Executive Orders (1996)

by Clancy, Tom - Jack Ryan 07

  Then a telex machine started chattering. An Army Spec-5 walked over to it.

  “FLASH-traffic from State, from Ambassador Williams in India,” he announced.

  “Let’s see.” Ryan walked over, too. It wasn’t good news. Neither was the next one from Taipei.

  THE PHYSICIANS WERE working four-hour shifts. For every young resident there was a senior staff member. They were largely doing nurses’ work, and though they mainly were doing it well, they also knew that it wouldn’t matter all that much.

  It was Cathy’s first time in a space suit. She’d operated on thirty or so AIDS patients for eye complications of their disease, but that hadn’t been terribly difficult. You used regular gloves, and the only real worry was the number of hands allowed in the surgical field, and for ophthalmic surgery that wasn’t nearly the problem it was for thoracic. You went a little slower, were a little more careful in your movements, but that was it, really. Not now. Now she was in a big, thick plastic bag, wearing a helmet whose clear faceplate often fogged from her breath, looking at patients who were going to die despite the attention of professor-rank physicians.

  But they had to try anyway. She was looking down at the local Index Case, the Winnebago dealer whose wife was in the next room. There were two IVs running, one of fluids and electrolytes and morphine, the other of whole blood, both held rigidly in place so as not to damage the steel-vein interface. The only thing they could do was to support. It had once been thought that interferon might help, but that hadn’t worked. Antibiotics didn’t touch viral diseases, a fact which was not widely appreciated. There was nothing else, though a hundred people were now examining options in their labs. No one had ever taken the time with Ebola. CDC, the Army, and a few other labs across the world had done some work, but there hadn’t been the effort devoted to other diseases that raged through “civilized” countries. In America and Europe research priority went to diseases that killed many, or which attracted a lot of political attention, because the allocation of government research money was a political act, and for private funding it tracked with what rich or prominent person had been unlucky. Myasthenia gravis had killed Aristotle Onassis, and the resultant funding, while not fast enough to help the shipping magnate, had made significant progress almost overnight—largely luck, Dr. Ryan knew, but true even so, and a blessing to other victims. The same principle extended to oncology, where the funding for breast cancer, which attacked roughly one woman in ten, far outstripped research in prostate cancer, which afflicted roughly half of the male population. A huge amount went into childhood cancers, which were statistically quite rare—only twelve cases a year per hundred thousand kids—but what was more valuable than a child? Nobody objected to that; certainly she did not. It came down to minuscule funding for Ebola and other tropical diseases because they didn’t have a high profile in the countries which spent the money. That would change now, but not soon enough for the patients filling up the hospital.

  The patient started gagging and turned to his right. Cathy grabbed the plastic trash can—emesis trays were too small and tended to spill—and held it for him. Bile and blood, she saw. Black blood. Dead blood. Blood full of the little crystalline “bricks” of Ebola virus. When he was done, she gave him a water container, the sort with a straw that gave a little bit of water from a squeeze. Just enough to wet his mouth.

  “Thanks,” the patient groaned. His skin was pale except in the places where it was blotched from subcutaneous bleeding. Petechiae. Must be Latin, Cathy thought. A dead language’s word to designate the sign of approaching death. He looked at her, and he knew. He had to know. The pain was fighting up against the border of the current morphine dosage, reaching his consciousness in waves, like the battering of a tide against a seawall.

  “How am I doing?” he asked.

  “Well, you’re pretty sick,” Cathy told him. “But you’re fighting back very well. If you can hang in there long enough, your immune system can beat this thing down, but you have to hang tough for us.” And that wasn’t quite a lie.

  “I don’t know you. You a nurse?”

  “No, I’m actually a professor.” She smiled at him through the plastic shield.

  “Be careful,” he told her. “You really don’t want this. Trust me.” He even managed to smile back in the way that severely afflicted patients did. It nearly tore Cathy’s heart from her chest.

  “We’re being careful. Sorry about the suit.” She so needed to touch the man, to show that she really did care, and you couldn’t do that through rubber and plastic, damn it!

  “Hurts real bad, Doc.”

  “Lie back. Sleep as much as you can. Let me adjust the morphine for you.” She walked to the other side of the bed to increase the drip, waiting a few minutes before his eyes closed. Then she walked back to the bucket and sprayed it with a harsh chemical disinfectant. The container was already soaked in it, to the point that the chemical had impregnated the plastic, and anything alive that fell into it would quickly be extinguished. Spraying the thirty or so cc’s that he’d brought up was probably unnecessary, but there was no such thing as too many precautions now. A nurse came in and handed over the printout with the newest blood work. The patient’s liver function was nearly off the scale, automatically highlighted by asterisks as though she wouldn’t have noticed. Ebola had a nasty affinity for that organ. Other chemical indicators confirmed the start of systemic necrosis. The internal organs had started to die, the tissues to rot, eaten by the tiny virus strands. It was theoretically possible that his immune system could still summon its energy and launch a counterattack, but that was only theory, one chance in several hundred. Some patients did fight this off. It was in the literature which she and her colleagues had studied over the last twelve hours, and in that case, they were already speculating, if they could isolate the antibodies, they might have something they could use therapeutically.

