“I work mostly with mice,” Sara said. “We work mostly with mice.”
“You mean in the labs?”
“Uh-huh. The knockout or the knock-in mice. We knock out a certain gene or add a certain gene to test diseases. My work is in arenaviruses and hantaviruses. Another team studies mouse feces. It’s a bit like the Columbia University research you mentioned: see what diseases are out there.”
“You all lead such glamorous lives,” Alexis told her.
“Saving the world, one piece of mouse poop at a time.”
“And other people work specifically with rats?”
“Sure. A couple have teams. Mice. Rats. Poop. It’s all toward the same end.”
“Which is?”
“Understanding what’s in the basements of our buildings that someday is going to kill us.”
“That’s a cheery thought.”
“I’m kidding. Mostly. The goal is to develop therapeutic agents or, better still, antibiotics and vaccines.”
“Do we even have hantavirus in New York City?” Alexis asked. “I mean, I’ve never seen it in the ER. I never saw it in Houston when I was there.”
“Not in the city. But we will. We’re up to thirty-plus states. Thirty-four or thirty-five, I think, including two cases I’m aware of on Long Island. We have plenty of deer mice here in the city and deer mice are easily infected. But so far it isn’t among the shit I’ve found in their shit.” Sara wiped her lips with a paper napkin and then went on, “Even at the best addresses in Manhattan, the little critters carry all sorts of disease-causing bacteria and viruses. My boss, Dr. Myung, lives in a pretty swank building on Park Avenue—he had us all over last year for a holiday party—and he says his apartment basement has its share of rats. And, you can bet, they have salmonella, E. coli, shigella. You know, the usual suspects.”
“And the others?”
“The other pathogens? It’s a long list, especially the new species. But each could, conceivably, be transmitted to humans.”
“And they’re drug resistant?”
“Some are. Totally untreatable by the stuff you have in your medicine cabinets in the ER. Cipro. Amoxicillin. They laugh at them.”
“The bugs do.”
“Yup. The bugs.”
“And the mice and the rats aren’t sick?”
She giggled and it was almost girlish. “The ones in your apartment building, Dr. Myung’s, or the labs?”
“I was thinking of the apartments.”
“Happy as can be. They’re carriers of the bacteria or the viruses, that’s all.”
Alexis thought about this. “How would the bacteria develop a resistance to antibiotics?”
“In the wilds of your apartment basement? Unclear. Could be natural selection. Could be from munching our food or our shit.”
“That’s gross.”
Sara nodded vigorously in agreement.
“And the endgame of your work is treatment,” Alexis said, echoing what the researcher had explained a moment ago.
“Got to be ready for the next pandemic. Got to have new antibiotics. Got to know what we’re up against. I mean, it’s coming, and New York City is the perfect place for a catastrophe: we have lots of people living in very close quarters. We have lots—and by lots, I mean millions—of rodents. We have people coming and going and visiting all the time. We have the subways. In 2015, a guy from Weill Cornell swabbed the subways and found anthrax and the bubonic plague. How’s that for disgusting? Trust me, the plague could make hantavirus look like a nosebleed.”
“I would say terrifying, not disgusting.”
“I stand corrected.” She looked down at her unopened yogurt and the plastic spoon on top of the container. “I’m not going to eat this,” she said. “I hadn’t eaten since last night and I was starving when I went to the counter. I was only going to eat half the bagel, but, well, I seem to have scarfed down all of it. You want my yogurt?”
“Sure. Thank you. I was going to have a banana and an energy gel before going to the gym. I didn’t bother with breakfast.”
“I love it when doctors eat right,” Sara told her, and Alexis smiled. The yogurt was blueberry flavored—her favorite—and she opened the container and started to eat it ravenously.
“My world has been sort of upside down since Austin died,” she said. “I probably haven’t been taking the best care of myself.”
“I get it,” the other woman agreed.
“So, tell me: what is the next pandemic?”
“It depends on what the bug is. I mentioned the plague a minute ago. Do you know you can still get the plague? We can still get the plague. It’s on the Russian steppes, it’s in Madagascar. I told you it was found in the subways.”
“Such a cheery thought.”
“Rats are supremely capable of adapting. They have a rapid reproductive rate. And so lots of things can cause mutations in them—and it doesn’t take any time at all. You have literally hundreds of generations of rats in half a century,” Sara said, and she finished the last of her coffee.
“Hundreds of generations,” Alexis repeated. “I came across a study from a university in Ho Chi Minh City that talked about that. It seems the ones we didn’t kill with napalm and herbicides in the Vietnam War are now, well, über-rats.”
“Oh, the ones we have here in New York could probably hold their own against them. And they haven’t even had to endure Agent Orange. Why in the world were you reading about Vietnamese rats?”
“I wasn’t. I think Austin was.”
“Wow. Some people Google where to find the best spring rolls or pho before going there. And your ex was looking up rats? That’s disturbing.”
“It is. That’s why I wanted to see you,” she said. “If you were to guess—and I know it’s just a guess—why do you think Austin was researching the animal? Why might he have been investigating the Vietnamese rat?” Alexis asked her.
