A four-wheeled wooden cart rested on twin rails to the right, containing hand tools and mining implements, pickaxes, hammers. The inside walls of the cart were dented and stained black.
We withdrew from the cave at once. Further exploration was never considered. The chance of compromising our suits was too great, the floating dust itself a formidable potential vector.
We followed the rails along a well-trod path to a long, flat-roofed, pale brick building to the right of the rise. Severed treetops were spaced in large pots atop the roof, and camouflage netting hung halfway down each of the high walls.
The wooden double doors were not secured. Inside, Peter's beam found four more wheeled carts on alternate rails, one filled with broken chunks of brownish-black ore still encrusted with dirt. The main track fed directly into what appeared to be a small refinery. We moved along the length of the left wall, past ovens, stone crushers, smelting vats, and piping, to the end of the line, where beneath a short, iron flume stood a sealed twenty-gallon drum painted sugar white. Peter found a steel rod and pried off the cover, which popped and fell with a clamor against four more barrels behind. It was full of sand packed chunks of clean, dark, lustrous ore laced with quartz.
Peter picked up a small piece and turned it over in the light of his beam. "Pitchblende," he said. "Uranium ore."
Radioactive material. I backed away from the barrel, and brushed something with my boot. My light found a small bat lying dead in a dried streak of blood. Its brown wing membrane was curled and spattered with sores. I turned my torch up toward the ceiling, pipes leading like steel vines to exhaust portals in the grimy roof. The vent windows along the high side walls were unscreened and open to pest and rodent intrusion. I looked back at the floor; it was fouled with guano.
We exited the infested building and crossed the road to a smaller structure fashioned of the same corrugated metal as the camp shanties, but twice the dimension, and bolted edge to edge. Rats and mice lay twisted along the roadside at our feet, as though having crawled out of the underbrush to die. Peter opened the door on the darkness, and we heard a rodent like scattering. His flashlight beam swept a long wooden counter where the miners had evidently been served lunch and dinner.
We moved behind it to a cramped cafeteria-style kitchen, and there he illuminated four objects set along a high shelf next to a stack of tin food trays. They were flowering plants of some sort, well-dead now, cauliflower like eruptions of bunched petals spilling off a broad stalk around inedusan strands of horny stigma. The pots holding them were cracked where the root system had burst through the clay and forced out dirt and leggy spindles. The color had since faded off the wrinkled petals, like a comic book bleached by the sun, leaving only shadows where apparently garish streaks of color once rioted.
Peter turned to me, his flashlight hanging down, fallen leaves and crumbs of dirt shining in its puddle of light. "Four weeks ago the miners broke through the dry gallery wall they thought was the rear of the cave," he said. "They followed a quartz vein of uranite down into a wide cavern running beneath most of the camp, beneath us now. It was a rich deposit. They held an impromptu celebration dinner that night, and some of them brought up a few of the strange plants discovered below. The cavern dips into the water table down there; they had to have waded through it. The ceiling is lower than two meters in places, the stalagmites and stalactites pointed and sharp. They reported large, strange-sounding flying insects. The soil in there hadn't been disturbed for centuries, perhaps never."
"How do you know all this?"
"Kaunda's tablet. He was a camp doctor hired to hand out quinine and Praziquantel tablets to keep the workers working, and got in way over his head. The glass cabinet in his dispensary, stocked with bottles: half are routine medical, peroxide, alcohol; the other half bourbon bottles with the labels soaked off. I found it tucked in there. He began charting the spread after the fifth or sixth incidence. It originated simultaneously in two cave workers and a female cook. The cooks were unmarried women who also accommodated the miners as prostitutes. A fourth case occurred in Kaunda's nurse; the virus spread quickly from there. Animals too. Pigs, sheep, and goats all crashed or had to be put down within days of the first human case."
I took a moment to digest this. "What about the girl?"
