Outbreak

by Robin Cook

  Tad shrugged. Then he motioned for her to follow him. He waddled over to the side of the room and pointed out an appliance next to one of the tissue-culture incubators. He wasn’t pointing at the insulated door.

  “In there?” questioned Marissa with surprise and disappointment. She’d expected a more appropriate container, one that would be safely locked away behind a bolted door.

  “It looks just like my parents’ freezer.”

  “It is,” said Tad. “We just modified it to take liquid-nitrogen coolant.” He pointed to the intake and exhaust hoses. “We keep the temperature at minus seventy degrees centigrade.”

  Around the freezer and through the handle was a link chain secured by a combination lock. Tad lifted the lock and twirled the dial. “Whoever set this had a sense of humor. The magic sequence is 6-6-6.”

  “It doesn’t seem very secure,” said Marissa.

  Tad shrugged. “Who’s going to go in here, the cleaning lady?”

  “I’m serious,” said Marissa.

  “No one can get in the lab without an access card,” said Tad, opening the lock and pulling off the chain.

  Big deal, thought Marissa.

  Tad lifted the top of the freezer, and Marissa peered within, half expecting something to jump out at her. What she saw through a frozen mist were thousands upon thousands of tiny plastic-capped vials in metal trays.

  With his plastic-covered hand, Tad wiped the frost off the inside of the freezer’s lid, revealing a chart locating the various viruses. He found the tray number for Ebola, then rummaged in the freezer like a shopper looking for frozen fish.

  “Here’s your Ebola,” he said, selecting a vial and pretending to toss it at Marissa.

  In a panic, she threw her hands out to catch the vial. She heard Tad’s laughter, which sounded hollow and distant coming from within his suit. Marissa felt a stab of irritation. This was hardly the place for such antics.

  Holding the vial at arm’s length, Tad told Marissa to take it, but she shook her head no. An irrational fear gripped her.

  “Doesn’t look like much,” he said, pointing at the bit of frozen material, “but there’s about a billion viruses in there.”

  “Well, now that I’ve seen it, I guess you may as well put it away.” She didn’t talk as he replaced the vial in the metal tray, closed the freezer and redid the bicycle lock. Marissa then glanced around the lab. It was an alien environment, but the individual pieces of equipment seemed relatively commonplace.

  “Is there anything here that’s not in any regular lab?”

  “Regular labs don’t have air locks and a negative pressure system,” he said.

  “No, I meant actual scientific equipment.”

  Tad looked around the room. His eyes rested on the protective hoods over the workbenches in the center island. “Those are unique,” he said, pointing. “They’re called type 3 HEPA filter systems. Is that what you mean?”

  “Are they only used for maximum containment labs?” asked Marissa.

  “Absolutely. They have to be custom constructed.”

  Marissa walked over to the hood in place over Tad’s setup. It was like a giant exhaust fan over a stove. “Who makes them?” she asked.

  “You can look,” said Tad, touching a metal label affixed to the side. It said: Lab Engineering, South Bend, Indiana. Marissa wondered if anyone had ordered similar hoods lately. She knew the idea in the back of her mind was crazy, but ever since she’d decided that the Phoenix episode had been related to the custard, she hadn’t been able to stop wondering if any of the outbreaks had been deliberately caused. Or, if not, whether any physician had been doing some research which had gotten out of control.

  “Hey, I thought you were interested in my work,” said Tad suddenly.

  “I am,” insisted Marissa. “I’m just a little overwhelmed by this place.”

  After a hesitation for Tad to remember where he was in his lecture, he recommenced. Marissa’s mind wandered. She made a mental note to write to Lab Engineering.

  “So what do you think?” asked Tad when he finally finished.

  “I’m impressed,” said Marissa, “ . . . and very thirsty. Now let’s go get those drinks.”

  On the way out, Tad took her into his tiny office and showed her how closely all his final results matched each other, suggesting that all the outbreaks were really one and the same.

  “Have you compared the American strain with the African ones?” she asked him.

  “Not yet,” admitted Tad.

  “Do you have the same kind of charts or maps for them?”

