Authors: Richard Preston
Suddenly a blue, windowless, unmarked van turned off the road and pulled through the gas
station and parked next to them. The van parked in such a way that no one on the road or at the gas station could see what went on between the two vehicles. A man swung heavily out of the driver’s seat. It was Bill Volt. He walked over to the Army people, and they got out of their cars.
“I’ve got ’em right back here,” he said, and he threw open the side door of the van.
They saw seven black plastic garbage bags sitting on the floor of the van. They could see the outlines of limbs and heads in the bags.
C. J. said to himself, What
is
this?
Nancy gritted her teeth and silently pulled in a breath. She could see how the bags bulged in places, as if liquid had pooled inside them. She hoped it wasn’t blood. “What on earth is all of that?” she exclaimed.
“They died last night,” Volt said. “They’re in double bags.”
Nancy was getting a nasty feeling in the pit of her stomach. “Has anybody cut himself fooling around with these monkeys?” she asked.
“No,” Volt replied.
Then Nancy noticed that C. J. was looking sideways at her. It was a significant look. The message was, So who’s going to drive the dead monkeys back to Fort Detrick?
Nancy stared back at C. J. He was pushing her, and she knew it. They were both division chiefs at the Institute. He outranked her, but he was not her boss. He can push me just so far, and I can push him right back. “I’m not putting that shit in
the trunk of my car, C. J.,” she said. “As a veterinarian, I have certain responsibilities with regard to the transportation of dead animals, sir. I can’t just knowingly ship a dead animal with an infectious disease across state lines.”
Dead silence. A grin spread over C. J.’s face.
“I agree that it needs to be done,” Nancy went on. “You’re a doc. You can get away with this.” She nodded at his shoulder boards. “This is why you put on those big eagles.”
They burst into nervous laughter.
C. J. inspected the bags—it was a relief to see that the monkeys were double-bagged or triple-bagged—and he decided to take them back to Fort Detrick and worry about health laws afterward. His reasoning, as he explained to me later, went like this: “If the guy drove them back to the Reston monkey facility, I felt there would be a certain added risk to the population just from his driving them around in the van, and there would be a delay in diagnosing them. We felt that if we could quickly get a definite diagnosis of Ebola it would be in everyone’s favor.” Surely some smart Army lawyers could figure out why the act of carrying Ebola-ridden dead monkeys across state lines in the trunk of a private automobile was so completely legal that there had never even been any question about it.
His old red Toyota was not in the best of shape, and he had lost any interest in its resale value. He popped the trunk. It was lined with carpet,
and he didn’t see any sharp edges anywhere that might puncture a plastic bag.
They didn’t have rubber gloves. So they would do the lifting bare-handed. Nancy, keeping her face well away from the enclosed air of the van, inspected the outsides of the bags for any droplets of blood. “Have the exteriors of the bags been disinfected?” she asked Volt.
Volt said he’d washed the outsides of the bags with Clorox bleach.
She held her breath, fighting the puke factor, and picked up a bag. The monkey kind of slid around inside it. They piled the bags one by one gently in the Toyota’s trunk. Each monkey weighed between five and twelve pounds. The total weight came to around fifty pounds of Biohazard Level 4 liquefying primate. It depressed the rear end of the Toyota. C. J. closed the trunk.
Nancy was anxious to dissect the monkeys right away. If you left an Ebola monkey inside a plastic bag for a day, you’d end up with a bag of soup.
“Follow behind me, and watch for drips,” C. J. joked.
They arrived at the Institute in midafternoon. C. J. Peters parked beside a loading dock on the side of the building and found some soldiers to help him carry the garbage bags to a supply air lock that led to the Ebola suite. Nancy went to the office of a member of her staff, a lieutenant colonel named Ron Trotter, and told him to suit up and go in; she would follow. They would be buddies in the hot zone.