"She never came into camp. Neither did her mother. Mr. Moutouari was in charge of the mine and came and went regularly back and forth by bicycle. He led the first expedition down into the cavern after it was discovered. Maybe he brought up one of the more exotic flowers as a present." I envisioned Jacqueline outside her front door, thrilled with her father's gift of a fantastically queer wildflower, placing it into a small porcelain vase and raising the petals to her nose for a deep breath.
Peter continued, "In any event, someone fronted this excavation.
The camp was set up to bring out the pitchblende and clean it off to be packaged and shipped out where it could be milled for uranium. Whoever it is, they've abandoned this place now. The disease scared them off.
Moutouari must have warned them. There haven't been any food shipments in more than a week."
"Radioactive ore," I said. "With whatever ancient microbes are sealed in down there. A closed system, mutating, slow-cooking the RNA, selecting and reselecting over time."
Peter agreed. "Over the millennia. A magma chamber of viruses.
These people go down there and break the seal, disrupt the ecosystem.
That's phase one."
"Then carry it back up here." I nodded. "Whatever they brushed up against, or whatever is in these plants, whatever they breathed, it surfaces and they are infected."
"The cave is clearly the epicenter. The surrounding camp is densely populated. From the incident group to their families, and the nurse to her patients. Then to nonmine workers, the bar owner, the tailor. The far camp was the last to get it."
"Casual contact, then. And aerosol delivery, but with limited capacity. It burns through the camp. Phase two."
"And now phase three," Peter said. "Opportunity for secondary spread must exist. The insect census is a wash for vectors-more species of bug in this tiny camp than in the entire state of Georgia. The river tests clean, no fish washing up yet. But mammals carry it."
Peter saved words by moving his light beam back and forth between us.
"Someone could become infected and vector this virus back to the U.S."
I agreed. "There's no physical boundary here, no safe wall we can put up between us and the bug. The sunlight is killing it in the clearing, and keeping it off the trees. But not for long."
Peter nodded meaningfully, looking into the darkness of the diseased kitchen.
I said, "If this has gotten out already, and is showing up anywhere else, we need to know. An international alert. We need entomologists, zoologists."
Peter shook his head distractedly. "Too hot," he said.
"Containment is most imperative now. Kaunda's log said there hadn't been any ore shipments out in almost a month-they thought the cave had run dry. We're contained now. More people here means only more meat for the bug."
"But we need support. I'm seeing only limited success in trauma.
Fluid management is only marginally effective in slowing the process."
Peter snapped off his light. "Or prolonging the agony," he said.
"It's going to burn right through this camp, nine doctors or nine hundred."
He was right, of course. As we left the kitchen I found myself feeling oddly reinvigorated, anxious to get back to trauma. Our challenge had finally taken shape. Peter opened the metal door and we emerged into the apricot dawn of our third day in the jungle. "A massive cleanup," I said, thinking ahead.
Peter looked around at the cave and the road and the morning trees. A wild plant was growing in the shadow of the cafeteria, its leaves spindly and fevered with overripe color. He uprooted it with his booted heel, and kicked it into the killing light. He said, "Leave that to me.In the afternoon of the th
ird day I was called away from the marketplace trauma by a young girl in her mid-teens on the healthy side of the quarantine line. She was attractive, even remarkably so, with expressive eyes and a chestnut face almost more sculpted than functional, but inside the charnel house this was just another detail among details, an identifying trait I might have listed along with size and weight on her chart, and in truth a feature not nearly as remarkable as the spectacular disfiguring qualities of the disease.
What did distinguish the girl were the stains of vitiligo over her neck and arms, and what I could see of her shins below the hem of her banana-yellow skirt, dappled with de-pigmented, strikingly pale pink flesh that, in my haze, I first mistook for symptoms of the scourge, and which brought me to her. The young woman's eyes, however, were white and clear. She began begging me, in quiet, controlled French, to take her away. Save me from this death, she said, her fingers plying at the red-orange fabric of my chest. Her entreaties became more desperate as I continued to decline, but she pleaded and pleaded, even offering herself to me, anything, grabbing on to my suit, until finally I had to wrest her hands and thrust her away. She dropped to her knees in the grass on the healthy side of quarantine, and continued calling after me.
