Minutes to Burn

Chapter 13

Rex leaned over the hotel phone as Tank stretched out on the bed. He had to dial three times before the call went through. Donald picked up on the first ring. "How is it?"

"Lovely as always," Rex said. "Puts Paris to shame."

"Some interesting news. Remember that seawater that Frank sent back?"

"Of course." Rex pulled off his shirt and turned so that he could see his back in the mirror. He pressed his hand to the back of his neck, and the white imprint of his fingers lingered a few moments before fading.

"I finally got it under a microscope. The sample from Sangre de Dios was highly unusual. Most of the plankton were dead. Clumped together. Mostly unicellular phytoplankton-dinoflagellates were most prevalent, but a lot of them I didn't recognize."

"Really?" Rex said. "Species you didn't recognize?"

"My guess is that they were nonviable mutations. Remember, plank-ton are extraordinarily sensitive to UV-B."

"Yes," Rex said, pulling a Natural History magazine from his bag and perusing the back cover, "but they live at depths that screen out most radiation."

"Ah," Donald said. "But this was a surface sample. So my thought was, seismically motivated shifting currents pushed them upward, and their composition was altered by UV exposure. But the range of the mutations was staggering-they couldn't be based on radiation alone."

"So?" The phone line cut out. Rex looked over at his sat phone, still charging at the outlet, cursed, and dialed again. This time, the call went through on the first try.

"So," Donald said, picking up right where they'd left off. "I did a gas chromatography mass spec to check for DDT, but that came back negative, so I isolated some dinoflagellate DNA, and ran a gel."

Donald checked his watch. His linen shirt was creased and wrinkled across the front, dotted with sweat. He'd spent the entire morning in the lab. The work required a precision that had quickly become tedious. First, he'd centrifuged the water samples, placing them in a rapidly spinning test tube so that the denser dinoflagellates would settle at one end of the tube. Then, he'd made genomic preps to isolate the DNA strands, cut specific segments, and ran those segments through ethidium bromide-soaked agar to see how they'd settle. When they did, their banding patterns were visible under UV light, and ready to be compared to the control.

From past studies, Donald was familiar with the banding pattern of dinoflagellate DNA from around Galapagos; generally it banded from three to five kilobases down to ten base pairs. The DNA from the island of Santa Cruz matched this banding pattern. However, the sample from Sangre de Dios was irregular, with several of the DNA segments remaining at the top of the agar, barely traveling downward.

When Rex heard the results, he sat down on the bed. "Holy shit," he said. "What are you thinking?"

"Those segments are swollen with something to be moving that slow," Donald said. "I'm guessing a virus got ahold of them, finding its way through the UV-weakened cell walls and inserting its own DNA into their structures."

Rex whistled. "Well, viruses are phenomenally bountiful in H2O."

"That was my understanding. But this is well out of our field. I'd like you to take plenty of water samples on Sangre de Dios. In the meantime, I've sent the sample off to Everett at Fort Detrick."

"Samantha Everett?" Rex rubbed his forehead. "Are you sure that's such a good idea? I've heard she's a little… " The line cut out. "Unpre-dictable."

Former Chief of Viral Special Pathogens Branch at the Centers for Dis-ease Control in Atlanta and current Chief of the Disease Assessment Division at the U.S. Army Medical Research Institute of Infectious Dis-eases at Fort Detrick, Maryland, Samantha Everett was decked out in a blue full-body space suit, complete with neoprene gloves taped to her sleeves. The droning air circulation unit inside the space suit was mes-merizing, forming a low-pitched symphony with the other sounds of the Biosafety Level Four lab-the constant one-way airflow, the blowers sit-uated near the doors to ensure negative pressure, the HEPA filters working double-time overhead. To maintain her sanity, Samantha sang "Itsy Bitsy Spider" to herself, substituting her own lyrics where she forgot the words.

A short woman-five foot two in sneakers-Samantha had the slightly frazzled air of a mother of three. Having neglected the wash for the past month and a half, she'd shown up to work wearing her daugh-ter's T-shirt featuring the five smiling faces of NVME's members. Fortu-nately, she also fit into her six-year-old son's shoes-green Velcro Adidas with asphalt marks on the white rubber outsoles-as she'd run from the house barefoot that morning only to realize it when she'd pulled up to base. She'd found the Adidas in the back of the minivan, buried in a mound of camping equipment from a trip into the Catoctins that, having been planned for two months and canceled three times, had almost come to fruition the prior weekend, only to be interrupted by the emergency at hand. A pair of wire-frame John Lennon-style glasses perched on her nose, the thin metal arms disappearing back into her curly brown hair.