  “Sure do,” said Tad. He stepped over to his file cabinet and pulled out the lower drawer. It was so full that he had trouble extracting several manila folders. “Here’s the one for Sudan and here’s Zaire.” He stacked them on the desk and sat back down.

  Marissa opened the first folder. The maps looked similar to her, but Tad pointed out significant differences in almost all of the six Ebola proteins. Then Marissa opened the second folder. Tad leaned forward and picked up one of the Zaire maps and placed it next to the ones he’d just completed.

  “I don’t believe this.” He grabbed several other maps and placed them in a row on his desk.

  “What?” asked Marissa.

  “I’m going to have to run all these through a spectrophotometer tomorrow just to be sure.”

  “Sure of what?”

  “There’s almost complete structural homology here,” said Tad.

  “Please,” said Marissa. “Speak English! What are you saying?”

  “The Zaire ’76 strain is exactly the same as the strain from your three outbreaks.”

  Marissa and Tad stared at one another for a few moments. Finally Marissa spoke. “That means there’s been just one outbreak from Zaire 1976 through Phoenix 1987.”

  “That’s impossible,” said Tad, looking back at the maps.

  “But that’s what you’re saying,” said Marissa.

  “I know,” said Tad. “I guess it’s just a statistical freak.” He shook his head, his pale blue eyes returning to Marissa. “It’s amazing, that’s all I can say.”

  After they crossed the catwalk to the main building, Marissa made Tad wait in her office while she sat and typed a short letter.

  “Who’s so important that you have to write him tonight?” asked Tad.

  “I just wanted to do it while it was on my mind,” said Marissa. She pulled the letter out of the machine and put it in an envelope. “There. It didn’t take too long, did it?” She searched her purse for a stamp. The addressee was Lab Engineering in South Bend, Indiana.

  “Why on earth are you writing to them?” Tad asked.

  “I want some information about a type 3 HEPA filtration system.”

  Tad stopped. “Why?” he asked with a glimmer of concern. He knew Marissa was impulsive. He wondered if taking her back into the maximum containment lab had been a mistake.

  “Come on!” laughed Marissa. “If Dubchek continues to refuse me authorization to use the maximum containment lab, I’ll just have to build my own.”

  Tad started to say something, but Marissa grabbed his arm and pulled him toward the elevators.

  9

  May 17

  MARISSA GOT UP EARLY with a sense of purpose. It was a glorious spring morning, and she took full advantage of it by going jogging with Taffy. Even the dog seemed to revel in the fine weather, running circles about Marissa as they crisscrossed the neighborhood.

  Back home again, Marissa showered, watched a portion of the Today Show while she dressed, and was on her way to the Center by eight-thirty. Entering her office, she deposited her purse in her file cabinet and sat down at her desk. She wanted to see if there was enough information available on Ebola viruses for her to calculate the statistical probability of the U.S. strain being the same as the 1976 Zairean strain. If the chances were as infinitesimally small as she guessed, then she’d have a scientific basis for her growing suspicions.

  But
Marissa did not get far. Centered on her green blotter was an interoffice memo. Opening it, she found a terse message telling her to come to Dr. Dubchek’s office immediately.

  She crossed to the virology building. At night the enclosed catwalk made Marissa feel safe, but in the bright sun the wire mesh made her feel imprisoned. Dubchek’s secretary had not come in yet, so Marissa knocked on the open door.

  The doctor was at his desk, hunched over correspondence. When he looked up he told her to close the door and sit down. Marissa did as she was told, conscious the whole time of Dubchek’s onyx eyes following her every move.

  The office was as disorganized as ever, with stacks of reprinted scientific articles on every surface. Clutter was obviously Dubchek’s style even though he personally was always impeccably dressed.

  “Dr. Blumenthal,” he began, his voice low and controlled. “I understand that you were in the maximum containment lab last night.”

  Marissa said nothing. Dubchek wasn’t asking her a question; he was stating fact.

  “I thought I made it clear that you were not allowed in there until you’d been given clearance. I find your disregard for my orders upsetting, to say the least, especially after getting Tad to do unauthorized studies on food samples from Medica Hospital.”

