“Thank you, Dr. Casey. I’m honored to hear you say that.” Despite herself, Hallie was pleased.
“Lew does fine. And I’ll call you Hallie, if that’s all right with you?”
“Of course.”
Barnard turned to the third man, who, Hallie could tell with a second’s glance, was no scientist. Too neat, too polished, too perfect. Could have stepped out of a Brooks Brothers catalog. He was slim and tan, wearing a tailored, three-piece suit of fine brown wool and what looked to be handmade English shoes. His razor-cut brown hair lay tight against his scalp and he sported a meticulously trimmed mustache. An otter, Hallie thought. Sleek and shiny and uncatchable. CIA was written all over him. His handshake was firm, and when he locked eyes with hers something inside her shuddered. The man had done some things.
“David Lathrop. With Central Intelligence.”
“Hallie Leland. With Deep Enough Dive Shop.”
He got it, laughed. “Don has told us both a great deal about you. His admiration is unbounded.”
She felt herself blushing. “Thank you.”
They settled into red leather chairs at a coffee table across the big office from Barnard’s desk. She hadn’t been sure how it would feel, coming back to BARDA, but here in Don’s office, at least, it was good. Barnard’s time in government entitled him to several rooms with tall windows on the top floor of a building that was, by design, four utterly unremarkable stories above ground and tucked back in a declining industrial park in Prince George’s County. The office walls could have been those of any senior bureaucrat in Washington, covered with framed citations, pictures of Barnard with his wife, Lucianne, and their two sons, plus photos of Barnard with senators and generals and presidents.
“Florida’s obviously agreeing with you.” Barnard looked pleased.
“Sunnier there. Smells better, too.”
“You deserved a respite, Hallie.”
“It’s good for a while. But I’m already starting to feel…”
“Bored?”
“Unchallenged.”
“That doesn’t surprise me.” Barnard fiddled with the big meerschaum pipe he had not smoked for fifteen years. “Well, you’re surely wondering why you’re here.”
“You could say that. It’s been a short, strange trip.” Fortier and Whittle had put her on a Bell Jet Ranger helicopter, which had taken her to a government Citation jet at a restricted airfield, which had flown her to Andrews, where another helicopter had brought her here. It was well after dark now.
“The request originated at the highest level.”
“You mean from the OD?” Office of the Director, CDC, of which BARDA was a part. Despite her fatigue, Hallie was sitting up straight, legs crossed, elbows on the chair arms, fingers tented.
“No. The White House.”
“Yeah, right. Don, I came too far for jokes.”
Lathrop broke in: “He’s not joking, Dr. Leland. I can assure you. Shortly before you arrived we were on a videoconference with President O’Neil.” He smiled. “It wasn’t long, but it was the president.”
Barnard nodded. “I’ve been briefing the president, Vice President Washinsky, Secretary of Homeland Security Mason, and Secretary of Health and Human Services Rathor every day.”
She saw no humor in his eyes, just fatigue, concern, and—something she had never seen before in her former boss—a hint of fear.
“Okay. What’s going on?”
Lathrop’s voice was smooth and modulated, like an FM radio announcer’s, but as he spoke this time it grew tight.
“Almost two weeks ago, one of our soldiers in Afghanistan was wounded at a combat outpost called Terok. Not seriously, but he was admitted to his base’s medical unit. That’s when it started.”
“What started?”
“Watch this. Don?”
Barnard punched buttons on a remote. A large flat-screen monitor on a near wall glowed to life. Hallie watched as the image on the screen showed a room with lime-green walls. It contained a stainless steel table, sinks, scales, trays of evil-looking instruments, and a wall of cold-storage lockers.
A figure walked into the picture wearing a blue Chemturion Biosafety Level 4 suit. Inflated to maintain positive pressure, it looked like the space suits in Buck Rogers movies, right down to the clear, bucket-shaped hood and futuristic backpack containing the battery-powered personal life support system. The attendant opened a locker door and rolled out a stainless steel rack. She unzipped the orange cadaver bag and pushed it open, exposing the body inside.
