Resistant

by Michael Palmer

  “I don’t think people understand what an unusual experience this is going to be. The Centers for Disease Control doesn’t even offer tours, except of their museum. My ex, Roger, is in the public relations office and pulled strings to arrange this for us. A guided tour of the CDC is a once-in-a-lifetime opportunity.”

  “Physician health people can be a little narrow,” Plimpton said. “What made you sign up, Lou?”

  “I’ve never been. I had no idea they didn’t give tours. I have always thought of the place as sort of a Disney World of microbiology, featuring Bugland and Epidemiologyland and AndromedaStrainland and the like.”

  The Templeton Rehabilitation Center was believed by many to provide the most effective treatment for chemically dependent health professionals in the world. Lou’s addiction, primarily to amphetamines, had evolved as he moonlighted more and more hours in an effort to help his father, Dennis, a union laborer then on disability, meet the college tuition expenses of Lou’s younger brother, Graham. The deal was that Graham was never to be told. Lou feared that the fragile relationship between the two headstrong brothers would shatter. As things were, they had never grown close.

  The last time Lou had been in Atlanta, the anniversary of his arrival at Templeton, was the last time he had been in the city. By then, many of those from his “class” had been lost to follow-up, and too many others were dead.

  Bad disease.

  The memories, tempered by the years and the recovery meetings, roiled in Lou’s mind as the van rolled through the streets of the city where the turnaround in his life had begun.

  Druid Hills, home to the CDC as well as some of Atlanta’s most elegant mansions, was some five miles from downtown. The van and its three passengers cruised to the main entrance past the agency logo—white rays on blue, beneath the block letters CDC. The driver pulled to a stop in front of the main building and informed the trio of the pickup time for the return trip to the lodge.

  “I could stay here for days,” Greene gushed.

  “Is your ex coming to greet us?” Lou asked.

  “Doubtful. Roger and I are on decent terms, but we split because I told him he wasn’t motivated enough to amount to anything.”

  Lou shielded his eyes against the glare of the morning sun. The air, free of the scent of lab chemicals, smelled instead of flowering plants and trees. He gestured at a towering brick smokestack rising up from behind a mirrored-glass building. The sprawling complex seemed perfect for incubating secrets as well as specimens.

  “I wouldn’t be a bit surprised to learn they’re taking volunteers for human experimentation, if you want to extend your stay,” he said.

  “I assume you’re joking.”

  “Alas, people are always making that assumption.”

  Lou followed the others into the tastefully apportioned lobby, chilled enough to raise goose bumps. He wondered about the negative pressure rooms, HEPA air purifiers, and other bio-safety protocols employed at various areas in the facility to keep lethal pathogens contained.

  “If you’ve ever wondered what a bioterrorist’s candy store looks like,” Greene said as if reading his thoughts, “well, this is it.”

  A brunette dressed in a sharply tailored navy blue suit approached. The tag pinned to her ample lapel said that her name was Heidi, and that she was with public relations. She glanced briefly at her clipboard, perhaps making sure she had the correct number of visitor badges to hand out.

  “Hello and welcome,” she said with the slightest hint of an accent. “My name is Heidi Johnson, and I’ll be your guide for your visit today. I assume you are Dr. Greene?”

  “Brenda Greene, that’s right.”

  “I have a message for you from Roger Greene. He regrets that he has meetings all day and won’t be here to escort you personally, but he welcomes you to the foremost facility of its kind in the world, and knows I will fill in admirably for him. Now, unless there are questions, I guess I should make sure I have the right people before we head off.”

  “I assume you know that we’re from the Physician Wellness conference,” Greene said.

  “Chattahoochee Lodge. We don’t generally offer tours, but Mr. Greene, who’s my boss, arranged your visit personally.”

  Lou glanced over at Brenda and felt certain he could read her mind about the relationship between her ex and Heidi.

  “I had expected a larger group, but the smaller numbers only mean we will be able to see more,” Heidi said.

