by Nancy Kress
“You know it,” Seton said, and winked.
“You must fill me in on all of it soon. In case one of your dangerous suspects tries a hit and I have to finish the investigation.”
Seton laughed. He was impervious to sarcasm. “Have a good meeting, Bob.”
“Robert,” Cavanaugh said automatically, yet again. But Seton had gone back to his computer. Cavanaugh glimpsed graphics of an alien spaceship. Soundlessly it blew up. He left for Baltimore.
Staff meetings were always mixed occasions. Just driving north filled Cavanaugh with intense longing for multilevel cloverleafs, interconnected malls, and Chinese restaurants. The row houses of Baltimore ignited nostalgia. But none of that began to approach the envy of sitting in the meeting itself.
Special Agent in Charge Jerry Dunbar, who supervised over two hundred investigators in Maryland and Delaware, tossed a cigarette-pack-sized object in the middle of the table. Wires dangled from its featureless metal surface. “This thing is our single worst nightmare. And we’ve made no progress at all on it.”
Twenty-four agents stared at the gizmo, which all of them recognized. It was legitimately marketed by mail-order electronics houses. It cost about $1,200. Cabled to a cellular telephone, it allowed criminals to change their cell phone number every three or four minutes with just a few key strokes. It was making wiretaps completely ineffectual.
“If it weren’t for that I’d have had a warrantable transcript on Carlo DiBenedetto,” said Alex Vallone, from the Wilmington Office.
“You know what the wiseguys are calling it? ‘The magic box,’” said Marie Mooney, from Hyattsville, outside D.C.
“Even the army noncoms have them,” said John Stoneham. “I was this close to a warrantable transcript on that weapons-stealing ring at Aberdeen Proving Ground.” He held up his thumb and forefinger a quarter inch apart. “This close.”
“Headquarters says they’re working on it,” Dunbar said. Sounds of derision around the table. Dunbar stiffened; he didn’t have much of a sense of humor.
Cavanaugh reached for his notebook and sketched the telephone device. He gave it horns and a sarcastic leer.
“Robert,” Marie said kindly, “have you run into any trouble with these magic boxes from your hate groups?”
“No,” Cavanaugh said, trying to keep the envy out of his voice. He hadn’t even “run into” any of the hate groups themselves, although southern Maryland was lush with them: home-grown militia, white supremacists, neo-Nazis, religious warriors. In the deep forests and trailer-park dirt roads and tidal swamps, they flourished like kudzu in Georgia. Thanks to Headquarters data, Cavanaugh knew who the hate groups were, and where they were. But lately they had all been quiet or inactive or—for all the opportunity they gave him to do anything—completely dead.
He labeled his drawing “THE MAGIC MOCKS.”
The conversation moved on: a terrorist investigation in Dover. A kidnapping in Baltimore. RICO statutes, task forces, warrants, informants, subpoenas. Cavanaugh said nothing. He sketched a cat, tightly imprisoned inside a perfect circle, squashed and motionless. Then a second one.
Surveillance, bomb teams, advanced training at Quantico.
A few more lines, and the cats inside circles became the wheels of a police car.
Sabotage, money laundering, bank fraud, problems in coordination with local law enforcement.
This drawing he labeled “UNSTOLEN HUBCATS.”
“Well, I think that pretty much wraps it up,” Agent Dunbar said. “Anybody need help with anything else? Robert?”
This week I have a housing discrimination in a senior citizen complex and an Adopt-a-School talk to the eighth grade. Want to help? “No,” Cavanaugh said. “I’m fine.”
He couldn’t get out of Baltimore fast enough, and he hated it that he had to leave.
On the way back to Leonardtown, Cavanaugh stopped at Dellridge Community Hospital in La Plata to talk to its director, who turned out to be a woman in her fifties, trim and cool except for her accent, which promised a lush magnolia-scented warmth that her manner did not deliver.
“I have to say that I still don’t understand why you’re here, Agent Cavanaugh,” Dr. Lawrence said, after he had explained for ten minutes why he was there. “Are you asking”—Ah yew-ah ay-askin’—“whether or not these deaths by stroke on the dates in question actually occurred? I can, of course, verify that for you.” Vuh-ah-fy.