“First of all, I’m sorry: I’m really sorry your boyfriend died. It’s just so freaking horrible.”
Alexis grimaced involuntarily, but nodded. “Thank you.”
“I never met him: Austin. I never heard of him until I heard that a hospital employee had died in a bike accident in Vietnam,” she said. “I know development and advancement are in the same wing as the labs, but no one goes into the labs without clearance. It’s why we’re meeting in the cafeteria. The labs are, well, labs. We have protocols. Parts are BSL-three, which is pretty secure. I mean, we’re not even on the same floor as the administrative offices.”
“Who might he have been seeing?”
“In the labs?”
“That’s right.”
She shook her head. “If he was researching rats? Let’s see, there are probably thirty or so of us up there. But it wasn’t me. And I really don’t see why he would have been researching rats. Rats aren’t big philanthropists. They don’t run family trusts or foundations. They aren’t grateful patients who want to buy the hospital new toys. New MRI machines or robotic arms or optical scanners.”
“But who? You said there were people who are studying rats.”
“Well, there would be Dr. Bhattacharya. Dr. Sinclair. And, of course, my boss, Dr. Myung, does a little bit with rats—but not as much as those two. That’s off the top of my head.”
“I’ve seen their names on the hospital’s research pages on our website. I’ll call them.”
“Let me ask around first. Discreetly.”
“That would be wonderful, thank you.”
“The likely candidates are Dr. Sinclair and Dr. Bhattacharya, if Austin really was meeting someone there. They do way more with rats than my boss. I’ll try to see them in the next couple of days. I’ll get back to you, okay? Maybe one of them could show you around or maybe, with their permission, I could show you around.”
&n
bsp; “That would be amazing.”
“Not a big deal. You work here. You might not be allowed into the BSL-three sections, but we can easily get you into the BSL-twos.”
“That would be so helpful.”
A short fellow with receding ginger hair sidled up to the table beside them. “Morning,” he said to Sara.
“Hey, Michael.” She motioned toward Alexis and said, “This is my lab partner, Michael Fodder. A little of what he does, when he’s not with me, overlaps with Dr. Sinclair’s research. Michael, this is Alexis Remnick. She’s an ER doctor here.”
“Nice to meet you,” he said, nodding affably. He had a cup of coffee in his hand.
“Want to join us?” Sara asked him. She took off her eyeglasses and cleaned them on a paper napkin.
“No, I just grabbed an egg sandwich and now I’m heading back to the lab. But thank you.”
“So, you work with Dr. Sinclair?” Alexis asked him before he could leave.
“Not a whole lot, actually.”
“But some?”
“Some,” he said. And then he volunteered, “He’s a nice guy. For a dude who spends most of his workday killing rats, he’s pretty damn sane. But, hey: I guess it’s what we all do.” He steepled his eyebrows, smiled sardonically, and left.
* * *
. . .
She hadn’t had much of an appetite since Vietnam, and she wondered if this was grief or sadness or anger—or something else entirely. She was lifting weights today, and so between sets on the bench she would gaze at pictures of Austin on her phone. She studied his face and thought of a quote from Walt Whitman she’d always loved: “What is that you express in your eyes? It seems to me more than all the print I have read in my life.” Those green eyes, the unmistakable glint of…
Of what? She would have said wonder or boyishness or exuberance.
But now? Was it irresponsibility? Deceit? Devilishness?
To sleep with a man and know him so little…
Was it her failing or his?
The banana and the yogurt and then the cup of coffee she had grabbed on the way to the gym had fortified her, and so the Psych gels still sat in the bottom of her gym bag as she recalled the single thing she had loved best about Austin: he was fun. He wasn’t one of those high-performance athletes who was all work and no play. Somehow, he could ride fifty or sixty miles on a Saturday and still have the energy to take her to a great dinner and be adoring and enthusiastic afterwards when they would retreat to his apartment or hers. Good Lord, they’d met after he’d been playing darts—darts!—with a stranger in a bar.
She wasn’t sure how to reconcile the lies he had told her with the man who, on the last day of his life, had either been tortured or gotten into some sort of fight. But she wanted to. No: she needed to. This was more than a semantic difference.
And maybe it was the synaptic connection of fight and fun, the alliteration, but she picked her phone up off the towel on the floor and studied the image of the wound on his hand. The roundness of the prick and the way the bruise radiated in perfect circles. She magnified it with her forefinger and thumb. She had thought the weapon had been a screwdriver or an awl. But now? Now she thought dart. Was it possible that someone had slammed a dart into the back of his hand?
Of course it was. She saw it happening all too clearly in her mind. Someone had used a dart to break the bones there.
And she was positive now that all of it—the trip, the disappearance, the torture, the murder—had something to do with rats.
She thought of what she and Sara Edens had discussed, how rats mutated rapidly.
She put down her phone and lay back on the bench. Then she pressed one hundred and fifteen pounds eight times. She could go higher, but she was working without a spotter today and decided that this was where she should max out. When the bar was racked, once more she sat up. What would she do if someone showed up in the ER with swollen lymph nodes, and when she took a fluid sample, she found present there Yersinia pestis—the plague? She’d admit the patient, and the person would be given cipro or gentamicin or some other hard-core antibiotic. The hospital would quarantine the individual and get her travel history: where had the patient been and with whom had she been in contact? And the patient would likely recover.