  From the gardens outside to the sparkling interior to Heidi’s perfect smile, Lou sensed that the CDC did its very best to downplay its important and often dangerous work. However, Heidi’s demeanor dimmed slightly after she finished handing out name badges.

  “I’m afraid Dr. Chopra, the director of our Division of Bacterial Diseases, has been called away on business, so we’re not going to be able to visit her lab before our tour of the grounds and the museum. We have two alternatives. We could visit the Division of Viral Diseases or take a tour of our Antibacterial Resistance Unit.”

  Viral diseases … Antibacterial resistance … A candy store for terrorists. The phrases reverberated in Lou’s thoughts.

  Harvey Plimpton, who had been taciturn in contrast to Brenda Greene, came alive at the option.

  “Antibacterial resistance. Before I changed specialties, I did research on E. coli mutation. Can we go there?”

  “If you both agree,” Heidi said.

  Lou and Greene made brief eye contact and nodded.

  “Great, we’ll start your visit there,” Heidi said. “I’ll call and let Dr. Scupman know that we’re coming. I think you’ll find him … well, quite interesting.”

  “What do you mean by ‘interesting’?” Lou asked.

  Heidi returned an enigmatic smile, but not an answer.

  CHAPTER 4

  The government exists to provide order to the people while 100 Neighbors exists to define what that order shall be.

  —LANCASTER R. HILL, 100 Neighbors, SAWYER RIVER BOOKS, 1939, P. 17

  It was three tenths of a mile from the main building to the CDC’s recently constructed Antibiotic Resistance Unit. Led by Heidi Johnson, the small group trooped there through a muggy, seventy-five-degree morning. The ARU, an expansive, single-story blockhouse-like rectangle, was constructed of gray cinder block. Dense low shrubbery surrounded it, but there was little in the way of artistic landscaping. Lou wondered if the designer had been intimidated by the notion of the germs the building was to contain or had simply been instructed not to make the place too inviting.

  As if validating his suspicions, security protocols commenced upon entry. An armed guard, young and fit and not the least bit engaging, came out from behind a small, unadorned desk in an equally uncluttered lobby. He took IDs and registered fingerprints using a biometric scanner. Moments later, another armed guard appeared from behind a locked steel door, this one secured by a keypad entry system. Escorted by the second guard, Lou followed the others into a long, windowless corridor, with unframed, foot-square photos lining the wall on each side—unlabeled, unappealing, colored microscopic and electron microscopic images of germs, mostly bacteria.

  The air, possibly filtered through some sort of recirculation system, tasted stale. Passing in front of a glass interior door, Lou spied a trio of scientists dressed in white knee-length lab coats at the far end of a hallway to their right. He glimpsed them just before they vanished through a side door into what might have been yet another corridor … or a stairway.

  Creepy.

  The mystery of what lay beyond that passage tugged at Lou’s curiosity and had him suspecting that there was more to the facility belowground than above. The labs housed germs that were resistant to treatment. The battles that must be raging within those unappealing walls were intriguing. How many lethal forms of microscopic life were being cultured and studied? Could the scientists he had seen be working on something other than antibiotic resistance—weapons of mass destruction, perhaps? He kept pace with th
e others but let his imagination run on high.

  Following a maze of shorter corridors, the group passed through an open doorway and entered into a space with no scientific equipment inside—a conference room and library, with floor-to-ceiling bookshelves. Tomes and bound periodicals, neatly arranged and labeled, occupied the entirety of two walls, and there were half a dozen bridge chairs set in front of a large flat-screen television positioned at the front of the room.

  Awaiting their arrival were two people, a man, mid-to-late fifties, and a woman, perhaps two decades his junior, both wearing knee-length lab coats. There was no identifying information—their names or the name of the unit—stitched above the breast pocket. The man had a broad, flat nose, heavy-lidded green eyes, and unruly gray-brown hair, carelessly parted on the right. His pallid complexion hinted to Lou at unbalanced hours spent indoors, probably in this vitamin D–deficient sarcophagus. The blue oxford shirt beneath his open lab coat would never pass anyone’s wrinkle-free test. His associate, her raven hair pulled into a tight bun, had an academic look, enhanced by heavy-framed glasses. Petite and quite cute in a mousy sort of way, she, at first take seemed reserved and uneasy around the arrivals.