  “I’m trying to do my job as best I can,” said Marissa. Her anxiety was fast changing to anger. It seemed Dubchek never intended to forget that she’d snubbed him in L.A.

  “Then your best is clearly not good enough,” snapped Dubchek. “And I don’t think you recognize the extent of the responsibility that the CDC has to the public, especially given the current hysteria over AIDS.”

  “Well, I think you are wrong,” said Marissa, returning Dubchek’s glare. “I take our responsibility to the public very seriously, and I believe that minimizing the threat of Ebola is a disservice. There is no scientific reason to believe that we’ve seen the end of the Ebola outbreaks, and I’m doing my best to trace the source before we face another.”

  “Dr. Blumenthal, you are not in charge here!”

  “I’m well aware of that fact, Dr. Dubchek. If I were, I surely wouldn’t subscribe to the official position that Dr. Richter brought Ebola back from Africa and then experienced an unheard of six-week incubation period. And if Dr. Richter didn’t bring back the virus, the only known source of it is here at the CDC!”

  “It is just this sort of irresponsible conjecture that I will not tolerate.”

  “You can call it conjecture,” said Marissa, rising to her feet. “I call it fact. Even Ft. Detrick doesn’t have any Ebola. Only the CDC has the virus, and it is stored in a freezer closed with an ordinary bicycle lock. Some security for the deadliest virus known to man! And if you think the maximum containment lab is secure, just remember that even I was able to get into it.”

  Marissa was still trembling when she entered the University Hospital a few hours later and asked directions to the cafeteria. As she walked down the hallway she marveled at herself, wondering where she’d gotten the strength. She’d never been able to stand up to any authority as she’d just done. Yet she felt terrible, remembering Dubchek’s face as he’d ordered her out of his office. Uncertain what to do and sure that her EIS career had come to an end, Marissa had left the Center and driven aimlessly around until she remembered Ralph and decided to ask his advice. She’d caught him between surgical cases, and he’d agreed to meet her for lunch.

  The cafeteria at the University Hospital was a pleasant affair with yellow-topped tables and white tiled floor. Marissa saw Ralph waving from a corner table.

  In typical style, Ralph stood as Marissa approached, and pulled out her chair. Although close to tears, Marissa smiled. His gallant manners seemed at odds with his scrub clothes.

  “Thanks for finding time to see me,” she said. “I know how busy you are.”

  “Nonsense,” said Ralph. “I always have time for you. Tell me what’s wrong. You sounded really upset on the phone.”

  “Let’s get our food first,” said Marissa.

  The interruption helped; Marissa was in better control of her emotions when they returned with the trays. “I’m having some trouble at the CDC,” she confessed. She told Ralph about Dubchek’s behavior in Los Angeles and the incident in the hotel room. “From then on things have been difficult. Maybe I didn’t handle things as well as I could have, but I don’t think it was all my responsibility. After all, it was a type of sexual harassment.”

  “That doesn’t sound like Dubchek,” said Ralph with a frown.

  “You do believe me, don’t you?” asked Marissa.

  “Absolutely,” Ralph assured her. “But I’m still not sure you can blame all your problems on that unfortunate episode. You have to remember that the CDC is a government agency even if people try to ignore the fact.” Ralph paused to take a bite of his sandwich. Then he said, “Let me ask you a question.”

  “Certainly,” said Marissa.

  “Do you believe that I am your friend and have your best interests at heart?”

  Marissa nodded, wondering what was coming.

  “Then I can speak frankly,” said Ralph. “I have heard through the grapevine that certain people at the CDC are not happy with you because you’ve not been ‘toeing the official line.’ I know you’re not asking my advice, but I’m giving it anyway. In a bureaucratic system, you have to keep your own opinions to yourself until the right time. To put it baldly, you have to learn to shut up. I know, because I spent some time in the military.”

  “Obviously you are referring to my stand on Ebola,” said Marissa defensively. Even though she knew Ralph was right, what he’d just said hurt. She’d thought that in general she’d been doing a good job.

  “Your stand on Ebola is only part of the problem. You simply haven’t been acting as a team player.”

  “Who told you this?” asked Marissa challengingly.