Later that day, one of the nurses brought me Dr. Kaunda. His eyes were bloodshot and glazed, and small lesions had appeared over his body, and he complained of prostrating lower back and abdominal pain.
He was still muttering something about quinine. The muscles of his face were lax and formless. The de-personalization phase had begun. I dosed him with Seconal to allow him some sleep, and moved on.
That evening, as I walked in on Peter in the dispensary, working over a corpse, I saw that his head was exposed. He had severed his rubber contact suit at the neck and removed the hood in favor of a respirator and a simple cotton surgical cap. The suit was taped sealed to his thick neck, while the decapitated hood piece lay on its side on the floor across the room.
He saw me in the doorway, looking up from his corpse. There was no explanation, no regret. No apology nor even defiance.
Though I strove to return a similarly cool expression, I certainly failed, and finally left without saying a word, proceeding to the hut behind the dispensary.
Jacqueline Moutouari's face was no longer distinguishable. I had seen decomposed bodies before and that was what she looked like now.
She was breathing in short, feral breaths with extended pauses in between. Each one seemed her last.
Peter appeared next to me. He was rubbing something sticky off his gloves and looking at her. She clutched at her chest with tiny, crooked fingers. "End it," Peter said.
The Seconal kit was in my gloved hands. I felt its weight and wondered, as though it were the greatest question in the universe, whether or not I had intended to bring it there. Seconal was a powerful barbiturate sedative, and when administered in significant dosages, was considered a humane instrument of physician-assisted death.
Peter grew impatient. "Give me the kit," he said. He did it himself.
Her pulse rate began to fade and, in less than thirty minutes, stopped.
I buried her myself. It was backbreaking work. I buried her behind the dispensary, away from the others.
Peter later abandoned the autopsy room and joined me out in the makeshift hospital, having capped and chilled many more biological samples than we would ever need. His protective gear had changed again, and now consisted merely of a lighter half mask that provided not much more protection than a simple surgical shield, goggles, and half-arm gloves taped to bloody cotton surgical scrubs. He had covered only the vulnerable membranes of his eyes, nose, ears, and mouth. The contact suit was gone. A nurse next to me saw him and gasped but I kept right on working. Peter was able to move more easily than the rest of us, and flaunted this advantage, rotating from patient to patient with breezy dispatch, like a barber inspecting haircuts. Later that evening I asked him for 2 cc of his blood. It came back negative for viral infection. Peter was clean.
When I was first getting to know my third-year roommate at Yale, I ignored Peter's boasting of never having been sick. I was myself descended from a long line of New York Episcopalians who claimed the same, my grandfather having "never missed a day of work in his life," simply by going to meetings ill and routinely infecting half of Wall Street. This was the starched white underpinning of my Protestant Yankee work ethic.
But as I came to know Peter, I watched as he immersed himself in the petri dish of university life without forfeiting a single class to illness; without contracting the case of mononucleosis that kept me, his finals study partner, from participating in the graduation ceremonies; without ever catching so much as a sniffle. I witnessed more of the same as we continued together through medical school: a defiance toward illness that went beyond the bragging of an extraordinarily hardy constitution. In our second year at Emory, in the CDC virology track, each candidate had to submit to a battery of inoculations before being allowed access to the most dangerous biological agents. Peter was the only one to smile through the endless vaccinations-yellow fever, Q fever, Rift Valley, tularemia, anthrax, hepatitis A and B, typhoid, meningitis A type and C type, and multiple flu and encephalitis strains-tolerating each of these and more without any side effects, without developing even the slightest rash or headache.