  “Hello and welcome,” the man said, his speech, purposefully or not, delivered in a sepulchral tone. “My name is Scupman—Dr. Samuel Scupman. I am the head of the Antibiotic Resistance Unit here at the CDC. My associate is Dr. Vicki Banks. She will be assisting with today’s presentation. Mr. Greene in public relations tells me you are all physicians.”

  “Except me,” Heidi said. “I work with Mr. Greene.”

  Lou again saw Brenda’s eyes flash.

  “I’m Dr. Brenda Greene,” she said. “Mr. Greene and I are—were—married. This is Dr. Harvey Plimpton and this is Dr. Lou Welcome. We’re attending the national physician health organization meeting, and we’re all thrilled to be here.”

  Scupman, looking as if he could not care less who they were, nodded but made no attempt to shake hands. His eyes narrowed, possibly at the notion of having to interact with a species composed of more than one cell. A cloud of sorts passed in front of his face.

  “I confess I was surprised that your husband would offer up our unit this way,” he said. “Much of the work we do here is top secret. To guide you into the heart of our lab would be profoundly irresponsible. You see, within the confines of this facility exist more than ten thousand different species of bacterium—”

  “Actually, at last count, we have more than twenty thousand,” Vicki Banks interjected.

  “Yes, of course, thank you,” Scupman said. “Twenty thousand different strains of germs, many of which are so lethal that even for people highly trained in biorisk management, including the most advanced biosafety and laboratory security protocols, the dangers are still quite pronounced. I know you’ll want more, but for your own protection, today’s tour will be confined to the safety of a slideshow.”

  “We understand,” Brenda said, her disappointment obvious.

  “Please, if you’ll take your seats,” Banks instructed. “Dr. Scupman has another commitment, so we’ll need to begin right away.”

  As soon as everyone was settled, the lights dimmed and the first slide—bright colors, high definition—appeared on screen. It depicted a series of pink, rod-shaped bacteria, housed within a pink culture medium.

  “What you are seeing here,” Scupman said, “is a Gram negative motile bacterium called Burkholderia pseudomallei. This impressive little creature is the root cause of the infectious disease melioidosis. Without proper treatment, mortality rate for infected organisms exceeds ninety percent. Vomiting, high fever, cough, and profound chest pain combine to deliver a mercilessly slow and agonizing death. This bacterium, endemic in parts of Asia, Australia, and Africa, is currently classified as a category B biological weapon agent. It is sturdy, easily obtained, easily cultured, and stable enough to be weaponized. Impressive, yes?”

  Scupman flashed through a series of slides depicting different germs while speaking of the miraculous properties of each of them as if they were his brilliant, accomplished children. The more he rhapsodized, the more uneasy Lou became. It was one thing for Scupman to love his work, but another altogether to idolize the very beasties he was trying to defeat.

  “Humans possess a vast array of defense systems to guard against such foreign intruders,” the entomologist went on, “and yet, despite all our impressive advances in science and medicine, we still have not unlocked the secret to the body’s abilities to defend itself. The step from genetic response to antibacterial effect remains as mysterious to us now as the origins of life itself. You may be impressed with our body’s capabilities, but I am here to tell you that frightening as it may seem, there are very few battles that bacteria are not equipped to win.

  “How can an organism like B. pseudomallei remain hidden inside the human body for years, undetected by the immune system, as though a prowler has taken up residency within a burgled home, and then suddenly and without warning, become active and spread throughout the body until the victim’s life-giving blood turns to poison? This”—Scupman held up a single finger—“is but one of the questions our researchers are working to answer. For the very fate of our planet, our ultimate survival, depends on gaining access to this knowledge—of separating out the bacteria essential to our well-being from those bent by their genetics on destroying us. We are at war each and every day against an armada of microscopic enemies—enemies without consciences, whose only purpose is to multiply and metabolize; enemies genetically determined to achieve complete and total victory, even at the expense of the life of their hosts.”

