The
Rationing
A NOVEL
Charles
Wheelan
This is a work of fiction. Names, characters, places, and incidents are the products of the author’s imagination or are used fictitiously. Any resemblance to actual events, locales, or persons, living or dead, is entirely coincidental.
For the Americans who
died during the Outbreak.
Contents
A NOTE ON SOURCES
PART 1 Running the Yellow
PART 2 Do the Right Thing
PART 3 What If ?
PART 4 It Hits the Fan
PART 5 The China Option
PART 6 Nature Fights Back
PART 7 Okay, Now What?
PART 8 The Hypothesis and the Ego
Epilogue
ACKNOWLEDGMENTS
A Note on Sources
THIS BOOK IS COMPILED PRIMARILY FROM MY RECOLLECTIONS. I took notes in most of the important meetings. I kept a journal on those rare evenings when I had enough energy after leaving the White House to pen a few lines before collapsing into bed. To be honest, though, most of the salient events are so firmly implanted in my memory that they were not terribly hard to recall in vivid detail. As a scientist, I recognize that the mind can play tricks. Whenever possible I have verified my recollection of events with the principals who were in the room. My notes were helpful in reminding me of the exact sequencing of events. During our long, contentious, often meandering meetings, I made a habit of writing down who said what, sometimes quoting them directly.
I took detailed notes because it was obvious that we were all spectators to history. Taking notes also passed the time and helped ease my frustration. (I noticed that the Secretary of Defense was a chronic doodler; somewhere in the archives there must be hundreds of drawings of buff soldiers operating impressive armaments.) The point is that I was able to reconstruct the dialogue for this book, not always word-for-word, but close enough to evoke the spirit of the conversations.
For some of the public reaction outside of the Beltway, I have drawn heavily on Gregg Brockway’s series of articles in Vanity Fair that have rightfully become the definitive contemporaneous account of the nation’s reaction to what will forever be known as “the Outbreak.” Experts and historians will be parsing documents for decades, but no one will ever match Brockway’s reportorial eye. While the nation arguably lost its collective mind, Brockway captured the extraordinary details that will forever illustrate popular reaction to the crisis, from Hollywood to Wall Street to some of the most obscure hamlets in Appalachia. We all knew that we were living something scary and extraordinary; Brockway was the guy writing it down.
For the meetings I did not attend, I have either interviewed the principals or drawn on their published memoirs. In cases where recollections differ, or where there are gaps in the public record, I have used my firsthand knowledge of the people and their personalities to infer what most likely happened. I have made use of some contemporaneous news coverage. These sources are generally cited in the text. However, I feel compelled to point out that a shockingly high proportion of the news coverage at the time was inaccurate—not incomplete, or misleading, or oversimplified, but just plain wrong. As my story will tell, we in the White House were partially responsible for creating the information vacuum that allowed this kind of misinformation to take root. Still, that should not give anyone, particularly the New York Times and the Washington Post–USA Today, the right to fill that vacuum with “news” that was not even tenuously connected to the truth. Many of the alternative news sources, with a few notable exceptions, were worse than that.
The publication of this book was delayed by nearly eighteen months of legal wrangling, as my lawyers did battle with various parties, including the U.S. government. (I often worked through disagreements with my own lawyers over what it would be prudent for me to reveal.) In that time, two fortuitous things happened. First, the Outbreak Inquiry Commission—the body created by Congress to investigate the crisis from start to finish—released its report, including material from closed-door hearings that had never before been made public. Second, WikiLeaks produced a huge trove of State Department documents covering this period, giving me remarkable access to the diplomatic wrangling behind the scenes. I do not condone such leaks; I can say that in this instance they have enabled me to tell a more complete story.
This is not the first book on the Outbreak. It is the most accurate. I am not a brilliant writer, but I am a scientist who happened to be in the right place at the right time (or the wrong place at the wrong time, depending on your perspective). I was in nearly every important science-related meeting at the White House during the crisis and in many of the political ones, too. In fact, I had greater access to the full scope of events than the President, since he was often consumed by other affairs of state and generally did not participate in the scientific meetings.
I am not writing to settle scores. I am not writing to burnish my leadership credentials or to make myself viable for the Iowa caucuses. (Yes, that is why some of the other books were written, and it explains why they were so ridiculously inaccurate and self-serving.) I was there. I understood the science. I watched our political process deal with an unprecedented crisis. This is what happened. It is not my story; it is our story.
PART 1
RUNNING THE YELLOW
1.
WAREHOUSE 61 IS AT THE END OF A LOADING DOCK in the Port of Long Beach. Sometime between midnight and two a.m. on March 21, it caught fire. For reasons that may never be clear (given that it was a very warm night), a homeless man had set a small blaze in an oil drum near the truck entrance to Warehouse 61. The fire somehow spread to a pool of motor oil, setting ablaze the warehouse and several small maintenance buildings. No one was injured except for the homeless man, who was treated for burns at a Los Angeles hospital. The Long Beach Fire Department responded and put out the fire after several hours.
