
“Wait. Here,” Quinn said, opening a drawer and finding freezer bags. The plants went into those bags, which the younger physician sealed carefully. Klein opened the refrigerator. Nothing unusual there. The same was true of the freezer. He’d thought it possible that some exotic food product ... but, no. Everything the patient ate was typically American.
The bedroom was a bedroom and nothing more. No plants there, they saw.
“Some article of clothing? Leather?” Quinn asked. “Anthrax can—”
“Ebola can’t. It’s too delicate. We know the organism we’re dealing with. It can’t survive in this environment. It just can’t, ” the professor insisted. They didn’t know much about the little bastard, but one of the things they did at CDC was to establish the environmental parameters, how long the virus could survive in a whole series of conditions. Chicago at this time of year was as inhospitable to that sort of virus as a blast furnace. Orlando, some place in the South, maybe. But Chicago? “We got nothing,” he concluded in frustration.
“Maybe the plants?”
“You know how hard it is to get a plant through customs?”
“I’ve never tried.”
“I have, tried to bring some wild orchids back from Venezuela once ...” He looked around some more. “There’s nothing here, Joe.”
“Is her prognosis as bad as—”
“Yeah.” A pair of gloved hands rubbed against the scrub pants. Inside the latex rubber, his hands were sweating now. “If we can’t determine where it came from ... if we can’t explain it ...” He looked at his younger, taller colleague. “I have to get back. I want to take another look at that structure.”
“HELLO,” GUS LORENZ said. He checked his clock. What the hell?
“Gus?” the voice asked.
“Yes, who’s this?”
“Mark Klein in Chicago.”
“Something wrong?” Lorenz asked groggily. The reply opened his eyes all the way.
“I think—no, Gus, I know I have an Ebola case up here.”
“How can you be sure?”
“I have the crook. I micrographed it myself. It’s the Shepherd’s Crook, and no mistake, Gus. I wish it were.”
“Where’s he been?”
“It’s a she, and she hasn’t been anywhere special.” Klein summarized what he knew in less than a minute. “There is no immediately apparent explanation for this.”
Lorenz could have objected that this was not possible, but the medical community is an intimate one at its higher levels; he knew Mark Klein was a full professor at one of the world’s finest medical schools. “Just one case?”
“They all start with one, Gus,” Klein reminded his friend. A thousand miles away, Lorenz swung his legs off the bed and onto the floor.
“Okay. I need a specimen.”
“I have a courier on the way to O’Hare now. He’ll catch the first flight down. I can e-mail you the micrographs right now.”
“Give me about forty minutes to get in.”
“Gus?”
“Yes?”
“Is there anything on the treatment side that I don’t know? We have a very sick patient here,” Klein said, hoping that for once maybe he wasn’t fully up to speed on something in his field.
“’Fraid not, Mark. Nothing new that I know about.”
“Damn. Okay, we’ll do what we can here. Call me when you get there. I’m in my office.”
Lorenz went into the bathroom and ran some water to splash in his face, proving to himself that this wasn’t a dream. No, he thought. Nightmare.
THIS PRESIDENTIAL PERK was one even the press respected. Ryan walked down the steps first, saluted the USAF sergeant at the bottom, and walked the fifty yards to the helicopter. Inside, he promptly buckled his belt and went back to sleep. Fifteen minutes later he was roused from his seat again, walked down another set of stairs, saluted a Marine this time, and headed into the White House. Ten minutes after that, he was in a sleeping place that didn’t move.
“Good trip?” Cathy asked, one eye partly open. “Long one,” her husband reported, falling back to sleep.
THE FIRST FLIGHT from Chicago to Atlanta left the gate at 6:15 A.M., Central Time. Before then, Lorenz was in his office, on his computer terminal, dialed into the Internet and on the phone at the same time.
“I’m downloading the image now.”
As the older man watched, the micrograph grew from top to bottom, one line at a time, faster than a fax would come out of a machine, and far more detailed.
“Tell me I’m wrong, Gus,” Klein said, no hope in his voice at all.
“I think you know better, Mark.” He paused as the image finished forming. “That’s our friend.”
“Where’s he been lately?”
“Well, we had a couple of cases in Zaire, and two more reported in Sudan. That’s it, as far as I know. Your patient, has she been—”
“No. There aren’t any risk factors that I have been able to identify so far. Given the incubation period, she must almost certainly have contracted it here in Chicago. And that’s not possible, is it?”
“Sex?” Lorenz asked. He could almost hear the shake of the head over the phone.
“I asked. She says she’s not getting any of that. Any reports anyplace else?”
“None, none anywhere. Mark, are you sure of what you’ve told me?” As insulting as the question was, it had to be asked.
“I wish I weren’t. The micrograph I sent is the third one, I wanted good isolation for it. Her blood is full of it, Gus. Wait a minute.” He heard a muffled conversation. “She just came around again. Says she had a tooth extracted a week or so ago. We have the name of her dentist. We’ll run that one down. That’s all we have here.”
“All right, let me get set up for your sample. It’s only one case. Let’s not get too excited.”
