Resistant

by Michael Palmer

  From what Lou could glean from the notebook, Humphrey had done meticulous and incredibly well-documented research. What he did not know, and could not know without some expert guidance, was if the brilliant pharmacy tech’s approach really did have as much or more chance of succeeding than the traditional ones.

  One thing seemed certain—Dr. Ivan To-Drink-Your-Blood was not up to the task, nor would he take Humphrey’s work seriously, even if he had done research on bacteriophage. Puchalsky would never be able to see the genius imprisoned within Humphrey’s tangled body. Still, some sort of expert evaluation of Humphrey’s proposals seemed like the only way to go at this point.

  With that in mind, Lou had contacted Vicki Banks and arranged a time when she and her boss, Sam Scupman, could meet with him. Seven more hours, and he might have some answers.

  Now, if only he could sleep.

  * * *

  IT SEEMED like a year since Lou last sat in the library conference room of the CDC’s newly constructed Antibiotic Resistance Unit. Certainly, in terms of eventfulness, it had been. As before, he had been escorted to the room by an armed security guard and informed of a delay in Dr. Scupman’s and Dr. Banks’s schedules. While he waited for them to arrive, he once again skimmed the five-page abstract of Humphrey Miller’s thesis, the only part of the thick notebook he had chosen to bring. After hours of study, he sensed he was getting a handle on things. And what he was understanding, he liked.

  Humphrey’s bacteriophages—bacterio for the target germ, and phage meaning to devour—were three of thousands of types of viruses, readily available in soil, shallow ocean water, and other ecosystems, capable of invading specific bacteria and interfering with their reproduction. The irony of a flesh-eating bacteria being eaten from within by another microorganism was not at all lost on Lou. Prior to their discovery in 1917, phages had been linked to miracle waters—rivers in India and other places with the power to cure diseases from leprosy to cholera. Only later did scientists, examining a naturally occurring treatment for dysentery, discover these “cures” were phages, feasting on and eradicating the disease-causing bacteria. Use of cultured phages to fight bacterial infections had not been without controversy, and had not at all enjoyed universal acceptance. Humphrey’s proposal would push the boundaries of what the virus could do beyond all known limits.

  But Lou sensed the theory was solid, and very well might work. With time running out for Cap, it simply had to.

  While Lou worried Scupman might balk at offering his professional assessment based on the five-page summary, he was equally concerned with revealing Humphrey’s identity. Humphrey had left it up to him, but they both knew that the wrong word to the wrong person might mean the end of his lab before it was even up and running.

  Ten minutes later, Sam Scupman entered the conference room, followed two minutes later by Vicki Banks. Scupman was even more frazzled and unkempt than Lou remembered, and had probably not changed his knee-length lab coat since then. Lou took extra notice of the dark circles encasing the man’s green eyes. Nothing like a flesh-eating, untreatable infection to induce insomnia in a microbiologist. For her part, Banks looked as interesting and unflappable as before, with her heavy, black-framed glasses and her raven hair knotted in a bun. If there was any change in her since their last meeting, it was that she seemed less reserved than Lou remembered, and quicker with a smile.

  “Dr. Welcome,” Scupman said. “Nice to see you again. You’re the one who asked that excellent Pseudomallei question.”

  “Thank you for remembering.”

  Lou shook hands with the two scientists before they took their seats at the conference table. Banks’s hand was smooth, and despite the air-conditioning, quite warm.

  Scupman spoke first. “In your phone conversation with Dr. Banks, you mentioned wanting to speak with us about a special type of bacteria. I admit your caginess pertaining to the specifics intrigued me. Unfortunately, my time today is short so we’ll have to get right to the point.”

  “Not a bacteria, Dr. Scupman. A bacteriophage.”

  “Oh?”

  The scientist seemed to perk up.

  “A patient at Arbor General named Hank Duncan is in trouble. He had a compound fracture of his femur a little over two weeks ago, and is now toxic from a flesh-eating bacteria for which it appears there is no treatment. Hank runs a gym in D.C. and is known around the city as Cap. He is my closest friend.”

  “The splint!” Banks exclaimed.