Hallie came half out of her chair, gaping. “Jesus Christ! Did terrorists do that?”
“Iatrogenic. It happened in Terok’s medical unit.” Lathrop shook his head as he said this, as though having difficulty believing it, despite the grisly evidence before them at that moment.
“How?”
“Just watch for a bit.”
The camera moved. Hallie saw close-ups, plate-sized patches of skin missing, exposed red tissue and even, in a few places, white bone. She had seen skinless cadavers in graduate school at Hopkins, but, treated with formaldehyde and phenol, they’d looked more like pink wax. This body was like fresh meat.
The screen faded to black. Barnard turned to Hallie. “That is … was Army Specialist DeAengelo Washington. A fine young soldier, from what I was told.”
“Was he captured? Tortured?”
“No. He wasn’t the one wounded. That young man is in another locker in the same morgue. It was ACE.”
“Acinetobacter? Can’t be. ACE doesn’t do that.”
“What do you know about ACE, Dr. Leland?” Lathrop asked.
“Thirty-one known species, thirty benign. One, Acinetobacter baumannii, is drug-resistant, but not often fatal in healthy adults. Transmissible by inhalation, ingestion, or through damaged skin. Lungs are the primary infection site, but it can also initiate in the urinary tract, stomach, or bowel.”
She paused a moment, not sure how much they wanted to hear. When no one said anything, she continued: “ACE loves hospitals. It can live for months on a stethoscope or examining table. But the biggest infection vectors are catheters. Of all bacteria, ACE has one of the highest transmutation indexes.”
“That’s exactly right,” Don Barnard affirmed. “All ACE species, including baumannii, have an extraordinary ability to exchange genes with each other through carrier viruses called bacteriophages. It’s almost like the way ants communicate with pheromones. Information, including immunity to an antibiotic, can spread through an entire population with astonishing speed. A matter of hours, in some cases. Back in 2005, geneticists at Stanford broke the code of a new ACE strain and found the greatest number of genetic upgrades ever discovered in a single organism.”
Hallie sat forward. “I remember that. But ACE only endangers people with compromised immune systems—HIV sufferers, the elderly, burn victims, chemotherapy patients.”
“And people with severe tissue trauma.” Lathrop sounded angry.
She understood. “Like wounded soldiers.”
“Correct.”
“Okay. But after ACE outbreaks in New York hospitals killed some older people in 2002, they dusted off a 1950s antibiotic called colistin. It worked. On some of the people some of the time, anyway.”
“All true, Hallie.” Barnard frowned, rubbed the pipe bowl with his thumb as if trying to remove something foul.
“So what happened over there? They didn’t have any colistin?”
“They got some. It just slowed ACE down. And colistin is in very short supply. Nobody has produced it in any quantity for at least forty years.”
“But surely ACE didn’t cause what we saw on that video?”
“It did. We have conclusive test results.”
“How?”
“It is a new ACE.” Lew Casey spoke for the first time, sitting forward in the chair, elbows on knees, looking up at them from beneath wiry red brows.
That stopped her. “So this is biowar, finally?”
; “Possible, but the intelligence people don’t think so. More likely, antigenic shift.”
“How did it do that to him?”
“This new ACE apparently grows in the bloodstream, then attacks organs and skin from inside out.”
“Bacteria usually burrow deeper, where it’s easier to propagate.”
“This ACE does just the opposite. It wants out. And it gets out fast.”
“Like being skinned alive, slowly.” Hallie tried to imagine what it would be like, but then gave up. “No drug on earth could blunt that agony.”
“No.” Barnard looked grim. “None.”
“It’s horrible,” she said. “But at least it’s contained.”
Barnard coughed, looked at the others.
“There are more cases?”
“His squadmate, a kid from Kansas, was the first—the zero man. Since then, two nurses and another patient in the medical unit.”
“Who’s in charge at that place?”