RAMAN GOT HOME shortly before dawn. It was just as well that the streets were almost entirely devoid of traffic at this time of day. He was in no condition for safe driving. Arriving home, he followed the usual routine. On his answering machine was another wrong number, the voice of Mr. Alahad.
THE PAIN WAS so severe that it woke him up from the sleep of exhaustion. Just walking the twenty feet around the bed and into the bathroom seemed like a marathon’s effort, but he managed to stagger that far. The cramping was terrible, which amazed him, because he hadn’t eaten all that much in the past couple of days despite his wife’s insistence on chicken soup and toast, but with all the urgency he could suffer, he dropped his shorts and sat down just in time. Simultaneously, his upper GI seemed to explode as well, and the former golf pro doubled over, vomiting on the tiles. There was an instant’s embarrassment at having done so unmanly a thing. Then he saw what was there at his feet.
“Honey?” he called weakly. “Help ...”
48
HEMORRHAGE
SIX HOURS OF SLEEP, maybe a little more, was better than nothing. This morning, Cathy got up first, and the father of the First Family came into the breakfast room unshaven, following the smell of coffee.
“When you feel this rotten, you should at least have a hangover to blame it on,” the President announced. His morning papers were in the usual place. A Post-it note was affixed to the front page of the Washington Post, just over an article bylined to Bob Holtzman and John Plumber. Now, there was something to start off his day, Jack told himself.
“That’s really sleazy,” Sally Ryan said. She’d already heard TV coverage of the controversy. “What finks.” She would have said “dicks,” a newly fav
ored term among the young ladies at St. Mary’s School, but Dad wasn’t ready to acknowledge the fact that his Sally was talking like a grown-up.
“Uh-huh,” her father replied. The story gave far more detail than was possible in a couple of minutes of air time. And it named Ed Kealty, who had, it seemed—unsurprisingly, but still against the law—a CIA source who had leaked information which, the story explained, had not been entirely truthful and, even worse, had been a deliberate political attack on the President, using the media as an attack dog. Jack snorted. As though that were new. The Post’s emphasis was on the gross violation of journalistic integrity. Plumber’s recantation of his actions was very sincere, it said. The article said that senior executives at NBC’s news division had declined comment, pending their own inquiry. It also said that the Post had custody of the tapes, which were entirely undamaged.
The Washington Times, he saw, was just as irate but not in quite the same way. There would be a colossal internecine battle in the Washington press corps over this, something, the Times editorial observed, that the politicians would clearly watch with amusement.
Well, Ryan told himself, that ought to keep them off my buck for a while.
Next, he opened the manila folder with the secret-tape borders on it. This document, he saw, was pretty old.
“Bastards,” POTUS whispered.
“They really did it to themselves this time,” Cathy said, reading her own paper.
“No,” SWORDSMAN replied. “China.”
IT WASN’T AN epidemic yet, because nobody knew about it. Doctors were already reacting in surprise to telephone calls. Excited, if not frantic, calls to answering services had already awakened over twenty of them across the country. Bloody vomit and diarrhea were reported in every case, but only one to a customer, and there were various medical problems that could explain that. Bleeding ulcers, for example, and many of the calls came from businesspeople for whom stress came with the tic and white shirt. Most were told to drive to the nearest hospital’s emergency room, and in nearly all cases the doctor got dressed to meet his or her patient there, or to have a trusted associate do so. Some were instructed to be at the office first thing, usually between eight and nine in the morning, to be the first patient of the day and thus not interfere with the daily schedule.
GUS LORENZ HADN’T felt like being in his office alone, and had called in a few senior staff members to join him at his computer. They noted that his pipe was lit when they came in. One of them might have objected—it was contrary to federal regulations—but she stopped short, looking at the image on the screen.
“Where’s this one from?” the epidemiologist asked.
“Chicago.”
“Our Chicago?”
PIERRE ALEXANDRE ARRIVED at his office on the eleventh floor of the Ross Building just before eight. His morning routine began with checking his fax machine. Attending physicians with AIDS cases regularly sent him patient information that way. It allowed him to monitor a large number of patients, both to advise treatment options and to increase his own knowledge base. There was only one fax this morning, and it was relatively good news. Merck had just fielded a new drug which the FDA was fast-tracking into clinical trials, and a friend of his at Penn State was reporting some interesting results. That’s when his phone rang.
“Dr. Alexandre.”
“This is the ER, sir. Could you come down here? I got a patient here, Caucasian male, thirty-seven. High fever, internal bleeding. I don’t know what this is—I mean,” the resident said, “I mean, I know what it looks like, but ”
“Give me five minutes.”
“Yes, sir,” she acknowledged.
The internist/virologist/molecular biologist donned his starched lab coat, buttoned it, and headed down toward the emergency room, which was in a separate building on the sprawling Hopkins campus. Even in the military, he’d dressed the same way. The Doctor Look, he called it. Stethoscope in the right-side pocket. Name embroidered onto the left side. A calm expression on his face as he walked into the largely idle ER. Nighttime was the busy period here. There she was, cute as a button ... putting on a surgical mask, he saw. What could be all that wrong this early on a spring day?
