The Rationing

by Charles Wheelan

  Yes, Larry Rowen sought to trade his stolen Dormigen for cash (from rich men) and sexual favors (from beautiful women). “I wanted them to respect me,” he explained at his arraignment. Rowen’s advertisement in the Hollywood Reporter intimated as much: Safe, plentiful supply of Dormigen. Only the rich and beautiful need apply. Yes, he really ran that ad. And yes, FBI agents arrested him one day after it appeared. According to court documents, however, he had already sold six doses of Dormigen and at least two of the buyers were women. The identities of the buyers were kept confidential—sealed by the court. Anyone who really needed Dormigen at that point could still get it. We had not run out yet. The good news is that Rowen’s clumsy sales effort inspired law enforcement to mount a nationwide sting operation. It was not terribly difficult to pose as buyers, track the Dormigen back to its illicit source, and arrest the dirtbags like Larry Rowen who were selling it.

  As the President flew toward Canberra, I became involved in an unfortunate communications snafu. Jenna and I did not see a movie, but we did continue our walk, still trying to piece together the mysteries of the colored binders. Jenna graciously invited me back to her apartment, where we continued our conversation. It was clear to both of us that I needed sleep more than anything else. I had been awake for fifteen hours. The radio and television interviews had been exhausting. My mind was moving at three-quarters speed. I took a nap and made the unwise decision to turn off my assorted communications devices, thinking it would just be a short power nap, fifteen or twenty minutes. The timing could not have been worse; several members of Congress showed up at the NIH office and demanded a personal briefing from the Director and me. There are a hundred reasons why members of Congress should not show up in the middle of a crisis and expect answers, not least because it wastes valuable scientific time. Still, there they were, sitting in the Director’s office, expecting answers from those of us whose time would be better spent generating those answers.

  The Director tried to reach me while I was sleeping. Tie Guy filled in for me and answered the basic questions. The important thing to recognize is that nothing about this unfortunate incident affected our scientific approach to the Outbreak. No time was lost. If I had not carved out some hours to refresh myself, I would have been answering basic questions for some of the Speaker’s congressional minions. Their pride was wounded—this I understand—and I was remiss in turning off my devices. But the finding by the Outbreak Inquiry Commission that “the top NIH adviser went AWOL at the peak of the crisis” is just political hyperbole.

  In fact, I stepped out of the shower reinvigorated and with a plan for moving forward. I turned on my secure phone and saw the series of frantic messages from Tie Guy and the Director. I was still wrapped in a towel when I called Tie Guy back. “Where the hell are you?” he answered.

  “I just needed some sleep,” I said truthfully. “And I have an idea.”

  “Well, if you want to explain it to six members of Congress, they just left.”

  “That’s a waste of our time right now,” I said.

  “Not yours,” Tie Guy answered angrily, though he was already starting to simmer down.

  I shared my unorthodox thought: “Maybe we just need to expose these people to the dust mite. Have you thought about that? Right? If the pattern is—”

  “Of course I thought of that,” he interrupted. “How could I not think of that?”

  I ignored him and continued. “Capellaviridae turns virulent when people with the virus are no longer exposed to the dust mite that carries it. So maybe the dust mite is preventive somehow?”

  “Yeah, that’s one possibility,” Tie Guy agreed. “But how? And why? I sent that idea up the chain yesterday afternoon but I can’t get anyone to bite.” Tie Guy had been curt before, even rude, but this was the first time he sounded patronizing, or maybe just angry.

  “What’s the harm of trying the dust mites?” I asked.

  “That’s what I said,” Tie Guy replied, still peeved. “But think about it. If someone has the virulent form of Capellaviridae, they can still be treated successfully with Dormigen. Who would want to forgo that for some experiment with dust mites?”

  “But what’s the worst thing that could happen if we try?”

  “The worst thing that could happen is that the dust mites have no effect and people get sick enough so that Dormigen is no longer effective and then they die.” He changed his voice slightly, imitating the NIH bureaucrats with whom he had obviously discussed this: “The NIH will not do a human trial when a safe, proven alternative exists and we have no theory or evidence to suggest the alternative treatment will be effective.”