  In the dimly lit room, Lou could almost see Scupman perspiring from his own enthusiasm. A weighty silence ensued, nobody sure of how to respond to the man’s rant. It was Brenda who eventually broke the tension.

  “Dr. Scupman, is there a genetic component that could explain why the bacteria remain dormant in some people?”

  Scupman appeared pleasantly surprised, perhaps by the literateness of her question. He turned up the lights.

  “Dr. Banks, would you like to handle this one?”

  Scupman’s associate looked as if she would prefer to listen. But when she did speak, her answer was delivered with confidence, and with none of the bravado of her boss.

  “You’re all familiar with Toll-like receptors?” she asked.

  The three physicians nodded.

  “Then you know these proteins are what initiate the fight against deadly bacteria. TLRs are like ten-digit alarm codes. For any pathogen that comes into contact with an immune cell, a code is entered, and if the germ is not benign, an alarm gets triggered, activating the body’s defenses. And yet, B. pseudomallei, like a microscopic magician, tricks the system by entering the code of a harmless bacterium, leaving the body unaware of the intruder’s presence. So to answer your question, yes, we believe there is a genetic reason why some people become infected but never get ill. Still, we are far from using that knowledge to develop an effective vaccine or antibiotic.”

  “Thank you, Vicki,” Scupman said.

  Banks smiled demurely, and looked to Lou even more attractive than on first impression. In spite of himself, he noticed that she wore no wedding ring—no jewelry of any kind, in fact.

  “This is for either of you,” Lou said. “Do scientists believe that bacteria like B. pseudomallei normally mutate after infecting the host or do their properties stay fairly constant?”

  “And you are?” Scupman asked.

  “Welcome. Lou Welcome. I’m an ER doc from Eisenhower Memorial in D.C., but I have my boards in internal medicine as well.”

  “Good question, Dr. Welcome. One thing I have learned during the course of my twenty-five-year career studying bacteria is that nature is constantly grooming and furbishing them to be the ultimate warriors. As I said, these are soldiers going to war without a conscience and without fear. In the battle for species survival, they are the most powerful threat mankind will ever
face. Trying to account for and combat the in-host mutations of bacteria is like pitting a child’s soccer team against a Manchester United team that is not only more powerful at the opening whistle, but ever-changing during the game, and playing by different rules. Put another way, bacteria are much better at surviving than we are at developing effective vaccines or antibiotics.”

  Lou pulled his eyes from Vicki.

  “Thank you for underscoring my point,” Scupman was saying. “Humans are messy, whereas microbes are perfect—a perfect society largely invisible to our eyes and yet existing all around and within us. As I said, there is no reasoning in a microbe, no hesitation, nothing to delay the inevitable attack. When threatened, these mindless killing machines transform, mutating seemingly at will into something that cannot be defeated. They act instantaneously without regret or regard for others.

  “You see, Dr. Welcome, a single bacterium contains all the necessary components for growth and multiplication. They do not contemplate their existence. They are neither impaired nor well. The simple state of being is their life’s sole purpose. With a blind, singular ambition to produce more of themselves, these magnificent organisms exist unburdened by man’s frivolities. In many cases, we are helpless to defend against their might.”

  The room took on the oppressive atmosphere of a midsummer day, weighty and dense. Even Vicki Banks looked a bit ill at ease. Scupman broke the mood with a wan smile.

  “Let’s continue with our slideshow, shall we?” Vicki said.

  For the next twenty minutes, she ran through a series of slides depicting the functions of the laboratory and the work being done to develop effective antibacterial treatments. Several minutes were dedicated to an explanation of the different types of agents that had been declared by the government as having the potential to pose a severe threat to public safety.

  The two scientists made quite a pair. Vicki was calm and academic, Scupman utterly passionate.

  If Filstrup’s speech conveyed even a tenth of the fervor Scupman demonstrated for his work, Lou was thinking, the man would have more than a decent shot at winning the election. But that simply wasn’t the case. Lou risked another glance at Vicki Banks, and just caught her looking at him.