The clincher came a few months later, when Peter was contact-traced by the CDC's own Crimes of Infection branch as having been seated on a recent flight from Seattle to Atlanta two rows in front of a man infected with multidrug-resistant tuberculosis.
Untreatable MDR-T]B was the second most prevalent infectious disease in the world, and in the United States it was illegal for carriers to fly on commercial airlines. Contact tracing had turned up all 221 passengers and members of the flight crew, and all were found to have contracted the incurable disease during the five-hour flight, and all went on to secure enormous financial compensation from the airline.
All except Peter Maryk. He was the only passenger who did not collect.
He had been exposed with the others, and yet somehow had thrown off the incurable disease. A battery of tests proved this. The only sensation of discomfort he recalled was one of exhaustion shortly after landing, which he slept off lying across three chairs inside the airport tenninal.
I set to work, initiating a series of laboratory tests exposing samples of Peter's blood to infectious agents both viral and bacterial.
He demonstrated resistance to each, and in time and in secret, Peter began exposing himself to some of the more exotic, non-lethal viruses.
He cast each one aside without manifesting a single symptom, and with only one unusual side effect.
The more serious exposures were followed by a period of mononucleoticlike languor, the duration of which varied according to the pathogenicity of the infectious agent, ranging from brief periods of sluggishness to deep reenergizing sleep. The effort required to expel invaders from his system prompted an overall energy drain, which Peter termed a "cascade." This typically meant his slumping in a corner chair following an exposure, as though dawn had found him the last survivor of a wild party with no ride home. When it compelled him to sleep, which was rare, he slept soundly, nearly unconscious. Given his imposing physical appearance and his superhuman immunological strength, these cascades were the only times he ever appeared vulnerable.
Our co-authored findings were published to acclaim in The New England Journal of Medicine and entitled, "Noninduced Superimmunoresponse and the Search for the Survival Mechanism: The Strange Case of Dr. Peter Christian." Peter's pseudonymous identity and reputation were however generally known within the CDC and the greater medical and scientific community, and the professional acclaim he enjoyed only exacerbated his alienation from his peers.
The origin of Peter's enhanced immune system could be explained only as an accident of genetics, although a six-generation family history had yielded no clues. His body somehow recognized and isolated unhealthy intruders with
alacrity, overwhelming and disabling them profoundly, and dispatching them without any trace of infection-including the production of antibodies. While this latter condition seemed to preclude any direct therapeutic application of his gifts, Peter's blood serum did evince certain benefits in laboratory tests. I determined the reactive process to be CMI, or "cell-mediated immunity," a little-known function of the immune system distinct from the classic antibody response. With CMI, patrolling killer T cells destroy not merely the invading virus, but the infected cell itself, simultaneously ending the virus's bid for reproduction and ridding the body of the threat.
Transfusions of his blood, however, wreaked havoc on laboratory animals. The problem was that Peter's killer Ts attacked without restraint in non-primates, not stopping at pathogens but going on to devour healthy body cells and eventually whole organs and the blood itself. Still, the prospect of a blood serum enhanced with disease fighting properties sustained my laboratory efforts over many more months.
Before that day in Africa, I had never seen him be anything but scrupulously careful, or otherwise dare to tax his system in an uncontrolled setting. Peter had the so-called doctor's disease, the compulsion of many twenty-first-century physicians and scientists acquainted with contagion prevalence and modes of transmission to wear latex gloves at all times, even socially. In fact I assumed that Peter went to bed with a pair on. He was conscientious to the point of compulsion regardless of his incredible natural gifts and had never before been one to take any unnecessary health risks. Direct transmission from an unknown virus like this one, such as infective matter gaining entrance into his body through membranes, or a direct blood exposure, such as from a needle stick, still posed a threat. I kept an eye on him throughout that long, hot night, and at one point noticed him working in a vaguely rhythmic fashion, moving in time to the patient drumbeat of the distant Pygmies.
Chuck Hogan Page 4