  If—maybe—might—could—possibly.

  That wasn’t medicine as she knew it. Certainly it wasn’t the clean, antiseptic medicine she practiced at Wilmer, fixing eyes, restoring and perfecting sight. She thought again about her decision to enter ophthalmology. One of her professors had pressed her hard to look at oncology. She had the brains, she had the curiosity, she had the gift for connecting things, he’d told her. But looking down at this sleeping, dying patient, she knew that, no, she didn’t have the heart to do this every day. Not to lose so many. So did that make her a failure? Cathy Ryan asked herself. With this patient, she had to admit, yes, it did.

  “DAMN,” CHAVEZ SAID. “It’s like Colombia.”

  “Or Vietnam,” Clark agreed on being greeted with the tropical heat. There was an embassy official, and a representative of the Zaire government. The latter wore a uniform and saluted the arriving “officers,” which courtesy John returned.

  “This way, if you please, Colonel.” The helicopter, it turned out, was French, and the service was excellent. America had dropped a lot of money into this country. It was payback time now.

  Clark looked down. Triple-canopy jungle. He’d seen that before, in more than one country. In his youth, he’d been underneath, looking for enemies, and with enemies looking for him—little men in black pajamas or khaki uniforms, carrying AK-47s, people who wanted to take his life. Now he appreciated the fact that there was something down there even smaller, that was not carrying any weapon, and was targeted not merely on him, but at the heart of his country. It seemed so damned unreal. John Clark was a creature of his country. He’d been wounded in combat operations and other, more personal events, and every time was restored quickly to full health. There had been that one time, when he’d rescued an A-6 pilot up some river in North Vietnam whose name he couldn’t remember anymore. He’d gotten cut, and the polluted river had infected him, and that had been fairly unpleasant, but drugs and time had fixed it. He’d come away from all the experiences with a deeply held belief that his country produced doctors who could fix just about anything—not old age, and not ca
ncer, yet, but they were working on it, and in due course they’d win their battles as he’d won most of his. That was an illusion. He had to admit that now. As he and his country had lost their struggle in a jungle like this one, a thousand feet below the racing helicopter, so now the jungle was reaching out, somehow. No. He shook that off. The jungle wasn’t reaching out. People had done that.

  THE FOUR RO/RO ships formed up six hundred miles north-northwest of Diego Garcia. They were in a box formation, spaced a thousand yards abeam and a thousand yards fore and aft. The destroyer O’Bannon took position five thousand yards dead ahead. Kidd was ten thousand yards northeast of the ASW ship, with Anzio twenty miles in advance of the rest. The replenishment group with its two frigates was westbound and would join up around sunset.

  It was a good opportunity for an exercise. Six P-3C Orion aircraft were based at Diego Garcia—the number had once been larger—and one of them was patrolling ahead of the mini-convoy, dropping sonobuoys, a complex undertaking for so rapidly moving a formation, and listening for possible submarines. Another Orion was well in advance, tracking the Indian navy’s two-carrier battle group from their radar emissions while staying well out of detection range. The lead Orion was not armed with anything but anti-sub weapons at the moment, and its mission was routine surveillance.

  “YES, MR. PRESIDENT,” the J-3 said. Why aren’t you asleep, Jack? he couldn’t say.

  “Robby, did you see this thing from Ambassador Williams?”

  “It got my attention,” Admiral Jackson confirmed.

  David Williams had taken his time drafting the communique. That had annoyed people at State, and caused two requests for his report which he had ignored. The former governor was drawing on all of his political savvy to consider the words the Prime Minister had chosen, her tone, her body language—the look in her eyes most of all. There was no substitute for that. Dave Williams had learned that lesson more than once. One thing he hadn’t learned was diplomatic verbiage. His report was straight-from-the-shoulder, and his conclusion was that India was up to something. He further noted that the Ebola crisis in America had not come up. Not a word of sympathy. That, he wrote, was probably a mistake in one sense, and a very deliberate act in another. India should have cared about it, or should have expressed concern even if she didn’t. Instead it had been ignored. If asked, the Prime Minister would have said that she hadn’t yet been informed, but that would be a lie, Williams added. In the age of CNN, things like that never went unnoticed. Instead, she had harped on being bullied by America, reminded him of the “attack” on her navy not once but twice, and then extended the remark into calling it an “unfriendly act,” a phrase used in diplomacy right before a hand descended toward the holster. He concluded that India’s naval exercise was not a mistake in either timing or location. The message he’d received was: In your face!

  “So, what do you think, Rob?”

  “I think Ambassador Williams is one shrewd son of a bitch, sir. The only thing he didn’t say is something he didn’t know: we don’t have a carrier there. Now, the Indians haven’t been tracking us in any way, but it’s public knowledge that Ike is heading toward China, and if their intel officers are halfway competent, they definitely do know. Then, shazam, they put out to sea. And now, we get this from the Ambassador. Sir—”

  “Stow that, Robby,” Ryan told him. “You’ve said that enough for one day.”

