Finally, at the time of the cease-fire in the Middle East in 1970, Gamal had written to his father. There had been no answer. But now, only four days ago, he had returned home to find a notice that a registered letter was waiting for him at the main post office.
When he saw the postmark on the letter, he tore it open with great anticipation. The only message it contained was an official notification of his father’s death. It was too late.
And so now for three days Gamal sat in loneliness and mourned and said to himself the words he should have said to his father long before.
It was warm in his room. But should he be so hot? He rose and turned on the light; the effort was overwhelming. There did not seem to be enough air. He reached to open the window. His hand and arm moved, but he could not feel where they hung in space. The lack of air was suffocating him. He sat back in his chair and tried to think, to take inventory of all he felt and of all his parts.
His left thumb was numb, and the numbness was spreading. Now the index finger; then the middle finger and part of his palm. As the lack of feeling overcame the ring finger and then the little finger, the whole of his left arm became dead. His brain told the right arm to move and lift the left—the volition was there, the parts were there, but the integration was lost. He looked across the room at the phone. But even as he looked, his vision blurred. The heavy pain in his chest, the feeling of suffocation, the will to move, the need to call for help, were all clearly imprinted in his mind. He could not move. He fought for breath. He thought it was too dark—perhaps the light bulb was failing. Darkness was enveloping him, separating him from reality, devouring him.
He experienced two final sensations—he tasted the blood welling up in his throat; he saw the red spots blossom on his feelingless hands. Before Death called, he had had one last fleeting chance to see his father—not the man, but his handiwork. But he never knew.
And so death came. To one. To many. Wherever it visited, it cast the shadow of fear on every life.
At first, it was fear with reason; but with time, fear would overcome reason—then there would be panic.
There is no greater catalyst for an epidemic than panic. For in the sudden, unreasoned and hysterical fear when caution and judgment are lost, disease spreads like wildfire.
In Washington, Chicago, Los Angeles, and all the other cities, people watched and waited. They watched persons known and unknown fall ill; a few lived to reach the hospital, but none returned. They waited in fear to see who would be next. They waited for an official word—from city and state health departments, from the federal government. None came. With this silence their fear grew; and then they began to see. They came step by step closer to panic.
None were spared. Men of wealth died beside the poor; strong men beside the weak; white men beside the black and yellow; Catholic beside Jew and Protestant. All fell before this enemy they could not see—an enemy they did not know and, therefore, could not fight. They could just lose. All of them.
eight
The material recovered from the post offices arrived at a special holding area at Andrews Air Force Base. From there, it was transported to Detrick by helicopter and then by van to an area reserved for highly virulent and communicable agents. The packages were taken from the vans by automatic conveyor belts that delivered them directly to laboratories built for working with only the most hazardous materials.
Fort Detrick was famous—or infamous—for the best facilities in the world for working with highly virulent and contagious microorganisms. Many of its laboratories were designed with mazes of barriers to allow men, animals, air, water, equipment and waste materials to move in and out without contaminating the immediate environment or the surrounding countryside. The buildings and the laboratories within them were subdivided into areas of different degrees of contamination. The atmosphere in these areas was carefully controlled; a predetermined number of air changes occurred per minute, and a system of graded negative pressure controlled the movement of air—always from less to more contaminated areas. Passage of personnel from one area to another was interrupted by ultraviolet air locks, change rooms and disinfectant showers. Everything that entered or left an area or a laboratory was carefully monitored, and all waste material was sterilized before it was allowed to mix with the general sewage system. Even the air exhaust vents led through a carefully planned incineration system that could kill any living cell. Then the sterilized air was finally blown into the atmosphere through a series of filters in tall smokestacks that rose hundreds of feet above the buildings that housed the laboratories.
The basic feature of each laboratory was safety—safety for the personnel who worked in the laboratories and for everyone outside. Most of the laboratories employed glove boxes—airtight enclosures fitted with rubber gloves and a system of pass boxes and sterilizations devices. These completely separated man from microbe, yet allowed the former to work with and manipulate the latter.
The packages recovered from the post offices would be opened in one of these laboratories.
Although Max Schwartz had great respect for his own laboratory technique and equal disdain for the dangers of working with virulent organisms, he had raised no objections to the precautions engineered for this particular microbe.
A cursory examination revealed plain paper wrappings, cardboard cartons, and open flasks.
“Well, Alex, at least we know how it’s being done.” Dr. Schwartz frowned and rubbed his chin. “Each carton contained a flask with the culture reconstituted in liquid broth. The flasks were sealed with a special type of polystyrene which obviously dissolved in the time it took the packages to reach their destinations. That whitish material around the mouths of the flasks is all that is left of the seals. When the seals were gone, the cultures spilled. Once free, the number of organisms in the air and on any contaminated object increased to the level necessary for spread, making every piece of mail and every person entering and leaving those forty post offices a vector. Fiendishly clever!”
Samples of material were immediately sent to special units being set up by Army Intelligence and the FBI in another part of the building. These would be carefully examined for clues that might lead to the origin of the fatal pieces of mail.