  “Pardon?”

  “You’re the ER doctor who splinted the fracture in the wilderness north of here, aren’t you?”

  Lou couldn’t completely pin down the expression in her eyes, but it was one he liked.

  “It appears the Arbor General grapevine moves information as fast as ours does in D.C,” he replied. “I splinted the leg, but couldn’t have done it without my friend’s help.”

  “So I heard,” Banks said. “Quite a story. Sorry there have been complications.”

  “Thanks. That’s why I’m here. The ID specialist consulting on the case, Dr. Ivan Puchalsky, used the term Doomsday Germ when he spoke with me.”

  Lou passed across two copies he had made of Humphrey’s abstract.

  “Is this from Puchalsky?” Scupman asked with a disdain that immediately lifted his standing in Lou’s mind. “Arrogant son of a bitch,” he then muttered, earning a few more points.

  “No,” Lou said. “Puchalsky has nothing to do with this. I made calls when I learned what was going on with Cap. One of my friends faxed me this.”

  Scupman scanned more than read the pages. His eyes narrowed and Lou sensed an immediate souring in his demeanor. His body language, arms crossed, leaning back in his chair, seemed more guarded.

  “You sure this wasn’t put together by Puchalsky? Actually, never mind. It doesn’t read as if it were something he would have come up with. Excuse me for saying so, but as a microbiologist, primarily interested in nosocomial infection, he really is quite limited in his scope and in his respect for the power of bacteria. Would you agree with that, Dr. Banks?”

  “Actually, Sam, I think you’re being a little hard on the man.”

  Lou suspected the same could be said for Scupman’s reaction to most of his colleagues. He wondered if Ahmed Kazimi had included the man in his cyber think tank. It wouldn’t surprise him in the least if he hadn’t.

  “I’m looking for any information that will help my friend,” he said.

  “I’m sorry to have to tell you this,” Scupman responded, “but most of our work with this bug is classified. That’s the way it is with a government lab. But I can assure you that if we had a treatment breakthrough of any kind, it would already be inside your friend.”

  “That’s why I wanted you to see this document,” Lou said.

  “Who wrote it?”

  “I promised to pass on your reaction to what’s written there before disclosing who wrote it.”

  “The truth is,” Scupman said, “it really doesn’t matter who wrote it. From what little material you brought me, I can say with some certainty that it’s not going to work. What do you think, Dr. Banks?”

  Lou had watched as Banks went through the pages a second time. At least one of the scientists had shown Humphrey’s work that much regard.

  “Dr. Welcome,” she said, “the truth is, Dr. Scupman and I have done some phage work, without much in the way of encouraging results. We haven’t done anything with the combination of phages that is discussed on pages three and four, but the information presented here is scant.”

  “Scant?” Scupman broke in. “It’s thin as a wafer. And what’s this with these footnotes? They don’t refer to anything. There’s no bibliography and nothing at the bottom of the pages. Whoever wrote this obviously has more information than he chose to include here. Why is that?”

  “I can’t say why,” Lou answered, “but I can tell you that there is more. A lot more.”

  “Well, bring it in if your mystery scientist wants
, but at the moment there’s not enough here for me to promise I’ll get to it in the next couple of months. Dr. Banks, anything to add?”

  “It’s clear how much your friend means to you. The truth is, I agree with Dr. Scupman that the theories presented here are interesting, but nothing that new. However, if it’s really that important to you, I will try and go through the total material over the next week.”

  “I’m afraid I’m going to have to insist that you don’t,” Scupman said, his expression pinched, and his irritation apparent.

  Banks’s cheeks reddened.

  “But I would be doing it on my own time.”

  “Dr. Banks, as long as I am your superior at this lab, your time is my time. We are locked in a death struggle here against one of the most cunning, baffling, powerful bacteria man has ever encountered. Think Attila and Genghis Khan and Hitler all rolled into one. If you have free time on your hands, I strongly suggest it be used to further your work on the antibiotic you and your staff are developing.”

  Lou felt a rush of heat across the back of his neck.

  “But—” he began to protest.