But what if, as Sara had speculated, the pathogen was resistant to antibiotics? What if the rats didn’t die of the disease and acted merely—merely!—as carriers?
And that, she began to suspect, was where the Vietnamese rat came in. Fifty years and hundreds of generations of rats ago, the Americans had been entrenched in Vietnam, trying to bomb or napalm parts of the country into the stone age and defoliating the rest with chemicals. She didn’t know what her ex-boyfriend was up to or where he had been in the hours that were unaccounted for earlier that month, but she was going to have to tell Ken Sarafian her theory. She did another set on the bench and then sat up and called the private investigator. She got his voice mail and left a message to please call her back: she had a couple of ideas she wanted to share.
It might not be the plague—it probably wasn’t the plague, she told herself—but Austin’s disappearance had something to do with the confluence of Vietnamese rats and disease. Austin Harper, fun as he was, had been into shit so nasty that someone was willing to smash a dart into the back of his hand—and then kill him.
They tell me that it’s actually easier to manipulate the eggs of a mouse than a rat, even though rats are bigger. The basements of most teaching and university hospitals are filled with genetically modified mice.
But an egg is an egg is an egg. Now we can manipulate the eggs of rats, too. We can manipulate the eggs of most rodents. Most mammals. Most animals. We take modified stem cells and inject them into an embryo to “knock out” a gene—hence the term knockout mice. Or we introduce a gene by “knock in.” This way we learn about the links between a particular gene and a particular disease. We create animals with specific pathologies, study them, and assess the roles of the genes in the creatures.
We were supposed to be developing new antibiotics. It was all very well intentioned. Yes, we also knew the results would be lucrative. The pharma companies were right next door.
But we heard about what they were doing in Ho Chi Minh City, the way they were working with Vietnamese rats. The descendants of the ones that had survived Agent Orange. The idea began there. Evolution is related to pressure, and the herbicides had exerted fantastic pressure on the species. They had evolved. They were heartier creatures and seemed to survive some diseases longer than other rats.
Even the plague.
And so we were injecting their plague-resistant gene into the rats who ruled the subways here in New York City. Then we would give them the mutated version of the plague—the one that did not respond to antibiotics. Imagine a rat that could carry the pathogen—that wasn’t sickened by it or felled by it? You think antibiotics are profitable? Trust me, biologic weapons are infinitely more bankable. They are, after all, rare. Most civilized nations agreed years ago not to create or store or deploy them.
But not all. If we found the right buyer for a weaponized strain of plague—one that didn’t kill its carriers—the sky was the limit.
The missing link wasn’t biologic or chemical. It was actually sales. We needed a middleman. A broker. We needed someone who could sell anything.
26
The lab tech was gone, his death fast and horrid. Xuan hadn’t lasted even through the night, the buboes swelling beneath his arms and on his neck with astonishing speed. It seemed likely a strain of plague, but heartier and accelerated. Usually the disease incubated for days. This one? Hours. And it went to the lungs fast. The young guy was sick within hours and then dead within hours. Literally, hours. He hadn’t lasted twenty of them. He had evidenced many of the signs of pneumonic plague: a cough thick with blood, a fever that spiked, vo
miting. And then respiratory failure and shock and death. He also had lesions on his arms and his legs and in his mouth, and the ones in his mouth bled so copiously that before he succumbed to the disease, twice he had almost choked on the fluid. One physician suggested this was a symptom of a particular autoimmune disorder that was very rare—perhaps not the plague at all. He had been treated with massive doses of antibiotics upon arrival at the hospital, but they had done nothing, nothing at all. The pathogen was oblivious to them.
Xuan was leaving behind a young wife and an infant son. And Quang suspected—because the captain had known Xuan so well—that the man had died blaming himself for leaving the woman he loved a widow and the son he loved fatherless. He hadn’t been wearing a hood, an uncharacteristic bit of sloppiness, and that was probably why he was dead. Certainly, it was a factor.
They’d scheduled the autopsy, but given the protocols necessary to protect against transmission of the pathogen, the morgue had to be prepared. The coroner, Minh Tran, reached Quang just before lunch. He had also autopsied Austin Harper, and admitted now that he wasn’t looking forward to this one. What unnerved him, he said, was not that they might be dealing with a plague strain, but that the bacteria hadn’t responded to antibiotics.
“Xuan went straight to the hospital and they started treatment right away,” Minh told him over the phone. “Antibiotics are supposed to kick the plague’s ass.”
“Supposed to?” Quang asked.
“Well, it’s not like we—as in planet Earth—see the plague all that often. But, yes, supposed to.”
“Tell me something.”
“Sure.”
“Was the plague spread entirely by fleas in Europe, or could humans give it to humans?”
“First of all, stop with the past tense. I said we don’t see it often. I didn’t say it was ever eradicated.”
“Okay.”
The Red Lotus Page 25