Max Schwartz, Alex Kahn and Sam Ross went to work immediately with the help of six bacteriologists imported from Fort Meade and the Walter Reed Army Institute for Research. Although each had had some experience with glove boxes, they all found themselves clumsy because of the loss of the delicate sense of touch in their fingertips; but the gloves meant safety.
They made smears of everything. Fixed smears, where the organism was killed by the fixative, were examined with a variety of dyes to help define the size and shape of the bacteria and the presence or absence of characteristic intracellular structures; any or all of these factors might help them identify the microbe. They examined living organisms with special dyes that colored the cells without killing them. Many types of media were inoculated, especially specific inhibitory media that contained substances to prevent the growth of certain groups of bacteria and enhance the growth of others. Tests for biochemical, nutritional, metabolic and serologic characteristics were instituted. A variety of experimental animals were inoculated from the flasks themselves, as well as from the material that had been prepared by Max Schwartz.
“Goddamn it, Alex, what do you want to use monkeys for?” the professor barked. “They’re hard to handle, expensive, and sensitive as hell. If you look at them sideways, their temperature goes up to 106˚. We need an animal that’s small and can be used with ease in these damned glove boxes.”
“Simply because the monkey is the experimental animal closest to man, Dr. Schwartz. Why waste a lot of time and effort doing studies in the guinea pig, for example, only to find its disease isn’t related to the disease in man? We don’t have to use monkeys, but we should use a similar primate.”
“Listen, Doc, people were doing experiments with the guinea pig, rat, mouse,
and rabbit and making damned significant contributions before you were even a glint in your father’s eye. Trouble with you young hotshots is that if it isn’t fancy-pancy or full of statistics, it isn’t worth anything. Well, let me tell you something—a lot of us old-timers did pretty good work before you were around with your high and mighty ideas. Do you think we can work with anaerobes as easily in a monkey as we can in a guinea pig?”
Alex knew the time had come—as it did sooner or later to each of “Max’s boys”—when he had to stand up and be counted for what he himself had done and said, not just another roll of memory tape programmed by the “boss.” The time when the mouth tired of saying, “Yes, Dr. Schwartz, you’re absolutely right.” The time when the mind started functioning independently, free of constant worry about “What would the ‘boss’ do?” or “What will the ‘chief’ say?” Well, screw Max’s job and the Chair and Boston! Alex Kahn had come of age.
“Look, Dr. Schwartz”—Alex was trying to be firm, yet polite—“your own studies in guinea pigs and rabbits were the foundation of what we know about septic shock, but they were only a foundation. Shock in these animals is far different from what it is in man. The target organs are different, and the reactions are different. Our present concepts of septic shock come from studies of experimental shock in monkeys and clinical shock in man. That doesn’t mean your earlier studies were any less valuable.” He tried to make his point with a minimum of damage to the older man’s ego. “There’s no doubt in my mind that the monkey is the best experimental animal in which to study human infection. As long as we’re here at Detrick, which has the best monkey facilities in the country, I think we should use them—even if they’re hard to work with.”
“I think he’s right, Max.” Alex was grateful for Sam Ross’s interruption. “If any place is set up to work with monkeys, this is it. If we use another animal and the disease turns out to be different in it than it is in man, we’re going to waste an awful lot of time.”
“Use whatever damned animals you like, but don’t come crying to me when you can’t get good anaerobic conditions in those little bastards.” His angry glare at Alex was tempered with puzzlement about his protégé’s sudden independent stand.
“I don’t think it’s an anaerobe, Dr. Schwartz,” Alex continued. “There’s no evidence for the presence of any bacteria other than the staph we’ve recovered. I think we’re dealing with an unusual species of 80/81.”
“Oh, you do, do you?” Few persons Alex knew were Max Schwartz’s equal in sarcasm. “And what crystal ball tells you that? I say we’re dealing with a mixed infection. When you’ve seen as much infection as I have—and I doubt you ever will—then you can come out with a dogmatic statement like that. I may be dogmatic, but at least I’ve got some thirty-odd years of experience to back me up. What have you got, five or six? You’re still wet behind the ears, sonny.”
His voice became softer. “Come on, Alex, you know better than to spar with the old man. You know there’s no substitute for experience. Tell you what, we’ll use monkeys; but let’s use guinea pigs to set up the anaerobic studies. OK?”
Alex looked at Sam Ross out of the corner of his eye. The imperceptible nod told him he’d made his point and to quit while he was ahead.
“That sounds reasonable.” Max Schwartz’s smile assured him that Ross had given him good advice. But as he continued working, he wondered if he had blown his chance to be Max’s heir.
They had worked for several hours without stopping.