Barnard took a deep breath, let it out, rearranged his bulk in the chair. “An Army doctor. National Guard, actually. It’s a field hospital with Level II trauma capability and that little morgue you saw, but they stabilize serious cases for transport to CENMEDFAC, in Kabul.”
“He’s still in there?”
“She. By herself, unfortunately. The Taliban launched a region-wide offensive. May or may not be a correlation. But there have been heavy casualties, so Terok’s other two doctors were called to other COPs.”
“She’s dealing with wounded and ACE. Tough assignment.”
“Yes.”
“Well, at least that COP is quarantined. Terok, was it?”
Again Barnard hesitated, stared down at his pipe’s empty bowl.
“My God, Don. People got out? How many?”
“Two went back to a forward operating base called Salerno, fifty miles east. But the big worry is CENMEDFAC.”
“The mother of all Army hospitals over there.”
“Right. Four patients were transferred there. All had contact with the cases at Terok.”
“CENMEDFAC sends the worst cases stateside.”
“Right.”
“So it could be coming here.”
“It is here, Dr. Leland.” Lathrop, sitting forward. “Some of them arrived two days ago.”
For a moment, nobody spoke. Hallie was stunned, the ramifications spinning out in her mind. As they sat in silence, Barnard’s secretary, Carol, came in. It was well after working hours, but she would never leave until he did. She was a trim widow with a rust-red beehive hairdo and a different-colored polyester pant suit for every day of the month.
“Here you are. I thought you people might want a snack.” She placed a tray with roast beef and turkey sandwiches and a big pot of coffee on the table.
“Thank you,” Hallie said. “I needed this. Nothing since breakfast.”
Carol put a hand on her shoulder. “It’s good to see you again, Hallie. I’ve missed you.”
Hallie smiled, patted her hand. “I’ve missed you, too, Carrie. You and Don.”
After a moment, Carol left them. The men poured cups of coffee but took nothing to eat. Hallie gobbled half a sandwich, poured coffee, dumped in cream and sugar. Not her usual way, but she needed energy.
“So where do things stand now?” She got the words out through a mouthful of roast beef.
“Colistin is buying us some time.” Barnard did not look relieved saying that.
“But it’s like water building up behind a dam. Colistin is the dam,” Lew Casey put in. “Those four cases from Terok remained at CENMEDFAC for three days. During that time they came in contact with dozens of patients and staff.”
“Where did the cases go here in the U.S.?”
The two scientists looked at Lathrop.
“Reed got one, Bethesda another, and two went to the burn center in Georgia.”
Hallie stopped chewing. “Those places are full of people with compromised immune systems. ACE will burn through them like fire in a hay barn.”
“And it will keep going,” Barnard continued. “There’s constant interchange between military facilities like those.”
“This is horrific. You’ve got thousands of sick and wounded soldiers in facilities all over the country. They might have survived combat injuries only to be killed in our own hospitals.” Feeling her eyes fill, Hallie set her cup down. “Sorry, gentlemen.”
“Don’t worry. A little emotion is good for the blood,” said Barnard, and the others nodded. “But it gets even worse. If this ACE can really attack healthy subjects as well…”
“The entire armed forces could be decimated. Not just the sick and wounded.”
“You see now why your presence is so important.”
“You need the drug we had been working on. Superdrug for a superbug.”
“Yes. You were close. Another few months and I believe you’d have had a whole new family of antibiotics.”
“Weeks, maybe.” Hallie recalled the research very well.
“That’s why Don wouldn’t let me spirit you away, actually.” Lew Casey sounded rueful.
“But I never finished. For obvious reasons. So Al must not have done it, either.”
Barnard shook his head. “Dr. Cahner—Al—is a very good microbiologist. I know the two of you got on well. And did fine work together.”
The two of them had worked well as a team, but it had been more complicated than that. More than twenty years older than Hallie, Al had reminded her, at first meeting, of those men she saw scrutinizing labels in supermarket aisles and reading books over the daily specials in chain restaurants. For their first months in the lab together, he spoke of nothing but work and always lunched by himself. He was never rude, just solitary.