  “You asked yesterday?”

  “Yeah, right after I saw the data on who is becoming sick,” Tie Guy explained.

  “But that was before they knew about the Dormigen shortage,” I pointed out. “Everything is different now. We have a safe treatment, but it’s going to run out. What’s the harm in testing something that might work?”

  “That’s true,” Tie Guy conceded. “But we still need a theory. We have to have some explanation for what’s happening here. Why would people get sick from Capellaviridae when they are no longer around dust mites? And why would reintroducing dust mites make them healthy?”

  “If it works, we can figure out the theory later,” I said.

  “We don’t have time to do any meaningful trial,” Tie Guy declared. “Capellaviridae is not fatal most of the time anyway, so it would take a long time to figure out if the dust mites have any real impact. Besides, I think it’s a dead end. There’s a confounding variable out there that we haven’t figured out. The data are right, but we’re not hearing what they are telling us.”

  “Why can’t we just test the dust mites?” I insisted. “We need a Jonas Salk.”

  Tie Guy’s tone turned caustic. “Really? Tell me how that would work.”

  My mind worked slowly as I tried to figure out why Tie Guy sounded so dismissive. Salk was the inventor of a polio vaccine. Like other successful vaccines, it works by introducing a weakened form of the virus to the subject, whose body then creates antibodies to fend off the full-strength version of the disease. Salk offered himself and his family as test subjects. As my mind ground away slowly, Tie Guy continued, “Why don’t you give yourself the virulent form of Capellaviridae and then try the dust mite cure?”

  My mind caught up to him: We still had no understanding of when or why the virus turned virulent, so even the notion of exposing someone to the harmful form of the virus was beyond us. I couldn’t test the dust mite cure on myself because I did not know how to make myself sick with the virulent form of Capellaviridae in the first place. “I’m a little worn down,” I said.

  “The media stuff looks awful,” Tie Guy said, finally betraying some sympathy. There was a brief pause and then he asked, “Don’t you think the Chinese are going to pony up the Dormigen in the end?”

  He had never asked me about any deliberations beyond the science. At that point, I had not been privy to the discussions on Air Force One, but I had heard enough at the White House to know that the President would likely refuse any offer that required abandoning the South China Sea Agreement. I took a seminar on negotiations in graduate school, a class where we broke down in pairs and did mock exercises. One of the things I learned is that sometimes there is not a deal to be had. Fifteen different pairs of negotiators read a set of secret instructions—half of us were banana plantation owners and the other half were fishermen—and somehow we were supposed to figure out how to split limited water resources in our village. All fifteen teams returned to the classroom ninety minutes later, and not one of us had managed to come to agreement. There just wasn’t enough water. That was what we were supposed to learn from the exercise.

  Tie Guy’s question was instructive to me. He was a hardheaded analyst if there ever was one, and here he was assuming optimistically that everything would work out okay. That may be a unique American gift, this ongoing optimism. It al
l works out in the end. How else can one explain what happened at that Washington Nationals game? The President of the United States gives the middle finger to the country offering us the Dormigen that would get us through the crisis, leaving us in a situation where thousands of people might die unnecessarily. The Atlanta Braves pitcher points at the flag, causing people to get to their feet and cheer for nearly five minutes. Why? Because they believed it would work out okay.

  There are two things I do not understand about that baseball game moment, even now as I write. First, Americans despise politicians. Faith in government has been trending down for forty years. The approval rating for Congress is routinely in single digits. Even politicians can get an easy laugh by bashing politicians, or better yet “government bureaucrats.” Our funding at NIH had survived more or less intact because we did work with counterterrorism implications, but my colleagues working on dementia or diabetes or heart disease had no such luck. Their budgets were all lower than they had been back at the turn of the millennium. Who did all these folks eating hot dogs at the Nationals game think was going to bail them out? Should I go back to the NIH, where teams were working around the clock, and yell, “Hey, everybody, it’s after five! Time to go home. This is government work”? What little we did know about lurking viruses came from research mostly funded by government grants. Who else cares about a lurking virus until it’s too late? When I told people I was a government scientist—at a party or my college reunion or among my parents’ friends—they would often make a wisecrack about studying the mating habits of potbellied pigs, intimating that my work was a waste of their hard-earned tax dollars. This, by the way, was often coming from someone who was marketing dandruff shampoo or doing research for a hedge fund, as if fighting bad hair or further enriching rich people were some kind of high calling. (Yes, that is a bit of a rant, but given my role in this whole debacle, I am entitled to some venting.)