The incubator was filled with cotton-plugged flasks and rack after rack of stoppered test tubes. The anaerobic jars were sealed and in a separate incubator. Samples had been incubated at room temperature and at 42˚ C as well as in the standard 37˚ C walk-in chests that characterized most large bacteriology laboratories. Monkeys and guinea pigs had been inoculated, and specimens had been prepared for examination with the electron microscope. Special samples were being flown to the Communicable Disease Center outside of Atlanta for gas chromatography studies; certain bacteria could be identified simply by the patterns of curves obtained with this instrument. Other specimens were being rushed to Ohio State University in Columbus for examination with the scanning electron microscope, a newer invention that allowed rapid visualization of populations of intact bacterial cells with three-dimensional perspective. Any piece of information that would help characterize the organism would be helpful.
Max Schwartz lit a cigarette and pushed his chair back. “Well, that’s it. We’ll just have to wait for the bastards to grow. What do we have up to this point? Sam, how about you?”
“No more than you had yesterday, Max. It looks like staph. It’s so typical, I’m even willing to stick my neck out and agree with Alex that there’s only one organism here. I’m afraid we’re just going to have to wait for the cultures.”
“Well, Alex, any new visions?” This time Max Schwartz’s tone and smile were good-natured.
“Same here. This bug looks more like staph than staph does. If it isn’t, it sure as hell is its twin brother.”
Their conversation was interrupted by Marion Slade’s urgent words over the intercom. “Excuse me, Max; General McKitridge would like to see all of you at once. It’s important.”
“Go ahead, you two,” Sam Ross said. “I’ll be along as soon as I’ve finished up here. Keeping up with you both is too much for a retired bacteriologist.”
As Alex dressed after discarding his scrub suit and showering, he noticed the general whispering to Max Schwartz in a corner of the room. His stern look and sudden return to strict military posture puzzled and worried Alex.
nine
The President was waiting at the head of the table where Max Schwartz had sat. Mark McKitridge and Warren Tracey were on his left, Roger Bergen and Marion Slade on his right.
It was as if they were seeing the picture on the covers of Time, Newsweek and a hundred other magazines and on the front pages of a hundred newspapers suddenly pasted onto a human body and sitting there, waiting for them.
The President rose as the two physicians entered. “Dr. Schwartz, good to see you again. And this must be Dr. Kahn; I’ve heard a lot of good things about you.” He nodded pleasantly to Sam Ross as he arrived somewhat out of breath.
“It’s good to see you again, too, Mr. President.” Max Schwartz reached for the outstretched hand. “I guess you’ve already met the others, and this is Dr. Ross. We dragged him out of retirement. In his younger days he was a pretty good diagnostic bacteriologist.”
General McKitridge looked puzzled. “I didn’t realize you had met Dr. Schwartz before, Mr. President.”
“Oh, yes, Mark. Dr. Schwartz was quite the adversary when we were discussing the termination of the biological warfare program a couple of years ago.” The President sat down and motioned to the others to do the same.
“Well, Mr. President, what has happened now is just what I tried to convince you then might happen.” Dr. Schwartz spoke gravely. “You will recall that I was against terminating the program, but I was outvoted. I felt that you made a mistake when you let political pressures force you to do something because it was expedient. It got the dissenters off your back and made you look good politically at a time when your image wasn’t particularly attractive. I like to think that you would not have made the same decision if there had been no outside pressure. I believe you made a very big mistake, Mr. President. In fact, I would venture to say that if you had told everybody to go to hell then, you might be a little less popular now, but a few thousand people might still be breathing.”
“To set the record straight, Dr. Schwartz, I signed the bill ending the program because I felt it was the correct thing to do. I’ll admit that public opinion was a factor, but its major role was to bring the matter to my attention. The threat that disease might be used someday as a weapon existed as long as all the major powers had biological warfare programs. And there was always the possibility of some tragic error. I honestly felt the program should be st
opped before any of these possibilities became a reality.”
“But why did you have to advertise your decision, Mr. President?” Dr. Schwartz asked.
“Because in some respects, Dr. Schwartz, the strategic importance of terminating our program would have been meaningless without the publicity it received. All the other powers would have continued their programs. At least this way several major powers have joined us in abolishing biological warfare as a potential future weapon. And by being first, we also gained favorable world opinion.”
“What you say may be true, Mr. President, but we also removed a powerful deterrent to our enemies. We had a great psychological weapon that could have been used at any time without harming anything more than a few ids and egos. And by giving it up—openly and unilaterally—we shifted the balance of power and invited someone to belt us in the mouth. Well, someone did. You made us first all right, Mr. President—the first major power to be the target of such a weapon.”
“You know, Max, the thing I just can’t figure out is how a physician whose vocation is to save lives and fight disease can be so set on a program that is its very antithesis.” Mark McKitridge shook his head to emphasize his inability to understand the paradox.
“Don’t give me that bullshit, Mark,” Max Schwartz countered. “I’ve spent more hours sitting up with sick patients than you’ve spent sleeping.” The general had hit a very sensitive chord. “Whether one is for or against a biological warfare program has nothing to do with the Hippocratic oath. And I’ve never been afraid to admit that I was in favor of a biological warfare program as a deterrent.”
The 11th Plague Page 9