But month after month they worked, pressed together in the microbiology laboratory, always conscious that they were in the company of Level 4 pathogens that had killed hundreds of millions of people throughout history. She came to respect Cahner’s grace under pressure and the precision of his lab techniques. She sensed, too, that he recognized her own dedication to good science and, even more, admired her ability to handle demons like Yersinia pestis with steady hands.
After eight months they started eating lunch together in the canteen. His meal never varied: a Red Delicious apple, a carton of V-8 juice, tuna salad on whole wheat with lettuce and tomato. He wasn’t much for idle chat, but she learned that he’d happily talk about microbiology. One day she mentioned that the CDC had just sent a team of pathogen hunters to some caves in Gabon.
Munching a bit of sandwich, he said casually, “Those African caves are nasty. I was in Bandubyo myself.”
She almost dropped her coffee. “Bandubyo?”
He looked sheepish, meeting her astonished gaze. “Well, yes. It was back in—let me think—’03 or maybe ’04.”
“My God. Ebola-B was discovered in that cave. The worst of the Ebola family. What were you doing there?”
“I was part of a WHO team of virologists and microbiologists. Some people had contracted hemorrhagic fever after eating Passiflora edulis grown near the cave.”
“Passion fruit.”
“Right. We determined that fruit bats from the cave contaminated the crops. Passion fruit and cassava both, in fact.”
“Bandubyo,” she repeated, shaking her head. “That is supposed to be one hell of a cave.”
“There was a lot of vertical. And to penetrate the dark zone we had to do some diving. Inside, the cave was clean. But from the twilight zone with its bat chamber on out—red-hot with what turned out to be that new species of Ebola virus.”
“I hadn’t realized you did that kind of fieldwork.”
“Oh, when the need arises. I don’t get out often enough to keep my skills really sharp. But I can still hold my own if I have to.”
This was a side of Al Cahner she had not known about and would not have suspected. But he was trim and looked reasonably fit, so it was not completely outlandish to imagine h
im exploring wild caves. And she could not help but admire him for it. Penetrating viral caves was as bad as fieldwork got, partly because it was so dangerous and required a host of technical skills like rock climbing and vertical rope work and scuba diving. The really bad part, though, was that such caves sometimes housed pathogens of unearthly virulence.
“I gather you’ve done some cave work yourself,” he said.
I wonder what else he knows about me? Hallie thought, but didn’t press the subject. BARDA was not a large facility. People talked.
“Yes. For fun and work both. A lot of cave diving, too.”
“It takes a special kind of person to do that for fun. It is dangerous business.”
“There’s no margin for error, that’s for sure.”
They talked a bit more about caves and viruses, then went back to their food. But the conversation had changed Hallie’s perception of her lab partner. There’s more there than meets the eye, she thought. And then: All he needs is a little TLC.
Their bond grew, and as the months passed they talked about themselves, laughed at odd fellow workers, bitched about the bureaucracy, damned do-nothing politicians—took the small risks that inched them closer together. Of all the things they talked about, Hallie was most surprised to find that Al Cahner was a walking encyclopedia of baseball statistics. He was especially fond of the 1950s—“baseball’s golden age,” he called it. He could recite ERAs and slugging percentages and double-play combos as if he were reading them off a page. He also delighted in the sounds of baseball. Not the smack of a fastball in a catcher’s mitt or the ring of a cleanly hit home run. The sounds he found most beautiful were players’ names, which he loved to recite, almost like a kind of poetry:
“Granny Hamner. Enos Slaughter. Ryne Duren.” Pause. “Paolo Discomenides. Hart Workman. Joe Bolt.” Pause. “Gino Cimoli. Rabbit Hopper. Artie Dedeaux.”
Hallie had never been a baseball fan. One of her brothers had played cornerback for Duke; the other had been a flanker for the University of Colorado on a nationally ranked team. Both had been high school standouts, so she had been watching football games since she was ten. Nevertheless, she enjoyed listening to her lab partner’s name-poems, and enjoyed, as well, seeing him smile.
The Deep Zone Page 5