  Second, things do not always work out okay. That is just an objective historical fact. Have these people not read about the Civil War? I am no historian, but I know enough to recognize that Americans could see that crisis coming for forty years before the shooting started at Fort Sumter. There are historical examples of when politicians did things that caused needless deaths and suffering (World War I, Vietnam). There are historical examples of when politicians did not cause the problem but were unable to stop the devastation (the Spanish flu pandemic, the opioid crisis). There are examples of when politicians were heroic and successful but the social cost was still enormous (World War II). In any event, I do not understand how anyone could make even a cursory examination of American history and just assume that the Outbreak was going to turn out okay. As I stood wrapped in a towel in Jenna’s apartment, I did not believe the President and the Chinese were going to come to a deal. In some ways, the President had backed himself into a corner with his cowboy-like takeoff from Honolulu. For their part, the Chinese would lose face (and all the diplomatic prestige that came with it) if they walked away from most of the bold demands in the “Friendship Agreement.” The two parties might have reached some agreement if the negotiations had been conducted in private, but that ship had sailed. (Or, to keep the metaphor correct, that plane had flown west.) The likelihood of some scientific breakthrough was getting less likely by the hour. Tie Guy was correct: we had run out of time to do even a simple clinical trial.

  I dressed and sat down next to Jenna on the couch in her tiny sublet apartment. I had known her for a mere three hours. It was clear that there was some connection between the two of us, though I had not told her I was still living with Ellen. I could try to explain that my relationship with Ellen was already over but that would make me sound like a lecherous sixty-year-old telling some young thing that his marriage had been “dead for a long time.” The fact is that I felt much better with Jenna sitting next to me on that couch. Not coincidentally, her instincts regarding Capellaviridae were good. I appreciated having a fellow Huke acolyte to share ideas with. In the back of my mind—lurking there, if you will—I was convinced that his approach was fundamentally correct. Our best hope was to “think like the virus.” There had to be some reason for the pattern we were seeing—some reason that Capellaviridae or the dust mite benefited in the long run from making people sick. As Huke told us repeatedly, “It’s all about evolutionary advantage.” So why couldn’t I figure that out? What organism was getting what advantage from this bizarre pattern we were seeing?

  I decided to walk home, in part to clear my head. Jenna offered to walk with me. I demurred, in part to avoid having to explain: (1) to Ellen, why I had invited a coworker up to our apartment; and (2) to Jenna, why I could not invite her inside for a drink of water after she had walked twenty blocks with me.

  63.

  I WALKED ALONE, MY MIND STILL IN A FOG. BY THE TIME I reached home, the sun had gone down and my neighbors were returning from work. I said hello to the older woman who lived in the unit above us; I could never remember her name, but I did recall that she did something for United Airlines. As I exchanged small talk with her, it dawned on me that I had left the apartment that morning without my keys. I buzzed my own apartment, hoping Ellen was home, while also kind of hoping she was not.

  Ellen buzzed me up. When I got to the door of our apartment, she was standing in the doorway waiting for me. “Oh, my goodness, how are you doing?” she asked. This was the first time we had spoken since I had run out of the apartment before dawn with no explanation. Once the news of the Outbreak became public, the late nights and cryptic comments over the previous days finally made sense to her.

  “I’m okay,” I said unconvincingly.

  “What’s going to happen?”

  “I have no idea,” I said with much more conviction.

  “Did you see the news about Cecelia Dodds?” she asked.