  “Telling you isn’t going to solve anything,” Ralph said.

  “Nor is my staying silent. I cannot accept the CDC’s position on Ebola. There are too many inconsistencies and unanswered questions, one of which I learned only last night during my unauthorized visit to the maximum containment lab.”

  “And what was that?”

  “It’s known that Ebola mutates constantly. Yet we are faced with the fact that the three U.S. strains are identical, and more astounding, they are the same as the strain in an outbreak in Zaire, in 1976. To me, it doesn’t sound as if the disease is spreading naturally.”

  “You may be right,” said Ralph. “But you are in a political situation and you have to act accordingly. And even if there is another outbreak, which I hope there won’t be, I have full confidence that the CDC will be capable of controlling it.”

  “That is a big question mark,” said Marissa. “The statistics from Phoenix were not encouraging. Do you realize there were three hundred forty-seven deaths and only thirteen survivors?”

  “I know the stats,” said Ralph. “But with eighty-four initial cases, I think you people did a superb job.”

  “I’m not sure you’d think it was so superb if the outbreak had been in your hospital,” said Marissa.

  “I suppose you’re right,” said Ralph. “The idea of further Ebola outbreaks terrifies me. Maybe that’s why I want to believe in the official position myself. If it’s correct, the threat may be over.”

  “Damn,” said Marissa with sudden vehemence. “I’ve been so concerned about myself, I completely forgot about Tad. Dubchek must know it was Tad who took me into the maximum containment lab. I’d better get back and check on him.”

  “I’ll let you go on one condition,” said Ralph. “Tomorrow’s Saturday. Let me take you to dinner.”

  “You are a dear. Dinner tomorrow night would be a treat.”

  Marissa leaned forward and kissed Ralph’s forehead. He was so kind. She wished she found him more attractive.

  As Marissa drove back to the CDC she realized her anger at Dubchek had been replaced by fear
for her job and guilt about her behavior. Ralph was undoubtedly correct: She’d not been acting as a team player.

  She found Tad in the virology lab, back at work on a new AIDS project. AIDS was still the Center’s highest priority. When he caught sight of Marissa he shielded his face with his arms in mock defensiveness.

  “Was it that bad?” asked Marissa.

  “Worse,” said Tad.

  “I’m sorry,” said Marissa. “How did he find out?”

  “He asked me,” said Tad.

  “And you told him?”

  “Sure. I wasn’t about to lie. He also asked if I was dating you.”

  “And you told him that, too?” asked Marissa, mortified.

  “Why not?” said Tad. “At least it reassured him that I don’t take just anybody off the street into the maximum containment lab.”

  Marissa took a deep breath. Maybe it was best to have everything out in the open. She put her hand on Tad’s shoulder. “I’m really sorry I’ve caused you trouble. Can I try to make it up to you by fixing supper tonight?”

  Tad’s face brightened. “Sounds good to me.”

  At six o’clock Tad came by Marissa’s office and then followed her in his car to the supermarket. Tad voted for double loin lamb chops for their meal and waited while the butcher cut them, leaving Marissa to pick up potatoes and salad greens.

  When the groceries were stashed in Marissa’s trunk, Tad insisted that he stop and pick up some wine. He said he’d meet her back at her house, giving her a chance to get the preparations going.

  It had begun to rain, but as Marissa listened to the rhythm of the windshield wipers, she felt more hopeful than she had all day. It was definitely better to have everything out in the open, and she’d talk to Dubchek first thing Monday and apologize. As two adults, they surely could straighten things out.

  She stopped at a local bakery and picked up two napoleons. Then, pulling in behind her house, she backed up toward the kitchen door to have the least distance to carry the groceries. She was pleased that she’d beat Tad. The sun had not set yet, but it was as dark as if it had. Marissa had to fumble with her keys to put the proper one in the lock. She turned on the kitchen light with her elbow before dumping the two large brown bags on the kitchen table. As she deactivated the alarm, she wondered why Taffy hadn’t rushed to greet her. She called out for the dog, wondering if the Judsons had taken her for some reason. She called again, but the house remained unnaturally still.