As she always did before going into Level 4, she took off her engagement ring and her wedding band, and locked them away in her desk. She and Trotter walked down the hall together, and he went first into the small locker room that led to AA-5 while she waited in the corridor. A light went on, telling her that he had gone on to the next level, and she swiped her security card across a sensor, which opened the door into the locker room. She took off all of her clothes, put on a long-sleeved scrub suit, and stood before the door that led inward, blue light falling on her face. Beside
the door there was another security sensor. This one was a numerical key pad. You can’t bring your security card with you into the higher levels. A security card would be melted or ruined by chemicals during the decontamination process. Therefore you memorize your security code. She punched a string of numbers on the key pad, and the building’s central computer noticed that
Jaax¬ Nancy¬
was attempting entry. Finding that she was
cleared to enter AA-5¬
the computer unlocked the door and beeped to let her know that she could proceed inward without setting off alarms. She walked through the shower stall into the bathroom, put on white socks, and continued inward, opening a door that led to the Level 3 staging area.
There she met Lieutenant Colonel Trotter, a stocky, dark-haired man whom Nancy had worked with for many years. They put on their inner gloves and taped their cuffs. Nancy put a pair of hearing protectors over her ears. She had started wearing them a while back, when people had begun to suspect that the roar of air in your suit might be loud enough to damage your hearing. They hauled on their space suits and sealed the Ziploc zippers. They edged around each other as they fiddled with their suits. People wearing biohazard space suits tend to step around one another like two wrestlers at the beginning of a match, watching the other person’s every move, especially watching the hands to make sure they
don’t hold a sharp object. This cringing becomes instinctive.
They closed up their suits and lumbered across the staging area to a large air-lock door. This was a supply air lock. It did not lead into the hot zone. It led to the outside world. They opened it. On the floor of the air lock sat the seven garbage bags.
“TAKE AS MANY AS YOU CAN CARRY,” she said to Lieutenant Colonel Trotter.
He picked up a few bags, and so did she. They shuffled back across the staging area to the airlock door that led to Level 4. She picked up a metal pan containing tools. She was getting warm, and her faceplate fogged up. They opened the airlock door and stepped in together. Nancy took a breath and gathered her thoughts. She imagined that passing through the gray-zone door into Level 4 was like a space walk, except that instead of going into outer space, you went into inner space, which was full of the pressure of life trying to get inside your suit. People went into Level 4 areas all the time at the Institute, particularly the civilian animal caretakers. But going into a containment zone to perform a necropsy on an animal that had died of an amplified unknown hot agent was something a little different. This was high-hazard work.
Nancy centered herself and brought her breathing under control. She opened the far door and went through to the hot side. Then she reached back inside the air lock and pulled the chain in the chemical shower. That started a
decon cycle running in the air lock that would eliminate any hot agents that might have leaked into the air lock as they were going through.
They put on their boots and headed down the cinder-block hallway, lugging the monkeys. Their air was going stale inside their space suits, and they needed to plug in right away.
They came to a refrigerator room, and put all the bags in the refrigerator except for one. This bag they carried into the necropsy room. Stepping around each other cautiously, they plugged in their air hoses, and dry air cleared their faceplates. The air thundered distantly beyond Nancy’s hearing protectors. They gloved up, pulling surgical gloves over their space-suit gloves. She laid her tools and specimen containers at the head of the table, counting them off one by one.
Trotter untwisted some ties on the garbage bag and opened it, and the hot zone inside the bag merged with the hot zone of the room. He and Nancy together lifted the monkey out and laid it on the dissection table. She switched on a surgical lamp.
Unclouded brown eyes stared at her. The eyes looked normal. They were not red. The whites were white, and the pupils were clear and black, dark as night. She could see a reflection of the lamp in the pupils. Inside the eyes, behind the eyes, there was nothing. No mind, no existence. The cells had stopped working.
Once the cells in a biological machine stop working, it can never be started again. It goes into
a cascade of decay, falling toward disorder and randomness. Except in the case of viruses. They can turn off and go dead. Then, if they come in contact with a living system, they switch on and multiply. The only thing that “lived” inside this monkey was the unknown agent, and it was dead, for the time being. It was not multiplying or doing anything, since the monkey’s cells were dead. But if the agent touched living cells, Nancy’s cells, it would come alive and begin to amplify itself. In theory, it could amplify itself around the world in the human species.