“Good morning, Doctor,” he said, in his most charming Creole accent. “What seems to be the problem?” She handed him the chart and started talking while he read.
“His wife brought him in. High fever, some disorientation, BP is low, probable internal bleed, bloody vomit and stool. And there are some marks on his face,” she reported. “And I’m not sure enough to say.”
“Okay, let’s take a look.” She sounded like a promising young doc, Alexandre thought pleasantly. She knew what she didn’t know, and she’d called for consultation ... but why not one of the internal-medicine guys? the former colonel asked himself, taking another look at her face. He put on mask and gloves and walked past the isolation curtain.
“Good morning, I’m Dr. Alexandre,” he said to the patient. The man’s eyes were listless, but it was the marks on his cheeks that made Alexandre’s breath stop. It was George Westphal’s face, come back from more than a decade in Alex’s past.
“How did he get here?”
“His personal physician told his wife to drive him in. He has privileges at Hopkins.”
“What’s he do? News photographer? Diplomat? Something to do with traveling?”
The resident shook her head. “He sells Winnebagos, RVs and like that, dealership over on Pulaski Highway.”
Alexandre looked around the area. There were a medical student and two nurses, in addition to the resident who was running the case. All gloved, all masked. Good. She was smart, and now Alex knew why she was scared.
“Blood?”
“Already taken, Doctor. Doing the cross-match now, and specimens for analysis in your lab.”
The professor nodded. “Good. Admit him right now. My unit. I need a container for the tubes. Be careful with all the sharps.” A nurse went off to get the things.
“Professor, this looks like—I mean, it can’t be, but—”
“It can’t be,” he agreed. “But it does look that way. Those are petechiae, right out of the book. So we’ll treat it like it is for the moment, okay?” The nurse returned with the proper containers. Alexandre took the extra blood specimens. “As soon as you send him upstairs, everybody strip, everybody scrub. There’s not that much danger involved, as long as you take the proper precautions. Is his wife around?”
“Yes, Doctor, out in the waiting room.”
“Have somebody bring her up to my office. I have to ask her some things. Questions?” There were none. “Then let’s get moving.”
Dr. Alexandre visually checked the plastic container for the blood and tucked it into the left-side pocket of his lab coat, after determining that it was properly sealed. The calm Doctor’s Look was gone, as he walked to the elevator. Looking at the burnished steel of the automatic doors, he told himself that, no, this wasn’t possible., Maybe something else. But what? Leukemia had some of the same symptoms, and as dreaded as that diagnosis was, it was preferable to what it looked like to him. The doors opened, and he headed off to his lab.
“Morning, Janet,” he said, walking into the hot lab.
“Alex,” replied Janet Clemenger, a Ph.D. molecular biologist.
He took the plastic box from his pocket. “I need this done in a hurry. Like, immediately.”
“What is it?” She wasn’t often told to stop everything she was doing, especially at the start of a working day.
“Looks like hemorrhagic fever. Treat it as level ... four.”
Her eyes went a little wide. “Here?” People were asking the same question all over America, but none of them knew it yet.
“They should be bringing the patient up now. I have to talk to his wife.”
She took the container and set it gently on the worktable. “The usual antibody tests?”
“Yes, and please be careful with it, Janet.”
“Always,” she assured him. Like Alexandre, she worked a lot of AIDS experiments.
Alexandre next went to his office to call Dave James.
“How certain are you?” the dean asked two minutes later.
“Dave, it’s just a heads-up for now, but—I’ve seen it before. Just like it was with George Westphal. I have Jan Clemenger working on it right now. Until further notice, I think we have to take this one seriously. If the lab results are what I expect, I get on the phone to Gus and we declare a for-real alert.”
“Well, Ralph gets back from London day after tomorrow. It’s your department for the moment, Alex. Keep me posted.”
“Roger,” the former soldier said. Then it was time to speak to the patient’s wife.
In the emergency room, orderlies were scrubbing the floor where the bed had been, overseen by the ER charge nurse. Overhead they could hear the distinctively powerful sound of a Sikorsky helicopter. The First Lady was coming to work.
THE COURIER ARRIVED at CDC, carrying his “hatbox,” and handed it over to one of Lorenz’s lab technicians. From there everything was fast-tracked. The antibody tests were already set up on the lab benches, and under exquisitely precise handling precautions, a drop of blood was dipped into a small glass tube. The liquid in the tube changed color almost instantly.
“It’s Ebola, Doctor,” the technician reported. In another room a sample was being set up for the scanning electron microscope. Lorenz walked there, his legs feeling tired for so early in the morning. The instrument was already switched on. It was just a matter of getting things aimed properly before the images appeared on the TV display.
“Take your pick, Gus.” This was a senior physician, not a lab tech. As the magnification was adjusted, the picture was instantly clear. This blood sample was alive with the tiny strands. And soon it would be alive with nothing else. “Where’s this one from?”