“Not exactly,” Cavanaugh said. “I’m asking more whether such strokes—such a number of cerebral strokes all in a clump—are normal.”
She squinted at him across her desk. “Strokes are completely natural, Agent Cavanaugh, in that the body has a million different ways to malfunction.”
“Yes, I know, Doctor. But the unusually high incidence of strokes here at Dellridge last weekend—is that medically notable?”
“Agent Cavanaugh, are you investigating a possible mishandling of medical emergencies at Dellridge? If you are, please tell me outright.” Out-raht.
“I’m not investigating anything at this point,” Cavanaugh said, and saw in her eyes the question, Then why are you here? “I’m merely following up on an anomaly. Any insight into the anomaly that you can give me would be very helpful.”
“And this anomaly is racial in nature. That’s what you mean, isn’t it? Let me just put a few facts on the table, if I may. The population of Maryland is twenty-five percent African American, far above the national average. African Americans, for some reasons we understand and some we don’t, are twice as likely as whites to suffer a stroke. For African Americans between thirty-five and fifty-five, the rate is four times higher than for middle-aged whites. National studies show that when blacks do suffer strokes, brain damage in survivors is more extensive than in other racial groups. No one knows why. And let me just add that Dellridge Hospital has an unparalleled commitment to providing quality care to all our patients. And the unblemished record to back that up. Is that the sort of insight you’re looking for, Agent Cavanaugh?”
Cavanaugh said neutrally, “It’s very helpful, yes.”
“I’m so glad.” Dr. Lawrence stood. “If there’s anything else I can do to assist you …”
“No, I don’t think so. You’ve been very helpful.” Clearly expected to stand and leave, he did.
He could feel her eyes on his back all the way down the hospital corridor, through the lobby, and out the door, where the unseasonable heat hit him like a damp shroud.
“Here’s the lab report you asked for,” the young doctor said, laying a sheaf of papers on the desk of the chief of medicine, “on Senator Reading.”
Dr. Goldstein skimmed the report. He was a slight, handsome man in his sixties, with a full head of curls the same gunmetal gray as his eyes. As he read, the gray eyes narrowed. “There’s some mistake.”
“I don’t think so, sir. I had the test done twice. Both reports are there.”
“Had the senator been traveling overseas? Or even in the Caribbean?”
“Not according to his wife. He’s been too busy precampaigning.”
Goldstein got up and walked to the window. The view from the third floor was discouraging. Like most New York hospitals, parking was a problem second only to sanitation. Cars jammed the inadequate parking lot, many of them skewed at clearly illegal angles in clearly illegal spaces, blocking Dumpsters and delivery bays and other cars. Among the illegals was a sound truck with CHANNEL SIX NEWS on the side. Goldstein scowled and turned back from the window.
“Rafe, I can’t give this out at the press conference. Not unless we’re absolutely sure.”
The young doctor didn’t answer. He had peered through the scanning tunneling microscope himself; he was already sure. He said, “I’m afraid there’s something else, sir.”
“Something else besides the fact that a United States senator and strong presidential candidate died of a thrombus, but tests show that he also had the beginning stages of malaria when there hasn’t been any malaria in the United S
tates since the end of World War II?”
“Yes, sir. The last page of the report.”
Still standing, Goldstein shuffled to the last page, past the tests confirming malaria: decreased hemoglobin, hemocrit, platelet count, and haptoglobin. Increased levels of lactic dehydrogenase and reticulocytes. Not to mention the Plasmodium falciparum parasites viewed under the X-ray microscope. The chief of medicine read the last page once, twice. “No,” he said. “Flat out impossible.”
The younger doctor said nothing.
Slowly Goldstein shuffled through the pages of lab reports, looking for a way to make sense of the results. He didn’t find it.
“Sir, I looked through the microscope myself. The merozoites—”
But Goldstein wasn’t in the mood for eyewitness news. He made a sudden decision.