She took up a scalpel and slit the monkey’s abdomen, making a slow and gentle cut, keeping the blade well away from her gloved fingers. The spleen was puffed up and tough, leathery, like a globe of smoked salami. She did not see any bloody lesions inside this monkey. She had expected that the monkey’s interior would be a lake of blood, but no, this monkey looked all right, it had not bled into itself. If the animal had died of Ebola, this was not a clear case. She opened up the intestine. There was no blood inside it. The gut looked okay. Then she examined the stomach. There she found a ring of bleeding spots at the junction between the stomach and the small intestine. This could be a sign of Ebola, but it was not a clear sign. It could also be a sign of simian fever, not Ebola. Therefore, she could not confirm the presence of Ebola virus in this animal based on a visual inspection of the internal organs during necropsy.
Using a pair of blunt scissors, she clipped wedges out of the liver and pressed them on glass slides. Slides and blood tubes were the only glass objects allowed in a hot zone, because of the danger of glass splinters if something broke. All laboratory beakers in the room were made of plastic.
She worked slowly, keeping her hands out of the body cavity, away from blood as much as possible, rinsing her gloves again and again in a pan of EnviroChem. She changed her gloves frequently.
Trotter glanced at her once in a while. He held the body open for her and clamped blood vessels, handing her tools when she asked for them. They could read each other’s lips.
“FORCEPS,” she mouthed silently, pointing to it. He nodded and handed her a forceps. They did not talk. She was alone with the sound of her air.
She was beginning to think that this monkey did not have Ebola virus. In biology, nothing is clear, everything is too complicated, everything is a mess, and just when you think you understand something, you peel off a layer and find deeper complications beneath. Nature is anything but simple. This emerging virus was like a bat crossing the sky at evening. Just when you thought you saw it flicker through your field of view, it was gone.
While Nancy Jaax was working on the monkeys, C. J. Peters was in the conference room at Fort Detrick’s headquarters building. Careers were at stake in this room. Almost all of the people in the world who understood the meaning of Ebola virus were sitting around a long table. General Russell sat at the head of the table, a tall, tough-looking figure in uniform; he chaired the meeting. He did not want the meeting to turn into a power struggle between the Centers for Disease Control and the Army. He also did not want to let the C.D.C. take over this thing.
Dan Dalgard was there, wearing a dark suit, seeming reserved and cool; in fact, he churned with nervousness. Gene Johnson glowered over the table, bearded and silent. There were officials from the Virginia Department of Health and from Fairfax County. Fred Murphy—the codiscoverer of Ebola virus, the C.D.C. official whom General Russell had called—sat at the table beside another
official from the C.D.C., Dr. Joseph B. McCormick.
Joe McCormick was the chief of the Special Pathogens Branch of the C.D.C., the branch that had been run by Karl Johnson, another codiscoverer of Ebola virus. Joe McCormick was the successor to Karl Johnson—he had been appointed to the job when Johnson retired. He had lived and worked in Africa. He was a handsome, sophisticated medical doctor with curly dark hair and round Fiorucci spectacles, a brilliant, ambitious man, charming and persuasive, with a quick, flaring temper, who had done extraordinary things in his career. He had published major research articles on Ebola. Unlike anyone else in the room, he had seen and treated human cases of Ebola virus.
It happened that Joe McCormick and C. J. Peters couldn’t stand each other. There was bad blood between these two doctors that went back many years. They had both rifled the darkest corners of Africa searching for Ebola, and neither of them had found its natural hiding place. Like Peters, Joe McCormick evidently felt that now, finally, he was closing in on the virus and getting ready to make a spectacular kill.
The meeting began with Peter Jahrling, the codiscoverer of the strain that burned in the monkeys. Jahrling stood up and spoke, using charts and photographs. Then he sat down.
Now it was Dalgard’s turn to speak. He was exceedingly nervous. He described the clinical signs of disease that he had seen at the monkey house, and by the end he felt that no one had noticed his nervousness.