Warehouse 61 is owned and operated by the U.S. government. It is used to store materials coming and going across the Pacific, everything from sophisticated research equipment to school supplies for students in Guam. On March 21, the warehouse also held fourteen chimpanzees, which were being shipped from a government research facility in Hawaii to a private laboratory at Stanford. Thirteen of the fourteen chimps were killed in the fire; the fourteenth, a female named Bobo, was rescued by firefighters. Bobo became the story. Protesters descended on Los Angeles and Long Beach to protest animal experiments by the U.S. government. The President of the United States, the head of the National Institutes of Health, the President of Stanford, and assorted other officials were called upon to explain the necessity of doing research on primates, and, more immediately, why these particular chimps had been left unattended overnight in a warehouse.
Meanwhile, Bobo clung to life. She was attended to by a team of veterinarians, as well as several prominent burn specialists for humans. Money poured in for Bobo’s treatment. By the time she regained consciousness several days later, still with serious burns and at high risk of infection, over $25 million had been collected to pay Bobo’s bills. This prompted a wave of counterprotests by those Americans, myself included, who found it perplexing, if not absurd, that our fellow citizens lavished money on a burned chimp only six months after repealing (once again) the health care coverage for fifty million Americans. The health care debate became even more pitched when it was disclosed that the homeless man burned in the fire, who had third-degree burns over 20 percent of his body, had been quietly turned out of a Los Angeles hospital because he could not pay his bills. This left him at serious risk of infection, and the police without the only witness to the start of the fire. The homeless man would never show up again.
Doctors and talking heads tweeted aggressively about who had been more seriously injured, Bobo or the homeless man. For three days, Home Depot Media made Bobo the feature story on all of its receipts and coupons.
The homeless guy was soon forgotten. Bobo got better. She was placed in the Los Angeles Zoo and became a hit attraction. Just last year she “mated successfully” (a term I now use with my married friends), and the world eagerly embraced the son of Bobo, Hanson, who was named for the Long Beach firefighter who rescued Bobo from the warehouse blaze.
2.
BOBO WAS A SIDESHOW, A DEVASTATING DISTRACTION. WAREHOUSE 61 also contained a shipment of research materials and pharmaceutical products that were en route from the naval laboratory in Honolulu to the mainland. That shipment included the core ingredients for twenty-five million doses of the drug transcriptin, which we now know by its commercial name, Dormigen. For anybody working anywhere in science or medicine—for people like me—the development of Dormigen was like the World Series and the Super Bowl rolled into one. Other kids dreamed of coming to bat in the ninth inning of the seventh game of the World Series with the score tied and the bases loaded. Guys like me cried when our mothers drove us to Little League practice. As I stood in right field, where the ball invariably came more than it was supposed to, I imagined inventing something like Dormigen—the most important breakthrough in medicine since penicillin.
Dormigen is an effective treatment for viral infections and bacterial infections and most parasites. If Dormigen were a person, he would play professional basketball, publish popular novels, and teach math at Harvard, all while dating a supermodel. I have given some thought to that metaphor. Just as we do not expect people who teach math at Harvard to play professional basketball, scientists had always assumed it was improbable, if not impossible, to find a drug that could be effective against all the different pathogens that pose harm to humans. Then we created Dormigen.
It was none too soon. By the 2020s, many traditional antibiotics were becoming less and less effective. The “golden half-century” of medicine—during which a cheap course of antibiotics would wipe out anything from venereal disease to tuberculosis—was over. We had collectively neglected what Charles Darwin taught us: pathogens adapt or die. Those that were not dying in the face of penicillin and its relatives were getting stronger and more dangerous. Pediatricians blithely passed out prescriptions for antibiotics to parents with screaming children, regardless of whether those drugs were necessary or even effective against little Ellie’s ear infection. The grocery shelves were full of every imaginable antibacterial product. Never mind that soap and water worked better than most of them. The peak of this dangerous silliness was when Hanes and Jockey both released antibacterial underwear, almost immediately capturing 40 percent of the market. (“Germ-free fresh!”)
The germs just kept getting stronger and more resilient. Evolution moves swiftly for organisms that can produce millions of offspring a day, any one of which could be the mutant strain equipped to live comfortably in antibacterial underwear. By 2024, public health officials were warning of a crisis. The number of fatal hospital infections from so-called “superbugs”—which are really just bacteria that have developed a resistance to our best antibiotics—had been rising steadily for a decade. Every public health meeting and conference included a breakout session on antibiotic resistance. The major medical journals wrote editorial after editorial pointing out the growing threat. I remember reading a dire warning in the Journal of the American Medical Association that concluded, “Without a major change in behavior, we will soon face a medical return to the pre-penicillin era, and that should scare us.”
That did not scare us, apparently, at least not beyond the medical and public health community. By then, almost half of us were wearing antibacterial underwear. We were also using antibacterial sunscreen, buying phones with bacteria-resistant keyboards, and decorating our homes with antibacterial paint. All the while, the germs marched and drilled and produced more robust offspring; the number of Americans dying from drug-resistant hospital infections quietly eclipsed the number of Americans dying from HIV/AIDS and motor vehicle accidents combined.