“Rafe, don’t mention this to anyone, including the senator’s family. Not just yet. And I’m going to leave the malaria out of that damned press conference, too. Meanwhile, package up samples of the senator’s blood and copies of all the lab tests, and send them to the CDC in Atlanta, and to the Infectious and Tropical Disease Unit at Walter Reed. Call both places and explain the problem. They’re set up for this kind of weirdness. We’re not.”
“Yes, sir,” Rafe said. His eyes met Goldstein’s. The two gazes, one gunmetal gray and one bright blue, held briefly. Then both looked away.
Each was intensely conscious of what had not been said aloud. David Goldstein was Jewish; Rafe DuFort was French. Both considered themselves fair-minded men, without prejudice, and politically astute.
“The CDC,” Goldstein repeated, “is set up for this. That’s what they’re there for.”
He went off to make his statement to the press on the causes of Senator Malcolm Peter Reading’s death.
The package from the New York hospital arrived at the Centers for Disease Control main receiving dock by overnight Federal Express. It was labeled in red magic marker: DANGEROUS. INFECTIOUS SUBSTANCES. DANGEROUS TO HUMANS. The men working at the dock paid no attention. They saw dozens of such packages every week.
The box was routed to Dr. Melanie Anderson, malaria epidemiologist in the Special Pathogens Branch. She read the accompanying letter, studied the lab reports, and removed the tubes containing blood samples from their packing of dry ice, staring incredulously.
Somebody somewhere had fucked up big time. What the letter and reports said just wasn’t in the annals of medicine.
Not that Melanie Anderson had any great respect for the annals of medicine. She had graduated third in her class from Yale School of Medicine, had returned to her native Mississippi full of crusading zeal to treat poor up-country folk in areas without a decent doctor, had set up shop in a dirt-poor community—and had then discovered that she hated being a doctor.
She hated it almost as much as she’d always hated her name. What kind of self-respecting black woman, she’d railed at her hapless mother when Melanie had been sixteen, named a black girl after a Gone With the Wind magnolias-and-Confederacy belle? Where was her mother’s pride, her righteous anger? Patty Anderson, intimidated into helplessness by this verbal and alien daughter, had only shrugged helplessly. She lacked the courage to say that she’d actually told the birth-certificate recorder “Melody,” as in “A Pretty Girl Is Like …” The white woman had apparently misheard Patty’s soft, blurred, childbirth-woozy accent, and the birth certificate came back “Melanie.” Patty had settled. Probably Melanie would have thought “A Pretty Girl Is Like a Melody” an even worse insult. It seemed that almost everything Patty said lately somehow was.
At med school Melanie had called herself “Mel.” She’d kept to the small number of blacks in her class. It was like that in the midseventies. She’d joined the Black Panthers and worn her hair in an Afro that, since she was light and her hair waved softly, was a pain in the ass to maintain.
Melanie reverted to her full name in her first practice, but within six months she didn’t care what she was called as long as she could be called it someplace else. She was bored with treating the same old things over and over, easy nonchallenging things: colicky babies and elderly influenza and summertime rashes. She found—appalled at herself—that she was growing resentful of the obese hypertensives who refused to lose weight, the smokers’ coughs who refused to quit smoking, the incipient cirrhoses who refused to give up the bottle. Out of boredom and frustration, she was coming to almost hate the people, her people, that she’d trained herself to help.
Before it reached that point, Melanie Anderson quit private practice and joined the CDC’s Epidemic Intelligence Service. If medicine was going to inspire her with hatred, let it be hatred for microbes and not people.
She turned out to have an enormous talent for disease identification and control. Her required field training took place in Africa, during a swine flu outbreak in Senegal. There she discovered that she also had a talent for languages. The natives trusted her, this African American who took the trouble to learn their dialects, and Melanie contributed to the Senegal team a set of outstanding epidemic curves, those all-important graphs that identify the growth and source of an outbreak. She was also a pretty fair lab epidemiologist, at least for anything larger than DNA itself.
Over the next five years, Melanie returned to Africa six times, five of them for malaria. In central Africa, malaria was still the single greatest killer. In some areas, during the most serious outbreaks of the most virulent strain, 40 percent of toddlers died. Melanie was sometimes heartsick by what she saw, but she was always challenged, always useful, never bored. She was happy. The men she dated on two continents, attracted to her silk-and-sass good looks and focused intelligence, eventually learned that she enjoyed their company, but no more. They would always come in second to a good outbreak of Plasmodium falciparum.