  Banks, her eyes riveted on his, stopped him with a minute shake of her head, and Lou pulled back.

  Was Scupman protecting something … or someone? he wondered. He had expected the bacteria sycophant to behave eccentrically, but by shutting the door on a concerned physician, as well as on his own second-in-command, he had taken a step over the line between eccentric and rude. Lou had already decided that because of Scupman’s behavior, he was going to help Humphrey set up his lab no matter what. Still, one final try at getting some encouraging information from the division chief seemed called for.

  “Dr. Scupman, Dr. Banks, I know you’ve taken a look at the effect of bacteriophage on the Doomsday Germ, but what do you think about the proposal of using three different types of phage administered simultaneously—one directed at the Gram positive, and two directed at the Gram negative?”

  Scupman pushed himself away from the table and stood.

  “Scientists have invented a dozen different antibiotics in just the past few years, and we are on the doorstep of creating a dozen more. One of them, or a combination, will eventually be enough to bring the so-called Doomsday Germ to its knees, at least until the tyrant figures out what’s going on and mutates. We have known about bacteriophage for close to a century. There is a reason why they haven’t caught on as an antibacterial agent.”

  Lou was disappointed when Banks also stood. He had no choice but to join them.

  “Three different forms of phage is an interesting approach,” she said. “It would be like forest rangers setting a fire to fight a fire. It seems a long shot, but maybe the proposal does have some merit. Sam?”

  “The only thing I’m willing to concede,” Scupman said, “and I’m sorry to have to say this so bluntly, is that I think it’s best if you light a candle for your friend. We only have the time and manpower to follow very promising lines of research. Bacteriophage therapy is most certainly not one of those. Now, as I said, I have another appointment, and Dr. Banks has some promising work I want to take a look at before that. Thank you for your effort, Dr. Welcome. I appreciate your sad situation. Now, if you’ll excuse us.”

  Lou felt stunned. Either Scupman did not like his opinions being questioned, or he hated the notion of this super-germ being vulnerable in any way. It was as though he were rooting against a cure—hoping that super-germ never stumbles onto any kryptonite.

  Scupman pointedly moved to the desk at the far end of the conference room, made a phone call, and began talking more loudly than he probably had to.

  Banks gave Lou a sympathetic look and said softly enough so only he could hear, “I’m sorry for Sam’s behavior. He isn’t a bad guy, he just has very strong opinions, and as you seem to suspect, he’s under a huge amount of pressure.”

  “But you don’t agree with his opinions?” Lou asked, gathering his papers.

  Banks pursed her lips, giving her next words careful consideration.

  “I think there is something to what you’re proposing,” she replied. “But Sam isn’t wrong. It would probably take a long time to perfect, and more manpower than we have.”

  Or, Lou thought, the most brilliant microbiologist nobody has ever heard of.

  “I don’t have many options left,” Lou said. “Thanks, Dr. Banks. You gave me something important.”

  “And what is that?”

  “You gave me a bit of hope.”

  Banks returned a weak smile. Hope, her expression said, would not be enough.

  “Please call me Vicki. Listen, Lou, I’m really very sorry about your friend. I deeply hope he makes it.”

  “You and a lot of other people,” he said. “Thanks again for caring.”

  Scupman was still on the phone, and Lou wondered in passing if there was anyone on the other end of the line. He had taken a step toward the door when Vicki blurted out, “Would you like to go out and get a drink sometime? I hate to think you’re by yourself in a city that’s not your own, dealing with what’s on your plate.”

  “Thanks. I’m going to spend some more time reading about bacteriophage,” he said, thinking about the work that awaited him in Subbasement Two of Arbor General. Then, quickly, before she could acknowledge that turning her down was okay, he added, “Oh, hell, I’d love to. What works for you?”

  “How about the day after tomorrow?” she said. “We have budget meetings this week. You can meet me outside this building at five. It’s a few blocks’ walk to a little place I like. The Blue Ox—long on atmosphere, a little short on delicacies.”

  “How’d you know?” Lou asked.

  “Know what?”

  “How’d you know I needed a friend?”

