Authors: Stanley Johnson
The old doctor took it well. “Young man. One way or the other I’ve been exposed to almost every disease you can think of in my life. And they haven’t got me yet. I’m pretty tough, you know. I’ve probably got enough antibodies in my blood to sink a battleship.”
Kaplan looked at him with admiration. This was a man who had probably seen the worst that life had to offer. You didn’t maintain a general practice in Greenwich Village without developing a certain immunity.
“I don’t doubt that you’re tough, doctor. That’s not my worry. My worry is that we may be dealing with something new. Entirely new. Being tough may not be enough.”
The old doctor scratched his chin. “I’ll come on in to hospital, if you like, but you’ll have to give me time to transfer my appointments.”
“Thank you doctor. I’ll have an ambulance pick you up. Meanwhile, no contacts of any kind.”
As they walked to the door, Kaplan had a last thought. “Was Diane Verusio an only child — or did she have brothers or sisters?”
Reuben stopped in mid-stride. “Didn’t I tell you about Stephanie, Diane’s younger sister?”
When Kaplan shook his head, the doctor went on:
“Stephanie Verusio is one of the most remarkable people I have ever met. If I was a younger man, I would have fallen in love with her myself.” A wistful look crossed Reuben’s face. “I almost did fall in love with her when she was growing up in New York. She had such fire and verve. And she was a real beauty too. I don’t think I’ve ever seen such a beautiful young woman.”
“Where is she now? We ought to let her know about her sister. Do you know where she lives?” Kaplan was aware that his interest in Stephanie Verusio was more than merely professional. He had a brief mental image of a pair of soft brown eyes smiling at him out of a framed coloured photograph.
Reuben answered his question in the negative. “I heard that Stephanie had gone to live abroad. But I don’t know where. Even the best general practitioner doesn’t know everything.”
The dreamy moment had passed.
Kaplan reverted to his normal, brisk matter-of-fact self.
“Don’t worry, doctor. We’ll track the family down somewhere. We’re used to that kind of thing.”
They stood in the hall together, talking for a minute or two. Kaplan’s glance fell on a framed photograph of the President of the United States. It was inscribed: “To Isaac Reuben, with best wishes and warm thanks for all your help.”
Kaplan was intrigued — what had Reuben done that had elicited such a glowing testimonial?
“That’s nice.” Kaplan nodded in the direction of the photograph.
Reuben was not to be drawn. “Good luck to you,” he said.
Kaplan’s last glimpse was of a pair of old black brogues, which looked as though they had seen at least thirty winters, shuffling back into the room, as Reuben closed the door.
Kaplan called his office before he left New York later that evening.
“Susan, I’m coming down with some specimens. Can you warn them that I shall need the Hot Lab. And I could use some help. We’re probably in for an all-night session.”
There was a car to meet him at the airport. He made it to the Center in twenty-five minutes which, thought Kaplan, was probably a record. Susan Wainwright was already waiting for him. There was concern in her voice.
“Christ, Lowell, you look tired.”
“I
am
tired.” Commuting to New York from Atlanta, Georgia, was a far cry from commuting from, say, Westport, Connecticut.
“The Lab’s clear,” Susan said. “I’ve warned them that we may be working late.”
Kaplan grunted. For the moment he felt too exhausted to speak.
The Hot Lab at the Center for Disease Control in Atlanta, Georgia, is, in a literal sense, a world within a world. Its correct title is Maximum Containment Laboratory, though “Hot Lab” is the more customary usage. It was built during the ’seventies to satisfy two major requirements. The first was the protection of the outside world from diseases which were being investigated in the Hot Lab. The second had to do with the safety of personnel working inside the Lab with lethal materials of one kind or another. To achieve these two objectives, the Hot Lab was constructed as a box within a box. An outer building housing the air purification plants, waste disposal units and other necessities was erected over the inner shell. Kaplan had once explained the principle to Susan Wainwright when she had first joined him as his assistant.
“All the air is airconditioned and cleaned. We retain inside the building itself 99.99% of all particles larger than 0.3 microns. All solid waste is steam-pressured in autoclaves before being removed. All liquid waste is sterilized at ultra-high temperatures.”