Now Melanie reread the New York reports, rolled her eyes in private disbelief, and prepared to thaw the blood samples for a battery of tests.
Four hours later, she stood dazed in the middle of her lab. No. No. It simply was not possible. She had made a mistake somewhere.
But she knew she hadn’t.
With most Special Pathogens Branch operations, the first, lengthy step was to isolate the unknown pathogen. That meant days—or weeks—of experimenting to find the right medium to grow samples in, the right techniques to manipulate cultures, the right tests and reagents and stains and optimum temperatures and a dozen other factors. This time, none of that applied. The New York lab had known what they were sending her. It just wasn’t supposed to exist.
She picked up an in-house phone and called her supervisor, Jim Farlow, head of the Special Pathogens Branch.
“Holy Mother of God,” Farlow said. “You’re sure, Melanie?”
“I’m sure,” she said grimly.
“All right, go over it once more. I just want to hear it again.”
“The stroke victim, Senator Malcolm Peter Reading, was in the first stages of malaria. Electrophoresis confirms that he was also positive for sickle-cell trait. And that malaria merozoites were in the Hb S blood cells.”
“That isn’t possible,” Farlow said.
“I know it isn’t possible! Do you think I don’t know it isn’t possible?” Melanie cried. She heard her own anger, but for the moment, at least, she couldn’t help herself.
Sickle-cell trait, an inherited blood abnormality, protected against malaria. That had been known for decades. Plasmodium, the one-celled parasite that caused malaria, couldn’t flourish inside red blood cells with the abnormal form of hemoglobin called Hb S. Those blood cells tended to sickle—that is, to curve into rigid sickle shapes—when they deoxygenated. Plasmodium found this uncongenial.
A person with sickle-cell trait had his own problems, of course, but they were not very serious. Unlike fullblown sickle-cell anemia, which caused frequent pain and sometimes death, the person born with sickle-cell trait carried only one gene for Hb S, not two. This meant that some of his red blood cells would sickle, b
ut most would not. Usually this meant that if he was careful not to exercise way past his limit or to take long flights in underpressurized airplanes, he might not realize he even had a genetic deficiency. The sickle-cell-trait carrier was slightly more susceptible to blood clots, because the red blood cells that did sickle grew sticky and tended to “sludge,” clogging small capillaries. This was a constant danger for those with two genes for Hb S, but a fairly minor danger for carriers of only one gene.
In exchange, the sickle-trait carrier was protected against severe malaria, although he might get a mild case of it at first infection—if there was malaria to get, which in the United States, for over fifty years, there had not been. The last of it had been wiped out by the end of World War II. In fact, the CDC had been founded in 1942 as the MCWA: Malarial Control in War Areas.
But now the CDC was looking at evidence that not only said that Senator Malcolm Peter Reading had died of a sickle-cell-crisis thrombosis, but also that the very red blood cells forming the fatal clot had been colonized by P. falciparum merozoites, cells with Hb S. Which was flat-out impossible.
Melanie willed herself to calm. “Look for yourself, Jim. There’s no mistake. The parasites are inside the sickled cells.” She pushed him toward the microscope.
Farlow looked. Melanie visualized what he saw: the unmistakable forms of P. falciparum like tiny signet rings, stained now to a small ruby nucleus embedded in a wispy blue circlet, inside long, banana-shaped, clearly sickled cells.
Farlow gazed a long time, turned away, and rubbed his jaw with the side of his palm. He and Melanie looked at each other.
“Senator Malcolm Peter Reading,” Farlow said.
She said clearly, “A black man.” And waited to see what he’d say next.
Nearly all carriers of sickle-cell trait were black. The disease’s genetic trade-off, hemoglobin S in exchange for protection against malaria, had evolved in Africa. Sickle-cell trait had come to the United States with the slave trade. At present, one in twelve African Americans carried the trait. Almost three million people.
