The Washington Times, he saw, was just as irate but not in quite the same way. There would be a colossal internecine battle in the Washington press corps over this,
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something, the Times editorial observed, that the politicians would clearly watch with amusement.
Well, Ryan told himself, that ought to keep them off my back for a while.
Next, he opened the manila folder with the secret-tape borders on it. This document, he saw, was pretty old.
“Bastards,” POTUS whispered.
“They really did it to themselves this time,” Cathy said, reading her own paper.
“No,” SWORDSMAN replied. “China.”
IT WASN’T AN epidemic yet, because nobody knew about it. Doctors were already reacting in surprise to telephone calls. Excited, if not frantic, calls to answering services had already awakened over twenty of them across the country. Bloody vomit and diarrhea were reported in every case, but only one to a customer, and there were various medical problems that could explain that. Bleeding ulcers, for example, and many of the calls came from busi-nesspeople for whom stress came with the tie and white shirt. Most were told to drive to the nearest hospital’s emergency room, and in nearly all cases the doctor got dressed to meet his or her patient there, or to have a trusted associate do so. Some were instructed to be at the office first thing, usually between eight and nine in the morning, to be the first patient of the day and thus not interfere with the daily schedule.
GUS LORENZ HADN’T felt like being in his office alone, and had called in a few senior staff members to join him at his computer. They noted that his pipe was lit when they came in. One of them might have objected–it was contrary to federal regulations–but she stopped short, looking at the image on the screen.
“Where’s this one from?” the epidemiologist asked.
“Chicago.”
“Our Chicago?”
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PIERRE ALEXANDRE ARRIVED at his office on the eleventh floor of the Ross Building just before eight. His morning routine began with checking his fax machine. Attending physicians with AIDS cases regularly sent him patient information that way. It allowed him to monitor a large number of patients, both to advise treatment options and to increase his own knowledge base. There was only one fax this morning, and it was relatively good news. Merck had just fielded a new drug which the PDA was fast-tracking into clinical trials, and a friend of his at Penn State was reporting some interesting results. That’s when his phone rang.
“Dr. Alexandre.”
“This is the ER, sir. Could you come down here? I got a patient here, Caucasian male, thirty-seven. High fever, internal bleeding. I don’t know what this is–I mean,” the resident said, “I mean, I know what it looks like, but–”
“Give me five minutes.”
“Yes, sir,” she acknowledged.
The internist/virologist/molecular biologist donned his starched lab coat, buttoned it, and headed down toward the emergency room, which was in a separate building on the sprawling Hopkins campus. Even in the military, he’d dressed the same way. The Doctor Look, he called it. Stethoscope in the right-side pocket. Name embroidered onto the left side. A calm expression on his face as he walked into the largely idle ER. Nighttime was the busy period here. There she was, cute as a button . . . putting on a surgical mask, he saw. What could be all that wrong this early on a spring day?
“Good morning, Doctor,” he said, in his most charming Creole accent. “What seems to be the problem?” She handed him the chart and started talking while he read.
“His wife brought him in. High fever, some disorien-tation, BP is low, probable internal bleed, bloody vomit and stool. And there are some marks on his face,” she reported. “And I’m not sure enough to say.”
“Okay, let’s take a look.” She sounded like a promising young doc, Alexandre thought pleasantly. She knew what she didn’t know, and she’d called for consultation . . . but why not one of the internal-medicine guys? the
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former colonel asked himself, taking another look at her face. He put on mask and gloves and walked past the isolation curtain.
“Good morning, I’m Dr. Alexandre,” he said to the patient. The man’s eyes were listless, but it was the marks on his cheeks that made Alexandre’s breath stop. It was George Westphal’s face, come back from more than a decade in Alex’s past.
“How did he get here?”
“His personal physician told his wife to drive him in. He has privileges at Hopkins.”
“What’s he do? News photographer? Diplomat? Something to do with traveling?”
The resident shook her head. “He sells Winnebagos, RVs and like that, dealership over on Pulaski Highway.”
Alexandre looked around the area. There were a medical student and two nurses, in addition to the resident who was running the case. All gloved, all masked. Good. She was smart, and now Alex knew why she was scared.
“Blood?”
“Already taken, Doctor. Doing the cross-match now, and specimens for analysis in your lab.”
The professor nodded. “Good. Admit him right now. My unit. I need a container for the tubes. Be careful with all the sharps.” A nurse went off to get the things.
“Professor, this looks like–I mean, it can’t be, but–”
“It can’t be,” he agreed. “But it does look that way. Those are petechiae, right out of the book. So we’ll treat it like it is for the moment, okay?” The nurse returned with the proper containers. Alexandre took the extra blood specimens. “As soon as you send him upstairs, everybody strip, everybody scrub. There’s not that much danger involved, as long as you take the proper precautions. Is his wife around?”
“Yes, Doctor, out in the waiting room.”
“Have somebody bring her up to my office. I have to ask her some things. Questions?” There were none. “Then let’s get moving.”
Dr. Alexandre visually checked the plastic container for the blood and tucked it into the left-side pocket of his lab coat, after determining that it was properly sealed. The
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calm Doctor’s Look was gone, as he walked to the elevator. Looking at the burnished steel of the automatic doors, he told himself that, no, this wasn’t possible., Maybe something else. But what? Leukemia had some of the same symptoms, and as dreaded as that diagnosis was, it was preferable to what it looked like to him. The doors opened, and he headed off to his lab.
“Morning, Janet,” he said, walking into the hot lab.
“Alex,” replied Janet Clemenger, a Ph.D. molecular biologist.
He took the plastic box from his pocket. “I need this done in a hurry. Like, immediately.”
“What is it?” She wasn’t often told to stop everything she was doing, especially at the start of a working day.
“Looks like hemorrhagic fever. Treat it as level . . . four.”
Her eyes went a little wide. “Here?” People were asking the same question all over America, but none of them knew it yet.
“They should be bringing the patient up now. I have to talk to his wife.”
She took the container and set it gently on the work-table. “The usual antibody tests?”
“Yes, and please be careful with it, Janet.”
“Always,” she assured him. Like Alexandre, she worked a lot of AIDS experiments.
Alexandre next went to his office to call Dave James.
“How certain are you?” the dean asked two minutes later.
“Dave, it’s just a heads-up for now, but–I’ve seen it before. Just like it was with George Westphal. I have Jan Clemenger working on it right now. Until further notice, I think we have to take this one seriously. If the lab results are what I expect, I get on the phone to Gus and we declare a for-real alert.”
“Well, Ralph gets back from London day after tomorrow. It’s your department for the moment, Alex. Keep me posted.”
“Roger,” the former soldier said. Then it was time to speak to the patient’s wife.
In the emergency room, orderlies were scrubbing the
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floor where the bed had been, overseen by the ER charge nurse. Overhead they could hear the distinctively powerful sound of a Sikorsky helicopter. The First Lady was coming to work.
THE COURIER ARRIVED at CDC, carrying his “hatbox,” and handed it over to one of Lorenz’s lab technicians. From there everything was fast-tracked. The antibody tests were already set up on the lab benches, and under exquisitely precise handling precautions, a drop of blood was dipped into a small glass tube. The liquid in the tube changed color almost instantly.
“It’s Ebola, Doctor,” the technician reported. In another room a sample was being set up for the scanning electron microscope. Lorenz walked there, his legs feeling tired for so early in the morning. The instrument was already switched on. It was just a matter of getting things aimed properly before the images appeared on the TV display.