  Vicki’s smile was radiant. “I’ve always had an overabundance of woman’s intuition,” she said.

  CHAPTER 28

  Mark my words: August 14, 1935, is a date Americans will come to rue.

  —LANCASTER R. HILL, PERSONAL COMMUNICATION TO JAMES KINCHLEY, ESQ., MARCH 1936

  All the mice were dead.

  Twenty cages, each occupied by one mouse of a genetically pure strain, were lined up along a bench in Kazimi’s laboratory. The Janus germ was not an airborne contaminant, but as a precaution, powerful HEPA filters droned on, continuously purifying the air. To prevent accidental spread, the lab contained a rack of level-B hazmat suits and a chemical shower for the decontamination process.

  A few hours before, the mice had been bustling—scurrying about, squeaking, sniffing, and standing on their hind legs as they tried to scale the plastic enclosures. Two hours after Kazimi injected their peritoneal cavities with the Janus bacteria, they grew listless. An hour after that, they were all dead.

  Kazimi took one mouse from its cage and carried it respectfully to the table where he performed his autopsies.

  Using a scalpel, he made a careful incision from belly to neck, and pried apart the skin and sternum with stainless-steel spreaders. The results were the same as those from his earlier trials. The mouse’s insides were gone, simply liquefied. Kazimi sliced open five more mice. Their organs had melted away in a similar fashion. In a few of the dead animals, he could actually see the liquefied rot through a portal the bacteria had eaten in the peritoneum.

  He had expected a fast reaction time as he had innoculated the mice with an unusually heavy dose of the germ, but the speed of morbidity, then mortality, was truly chilling.

  The lab, as promised, was perfectly equipped for Kazimi’s work. He might still want to collaborate with the developer of the Janus strain, as Bacon had offered, but for now his preference was to work alone. It had taken three days to grow this latest preparation of bacteria, which was designed to protect the mice against Janus. The approach was a form of competitive interference, using a genetically “neutered,” non-toxic bacteria derived from the Doomsday Germ.

  The idea was to flood the mice’s bodies with the harmless, modified bacte
ria, which would compete with the virulent form for binding sites. At the same time, the competing bacteria would stimulate the immune system to make antibodies against both itself and Janus.

  Only all the mice were dead.

  Kazimi packed the tiny liquefied carcasses in airtight cartons, and shuffled off to the chemical shower. He was feeling more and more like a man trying to type with no hands. Once in street clothes, he went to the vast lounge and slumped onto a leather easy chair, cognizant that he was almost certainly on camera—probably more than one. He’d been working with little sleep, and exhaustion was taking a toll. The damp chill of Red Cliff was seeping into his bones and causing him to shiver. Someone had built a blaze in the massive fieldstone fireplace, but the warmth did not reach across to where he sat. He considered moving closer, but his legs were rubber, and his back ached. Instead, he grabbed a throw from a nearby sofa, wrapped it around himself, and closed his eyes, searching for sleep that just would not come.

  From the reports he was receiving, the Janus strain was becoming even more deadly. The bacteria, which before required a deep wound to take root, could now enter the bodies of its victims through even a tiny cut. Epidemiologically, the Doomsday Germ was spreading with increasing speed, and in some hospitals had already breached containment protocols. Before long, Kazimi feared, the devastation could become unparalleled.

  Chilled as much by the terrifying prospects of a pandemic as he was by the stone walls, Kazimi knew that the persistent failure of his research made it even more critical that he escape. If One Hundred Neighbors did not carry out their threat to kill every person he held dear, Janus might eventually do the job for them. He had to be fearless. He had to warn the people in Washington of the looming crisis. The time for his secret lab was over. He had given it his best shot, and he was failing.

  It was nearing Asr—midafternoon prayers. As he was doing more and more, Kazimi was staying in the lab to pray. He forced himself to his feet, crossed to the massive windows, gazed down the nearly sheer cliff at the craggy shoreline, and reviewed what he had learned about Red Cliff. The wing housing the lab and the great room was attached to the massive main structure by the winding corridor that was constantly guarded. As far as Kazimi could tell, there was no other way in or out.