  “Of course.”

  “I did a term paper on her in high school,” she offered.

  “You and a lot of other people,” I said.

  “It’s horrible.”

  “Yes.”

  “Do you want something to eat?” she asked.

  “I just need to think.” I turned on the television and was surprised to see that the Outbreak was not the top story on Headline News. The President was still flying westward, so there was nothing new to report there. Two things had happened that afternoon to distract attention, if only for a few hours, from Capellaviridae. First, the country music star Tigue McBride (remarkably, the name he was born with) died in a fiery car crash somewhere in West Texas. I am no country music fan, but even I knew that Tigue McBride was a known “bad boy” with a history of substance abuse and broken relationships. He ran his pickup truck into a tree with a seventeen-year-old girl (unnamed because she was a minor) in the front seat. Tigue (thirty-eight years old and married to the B-actress Rhyme Marr—not her born name) was killed on impact; the unnamed minor was in critical condition. Country music fans were scandalized and devastated; everyone else saw the irony in the fact that McBride had died in circumstances that sounded like one of his songs. The news was full of speculation about whether McBride was drunk (yes, it would turn out) and why he was driving on the back roads of Texas with a seventeen-year-old girl who was not his daughter (still not clear).

  The second story sucking up airtime was a bizarre kidnapping in Germany. An aggrieved scientist with some serious mental health issues had stormed the podium at a political rally near Munich. Before anyone knew what was happening, the guy jumped up onstage with what looked like a small syringe. There was video of all this, which explained part of the appeal of the story. The crazed scientist, who had been fired from his university post some years before, had a long white beard and frantic eyes. As the startled crowd looked on, the scientist poked the speaker, the CEO of a major agribusiness company, with the small syringe, jamming the pointed end through the man’s suit into his upper arm. The CEO looked more perplexed than pained after he had been poked in the arm. There was no shooting or gore.
Local police stormed on the stage and the wild professor left willingly with them.

  That, however, was when the story took a turn for the bizarre, as all the news channels were reporting. Once in custody, the scientist explained that he had injected the CEO with a slow-acting toxin of some sort for which only he would be able to provide the antidote. The mad scientist reportedly sat calmly in the police station, explaining to officers that if they wanted the CEO to live, they would have to honor his demands. The former professor had been in the chemistry department at a university in Berlin; there was no doubt that he had the expertise to concoct some fatal formula. Experts had no idea what it might be, however. The scientist intimated that he had used some combination of snake venoms. The CEO was rushed to a hospital, where he developed nausea and a mild fever. Needless to say, he was frantically urging authorities to do whatever it would take to procure the antidote.

  The scientist, sitting in the police station, made what he said would be the first of several demands: He wanted an ice-cream cone—a strawberry ice-cream cone, to be more precise. And he wanted to walk freely with police officers to get it. He did not want them to bring his ice-cream cone to the station, and he did not want to walk to the ice-cream parlor in handcuffs. This demand set off a wave of protest and debate in the law enforcement community, not just in Germany but around the world. Germany had a strict policy against publicly negotiating with terrorists; the mad professor’s act had been declared terrorism, mostly for the lack of a more appropriate description of his bizarre behavior. Would it violate Germany’s policy to give the guy his strawberry ice cream? German police officers argued that giving their suspect ice cream was not radically different than giving a suspect a cup of coffee or a cigarette to encourage cooperation.

  Right-wing pundits everywhere argued that acceding to the ice-cream demand would encourage the “terrorist” to make more outrageous demands. This prompted the FBI Director’s now-famous retort, “If we give him an ice-cream cone now, we can always say no if he asks for the release of one hundred Hamas prisoners in the future.” There was a robust debate in the media over whether torture would be appropriate in this kind of situation—the poison equivalent of the “ticking bomb” that U.S. presidential candidates are always asked about—but Germany forbade torture under any circumstances, so as a practical matter this was a nonstarter. Meanwhile, the CEO, growing more ill by the minute, was apoplectic that he might expire for lack of a strawberry ice-cream cone.