They reached the Hot Lab over some covered metal catwalks which connected it to the main complex of buildings. Kaplan waited while Susan Wainwright went ahead and used the chemical shower.
When his own turn came, he stood there naked for two or three minutes, letting the water beat the tiredness out of him.
Susan who had already gone on through the air-lock called to him on the intercom.
“Lowell, are you okay?”
“Yeah, I’m just coming.”
They got into their lab garments. Each of them wore a positive pressure suit made of one-piece flexible urethane plastic with zipper. Each suit was fitted with an air filter and a device which cooled air for breathing; it also carried three minutes’ supply of air in case of emergency. When they were ready they moved on through into the maximum containment area itself. The doors clicked shut behind them and, as they did so, the inflatable rubber gaskets expanded, producing an hermetically sealed airtight fit.
Their first act, once inside, was to clip themselves onto the airline, their sole umbilical connection with the outside world. The airline was fed by compressed air piped in from cylinders outside the building. Similarly, the air they exhaled through their face-masks was piped away to the service area where it was filtered and sterilized before being released.
Without this umbilical access to an outside source of air, scientific use of the Hot Lab’s facilities would have been greatly hampered. With it, they had almost complete freedom of movement and could stay in the Lab as long as the outside air supply lasted.
The Hot Lab itself was divided into two sections. The first was filled with glass cabinets. A line of them ran down the center of the room, and others were ranged along the walls. The air inside the room was under negative pressure in relation to the air outside the Hot Lab. In the same way, the air inside the cabinets was under negative pressure in relation to the air circulating within the lab.
“We work with the specimens inside the cabinets,” Kaplan had explained during that first guided tour, “using the automatic handling devices. If we make a mistake and there’s a leak from the cabinet, that leak — because of the negative pressure — doesn’t contaminate the room outside. Similarly, if there is a spill in the maximum containment area, that spill should never go beyond the Hot Lab itself. It should automatically be limited to where it occurs, again through negative pressure.”
A major advantage of the pressurized suit was that the researcher was no longer limited to working on material within the cabinets. Since he had built-in protection, he could move into the second area — again through an air-tight door — where material could be removed from the cabinets and handled in a much more direct way. This was both safer and more convenient. There was always a risk, when handling items with rubber gloves and through arm-ports, of the researcher sticking a needle into his own finger instead of the cell he was seeking to inoculate. Being able to work in the open was an important step forward in toxicological research.
Lowell Kaplan and Susan Wainwright moved straight on to the “open” area. Their first task was to receive the specimens they had brought down from New York through the double-door autoclave which connected the containment area with the outside.
Lowell Kaplan carefully removed the watertight metal container from the outer container he had brought on the plane from New York. Inside the sealed watertight container were test-tube specimens wrapped in cotton. Susan Wainwright stood beside him, like a nurse assisting at an operation. She took the outer and the inner wrappings from him and disposed of them; she passed him the tools of his trade; she assisted him with advice and encouragement.
For an hour they worked in silence, the clear plastic face-plates of their pressure suits making possible the use of instruments requiring accurate vision.
Through an electron microscope capable of magnification up to a million times, Kaplan examined blood samples taken from the patient. Hunched over the eye-piece, he saw the strange shapes almost immediately. Susan Wainwright noted down his remarks as he spoke.
“Unusual morphology.” Kaplan was always laconic when he had his eye to the microscope. “We’ve got pleomorphic filaments here of exceptional length. Straight rod particles. Some are bent into horseshoes or b’s, as well as hooks and loops. The ends are rounded. In some cases one pole is dilated. We have occasional branching.”
“What’s the present magnification?”
“One hundred thousand. I’ll take it up to two and then three hundred thousand.”
At the higher magnifications, the shapes were more clearly apparent. “I think we’re dealing with a virus all right,” Kaplan exclaimed. “But I’ve never seen one quite like it. There seem to be three basic forms. First, there’s the naked helix; then we have coiled structures enclosed by a membrane; finally, there’s a circular form or torus. I think this last must be the mature virus.”