  “Fine. Jack, we have every reason to believe that China and India were working together before. So what happens now? China stages an incident. It gets nastier. We move a carrier. The Indians put to sea. Their fleet is on a direct line between Diego Garcia and the Persian Gulf. The Persian Gulf heats up.”

  “And we have a plague,” Ryan added. He leaned forward on the cheap desk in Signals. He couldn’t sleep, but that didn’t mean he was fully awake, either. “Coincidences?”

  “Maybe. Maybe the Indian Prime Minister is pissed at us because we rattled their cage a while back. Maybe she just wants to show us that we can’t push her around. Maybe it’s petty bullshit, Mr. President. But maybe it ain’t.”

  “Options?”

  “We have a surface-action group in the Eastern Med, two Aegis cruisers, a Burke-class ’can, and three figs. The Med’s quiet. I suggest that we consider moving that group through Suez to back up the Anzio group. I further suggest that we consider moving a carrier from WestLant to the Med. That will take a while, Jack. It’s six thousand miles; even with a speed of advance of twenty-five knots that’s almost nine days just to get a carrier close. We have more than a third of the world without a carrier handy, and the part that isn’t covered is starting to make me nervous. If we have to do something, Jack, I’m not sure we can.”

  “HELLO, SISTER,” CLARK said, taking her hand gently. He hadn’t seen a nun in quite a few years.

  “Welcome, Colonel Clark. Major.” She nodded to Chavez.

  “Afternoon, ma’am.”

  “What brings you to our hospital?” Sister Mary Charles’s English was excellent, almost as though she taught it, with a Belgian accent that sounded just like French to the two Americans.

  “Sister, we’re here to ask about the death of one of your colleagues, Sister Jean Baptiste,” Clark told her.

  “I see.” She waved to the chairs. “Please sit down.”

  “Thank you, Sister,” Clark said politely.

  “You are Catholic?” she asked. It was important to her.

  “Yes, ma’am, we both are.” Chavez nodded agreement with the “colonel.”

  “Your education?”

  “Actually all Catholic schools for me,” Clark said, indulging her. “Grade school was the School Sisters of Notre Dame, and Jesuits after that.”

  “Ah.” She smiled, pleased at the news. “I have heard of the sickness that has broken out in your country. This is very sad. And so you are here to ask about poor Benedict Mkusa, Sister Jean, and Sister Maria Magdalena. But I fear we cannot be of much help to you.”

  “Why is that, Sister?”

  “Benedict died and his body was cremated on government order,” Sister Mary Charles explained. “Jean was taken ill, yes, but she left for Paris on a medical evacuation flight, you see, to visit the Pasteur Institute. The airplane crashed into the sea, however, and all were lost.”

  “All?” Clark asked.

  “Sister Maria Magdalena flew off also, and Dr. Moudi, of course.”

  “Who was he?” John inquired next.

  “He was part of the World Health Organization mission to this area. Some of his colleagues are in the next building.” She pointed.

  “Moudi, you said, ma’am?” Chavez asked, taking his notes.

  “Yes.” She spelled it for him. “Mohammed Moudi. A good doctor,” she added. “It was very sad to lose them all.”

  “Mohammed Moudi, you said. Any idea where he was from?” It was Chavez again.

  “Iran—no, that’s just changed, hasn’t it? He was educated in Europe, a fine young physician, and very respectful of us.”

  “I see.” Clark adjusted himself in his seat. “Could we talk with his colleagues?”

  “I THINK THE President’s gone much too far,” the doctor said on TV. He had to be interviewed in a local affiliate since he was unable to drive from Connecticut to New York this morning.

  “Why is that, Bob?” the host asked. He’d come in from his home in New Jersey to the New York studio off Central Park West, just before the bridges and tunnels had been closed, and was sleeping in his office now. Understandably, he wasn’t very happy about it.

  “Ebola is a nasty one. There’s no doubt of that,” said the network’s medical correspondent. He was a physician who didn’t practice, though he spoke the language quite well. He mainly presented medical news, in the morning concentrating on the benefits of jogging and good diet. “But it’s never been here, and the reason is that the virus can’t survive here. However these people contracted it—and for the moment I will leave speculation on that aside—it can’
t spread very far. I’m afraid the President’s actions are precipitous.”

  “And unconstitutional,” the legal correspondent added. “There’s no doubt of that. The President has panicked, and that’s not good for the country in medical or legal terms.”

  “Thanks a bunch, fellas,” Ryan said, muting the set.

  “We have to work on this,” Arnie said.

  “How?”

  “You fight bad information with good information.”

  “Super, Arnie, except that proving I did the right thing means people have to die.”

  “We have a panic to prevent, Mr. President.”

  So far that hadn’t happened, which was remarkable. Timing had helped. The news had mainly hit people in the evening. For the most part, they’d gone home, they had enough food in the pantry to see them through a few days, and the news had shocked enough that there had not been a nationwide raid on supermarkets. Those things would change today, however. In a few hours people would be protesting. The news media would cover that, and some sort of public opinion would form. Arnie was right. He had to do something about it. But what?