And then Buster Bowman died. I liked him well enough; his music was popular in a “retro” kind of way when I was in college. The cable news networks played the announcement of his death over and over again. He had been admitted to a prestigious New York hospital for a routine procedure. The media and Bowman’s die-hard fans had camped out on the sidewalk outside the hospital, hoping to snap some photos of him or to get an autograph on his way out. What they got instead was Bowman’s physician, a white-haired fiftyish-looking man, who stepped out of the main doors of the hospital entrance in his blue scrubs to give them shocking news: “Buster Bowman died shortly after seven this morning,” he said.
The doctor was so quiet that many of the fans sprawled on the sidewalk did not hear him. Most of the tabloid photographers were around the corner vaping. Those who heard the doctor’s mumbled pronouncement rushed forward; the news spread through the crowd like an electric current. The reporters began yelling for the doctor to repeat his statement. They demanded more details. How does someone who comes in for a ruptured Achilles tendon end up dead?
Bowman’s physician had the look of a man who had been awake all through the night. He composed himself and stepped toward the bundle of microphones now being thrust in his direction. “Is this okay?” he asked of no one in particular, giving the statement a sense of performance art. Then he delivered the stunning details: “Buster Bowman was pronounced dead at 7:05 a.m. He died of a massive infection that we were unable to control with antibiotics. That is all the information I can provide at this time, pending an autopsy and a hospital investigation.”
My parents and their friends were devastated; Bowman was the rock icon of their generation. Public opinion toward antibacterial products changed overnight. Being spotted at the gym in antibacterial underwear was now only slightly more socially acceptable than wearing baby sealskin. But the pathogens were literally out of the bottle. Dormigen would have saved Buster Bowman, but it had not been invented yet.
3.
AL GOYAL, THE CEO OF CENTERA BIOMEDICAL GROUP, STARED at the spreadsheets arrayed on his desk. “This won’t work,” he said to his CFO, who was sitting opposite the impressively large and orderly desk. “We can’t have another quarter like this.”
Aditya “Al” Goyal was born in Mumbai, still Bombay at the time. He became Al at Harvard Business School, where he recognized that his classmates preferred their diversity in manageable doses. (At trial, his mother still referred to him as Aditya, causing some confusion.) Goyal knew his way around a balance sheet. He graduated from one of the prestigious Indian Institutes of Technology, which admit students based on the results of a single standardized test given across India. More than a half million students sit for the exam every year and fewer than ten thousand are admitted to the Institutes—making Harvard and Yale seem like community colleges by comparison.
Goyal joined McKinsey & Company, the prestigious consulting firm, in their Mumbai office. He was promoted to the New York office and then McKinsey sent him to Harvard, the business equivalent of finishing school, where he was a Baker Scholar (top 5 percent of the class). No one ever denied that Al Goyal was a very smart man, even after the trial. He was not necessarily brilliant, as that implies some creativity or exceptional skill. Goyal was most adept at running slightly faster than everyone else, jumping through whatever hoops happened to be placed in his path. He was not one to spend a lot of time questioning the direction he was being told to run, or why he was jumping through the hoops along the way.
“We might as well drop our trousers, bend over, and let Wall Street have their way with us,” Goyal told his CFO. Goyal was not a crude man, but as part of the assimilation process he had adopted common colloquial expressions and sports references, not unlike transforming himself into Al. He was determined to be as American as the Americans around
him—the professional equivalent of a chameleon changing its color.
“We can put off some capital spending,” the CFO answered. “I’ve toyed with the idea of selling one of the plants and then leasing it back. We could book the revenue now. It’s not obvious we should own the real estate anyway.” The CFO, Johannes Swensen, was a neat, thin, athletic man. He did triathlons and the occasional marathon. Swensen had spent most of his career in his native Sweden, and then elsewhere in Europe. He had come to New Jersey when Centera Biomedical Group bought out the small genetic engineering firm he had founded in Stockholm. Swensen looked particularly pale and skinny opposite Goyal, who had the dark complexion of South India and the physique of an executive who had spent more time in airports than the gym. There was more than a little irony in the fact that the two men described on the cover of The Economist as embodying “The Low Point of American Capitalism” were both born somewhere other than America. When photographed together, the two of them—big and dark, thin and pale—looked like corporate villains designed by Disney animators.
“That’s small change,” Goyal muttered. “The analysts will see right through it.”
“Small change adds up,” Swensen said. “When the number hits the wire, that’s what the market will react to. The rest of the story will dribble out later. Besides, there is logic to getting out of the real estate business. We make pharmaceutical products. We don’t need to own the land under the plants. The analysts love that kind of thing. We can tell them there is more to come, this is just the beginning, lots of future cost savings, and so on.”
“They’re going to crucify us,” Goyal said, tapping the spreadsheet distractedly. “The board will not tolerate another quarter like this.”
“Well, this is the quarter we’re going to have,” the CFO answered, losing patience with the spreadsheet equivalent of hand-wringing.
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