“Can I have a look?” Susan Wainwright was anxious to see for herself. Over the years she had graduated from being a fledgling assistant into a fully-trusted collaborator.
For several minutes she observed the peculiar structures in silence. Kaplan stood next to her, watching intently behind his perspex face-plate and breathing steadily from the supply of pure air being piped into the Hot Lab.
“What about size?” he asked. “It struck me that the mean length is fairly high.”
Susan Wainwright agreed. She looked at the scale etched at the side of the plate. “Some of the particles are over 900μ. I’d say the mean length is around 700μ with a cross-sectional diameter of between 70 and 80μ.”
Kaplan nodded. “That means for the safe elimination of the infectious agent by filtration we’d need a pore size of 100μ or less.” He took over the microscope once more.
Speaking slowly and clearly so that Susan could note precisely what he was saying, he completed his observations.
“The ends of ring-shaped particles apparently do not merge, even if they touch. The nucleo-capsid usually consists of a single strand. Breaks in the nucleo-capsid are generally found in the coiled portion; they are probably artifacts. Each ring usually contains four helix fragments.”
He turned off the power and straightened up.
“What the hell is it, I wonder?”
Susan looked at him. “Your guess is as good as mine.”
Lowell Kaplan moved towards the door. “I think we’re going to have to feed this one into the computer.”
They exited from the Hot Lab, following in reverse order the procedure they had used to enter. They unclipped themselves from the airlines, crossed the double door airlock, again made use of the chemical shower and finally emerged into the outside world. Telefacsimiles of Susan Wainwright’s notes were already waiting for them on the other side. The originals had been consigned to the maximum containment facility’s waste disposal system without ever leaving the inner sanctum.
The computer facility to which Kaplan had referred was in its way as unique as the Hot Lab itself. Over the last fifteen years the Center for Disease Control had been building up an unrivalled store of information on diseases. Collectors from all over the world had availed themselves of the Center’s special mailing facilities to convey bits of dead or dying people, of every shape and form, size and colour. The airtight containers used were capable, supposedly, of surviving a plane crash or terrorist attack. Special instructions, including a telephone number to call in emergency, were printed on the boxes in a half-dozen languages. There had been one or two mishaps, but nothing had gone seriously wrong. By the end of the ’seventies, Atlanta, Georgia, was the proud possessor of the world’s largest collection of deep-frozen diseases. If a sperm-bank could be called a life-bank, this was the opposite; it was a death-bank.
Apart from information contained in jars and bottles, the Center for Disease Control possessed an unmatched collection of computerized records stored under a binary coding system. Even where the Center did not itself possess tissues or cultures relating to a particular disease, it had taken steps to acquire the maximum possible data from available sources and to store that data on tape at the Computer Center.
The Computer Center was located on the fourth floor of the building. Access was limited to those in possession of a special pass. This restriction was in force not so much because of the sensitivity of the data, but because of the damage that untrained or ham-fisted utilizers could inadvertently cause.
A young man called Vincent Peters was on duty in the computer terminal that night. He had been warned to stand by, and to clear the lines for some high-priority work. Clearly gratified to be in on the action, he was doubly pleased when Kaplan appealed to him.
“Give us a hand, Vincent, will you? I’ve an urgent trace request here on what could be a dangerous pathogen, and I don’t want to be stalled behind some routine enquiry from Peoria.”
Vincent Peters pushed back a dark lock of hair which had flopped forward over his forehead.
“She’s all yours, Dr Kaplan. I’ve already told Peoria to wait till the morning.”
In practical terms, the Disease Control Computer Center in Atlanta, Georgia, was not much different from hundreds of other such centers up and down the country. A data bank is a data bank, whichever way you look at it — the repository of millions of pieces of information stored on magnetic tape. It is the system of retrieval whereby specific information may be hunted down and recovered that makes a unit more or less effective for its purposes. In this respect, through the development of sophisticated enquiry techniques, the Disease Control computer facility was exceptional. In particular, the PRS — Pathogen Record System — had proved invaluable on account both of the extent and depth of the material incorporated in its magnetic files and as important, of the particular system of pathogen classification used.