by Tom Clancy
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 favored 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 express
ion 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?”
“Chicago,” Lorenz answered.
“Welcome to the New World,” he told the screen as he worked the fine control to isolate one particular strand for full magnification. “You little son of a bitch.”
Next came a closer examination to see if they could sub-type it. That would take a while.
“AND SO HE has not traveled out of the country?” Alex was running down his list of stock questions.
“No, no he hasn’t,” she assured him. “Just to the big RV show. He goes to that every year.”
“Ma’am, I have to ask a number of questions, and some of them may seem offensive. Please understand that I have to do this in order to help your husband.” She nodded. Alexandre had a quiet way of getting past that problem. “Do you have any reason to suspect that your husband has been seeing other women?”
“No.”
“Sorry, I had to ask that. Do you have any exotic pets?”
“Just two Chesapeake Bay retrievers,” she replied, surprised at the question.
“Monkeys? Anything from out of the country?”
“No, nothing like that.”
This isn’t going anywhere. Alex couldn’t think of another relevant question. They were supposed to say yes to the travel one. “Do you know anybody, family member, friend, whatever, who does a lot of traveling?”
“No—can I see him?”
“Yes, you can, but first we have to get him settled into his room and get some treatment going.”
“Is he going to—I mean, he’s never been sick at all, he runs and doesn’t smoke and doesn’t drink much and we’ve always been careful.” And then she started losing control.
“I won’t lie to you. Your husband appears to be a very sick man, but your family doctor sent you to the best hospital in the world. I just started here. I spent more than twenty years in the Army, all of that in the area of infectious diseases. So you are in the right place, and I am the right doc.” You had to say things like that, empty words though they might be. The one thing you could never, ever, do was take hope away. The phone rang.
“Dr. Alexandre.”
“Alex, it’s Janet. Antibody test is positive for Ebola. I ran it twice,” she told him. “I have the spare tube packaged to go to CDC, and the microscopy will be ready to go in about fifteen minutes.”
“Very well. I’ll be over for that.” He hung up. “Here,” he told the patient’s wife. “Let me get you out to the waiting room and introduce you to the nurses. We have some very good ones on my unit.”
This was not the fun part, even though infectious diseases was not a particularly fun field. In trying to give her hope, he’d probably given her too much. Now she’d listen to him, thinking that he spoke with God’s voice, but right now God didn’t have any answers, and next he had to explain to her that the nurses would be taking some of her blood for examination, too.
“WHAT GIVES, SCOTT?” Ryan asked across thirteen time zones.
“Well, they sure as hell tossed a wrench into it. Jack?”
“Yes?”
“This guy Zhang, I’ve met him twice now. He doesn’t talk a hell of a lot, but he’s a bigger fish than we thought. I think he’s the one keeping an eye on the Foreign Minister. He’s a player, Mr. President. Tell the Foleys to open a file on the guy and put a big flag on it.”
“Will Taipei spring for compensation?” SWORDSMAN asked.
“Would you?”
“My instinct would be to tell them where they could shove it, but I’m not supposed to lose my temper, remember?”
“They will listen to the demand, and then they will ask me where the United States of America stands. What do I tell them?”
“For the moment, we stand for renewed peace and stability.”
“I can make that last an hour, maybe two hours. Then what?” SecState persisted.
“You know that area better than I do. What’s the game, Scott?”
“I don’t know. I thought I did, but I don’t. First, I kinda hoped it was an accident. Then I thought they might be rattling their cage—Taiwan’s, I mean. No, it’s not that. They’re pushing too hard and in the wrong way for that. Third option, they’re doing all this to test you. If so, they’re playing very rough—too rough. They don’t know you well enough yet, Jack. It’s too big a pot for the first hand of the night. Bottom line, I do not know what they’re thinking. Without that, I can’t tell you how to play it out.”