Having little use for a husband, she'd adopted all three of her children over the past nine years. Earlier in her career, she couldn't have even considered being a mother. She'd been dispatched for months at a time on various projects-bleeding horses in rural Costa Rica for Venezuelan equine encephalitis, chasing Machupo virus up the eastern slope of the Andes, trekking through mosquito breeding grounds in the Nile Delta. But after her stint at CDC in Atlanta, she was given an offer to run DAD at USAMRIID, and she'd vowed to attempt some form of a domestic life. Being a mother, she'd found, had toughened her considerably more than being a major and running a division of testosterone-poisoned, military-sanctioned control freaks. But she liked Fort Detrick nonethe-less, and the seasons in central Maryland.

The stark modern USAMRIID building looked as if it had been dropped into the middle of the base from orbit, so out of place did it look among the conservative, faded-brick buildings. Inside, the sleek, tiled floors and fluorescent lights countered the battleship-gray walls. All work with infectious agents was undertaken in one section, divided into four units, each of which was in turn split into four "hot suites." Each hot suite employed a constellation of blowers, vents, and pressure sys-tems to ensure that airborne pathogens could not leak from the area. The filters killed any atomized biohazard before laboratory air was released to the outside. Everywhere in the building, the airflow was directed inward.

It was precisely this inflow of white noise that Samantha sought to combat with her singing. "The itsy bitsy spider…" Her voice, soft and high like a child's, activated the small microphone that allowed her to communicate with her lab technician, who wore a space suit similar to her own. "… contracted a new strain of aerosol-infectious Bolivian hemor-rhagic fever…" She leaned forward over the cadaver. She'd already made a Y-shaped incision to open the chest and abdomen. Her arm throbbed slightly from the latest battery of inoculations; because of all the shots she received in her line of work, her deltoids were usually sore.

She gestured with her scalpel at the lab tech. "Retract the small bowel so I can get at the root of the mesentery." The abdominal cavity was always difficult because it was so full; with all the coils of bowel, there was less room for maneuvering. She reached down and poked at the fattened stomach, knowing from experience it would be filled with clotted, foul-smelling liquid. Unfortunately, the respirators did not screen out odors.

"Down came the virologist, and washed the virus out," she sang.

The lab tech leaned forward and secured the squishy bowel in his gloved, slightly unsteady hands. "Don't cut me," he said.

"Oh really?" Samantha replied. "Well, there go my plans for the week. I was hoping to watch the effects of the disease take hold in one of my colleagues."

Starting at the mesentery, she cut away excess tissue and muscle attachments so that she could pull out the organs. The procedure was crassly referred to as "the pluck." One "plucked" out first the thoracic organs, then the abdominal organs.

"Hemorrhaging around the gums, yellow sclera, bloody stool, ecchy-moses, petechial hemorrhages, blood in the urine… " Samantha grasped the enlarged heart, pulling gently, and began singing again. "Out came the sun and dried up all the rain…"

The tech nervously regarded the nearby formalin, ready to plunge his hand into the sterilizing agent at the slightest nick. But Samantha's hands were completely steady. She trimmed neatly around her assistant's fin-gers, humming the next bar from the children's song as she sliced through tissue. She stopped suddenly. "Aha! Look at this."

The pleural cavity was filled with fluid, and the lungs were scattered with hard patches of red. She took a sample, placing it in a small vial and screwing the lid on tightly before scrubbing the outside with a disinfectant.

"Condom," she said. Another lab tech stepped forward, holding open an unfurled, nonlubricated Trojan. They'd had to be slightly inventive with their equipment; the last shipment from the supplies company in San Diego hadn't arrived due to a train derailment outside Vegas. Samantha dropped the vial into the condom, and the assistant knotted the end of the latex, placing it into a nylon stocking and lowering it into a tank of liquid nitrogen. He hooked the end of the stocking on the lip of the tank, careful to keep his hands clear of the liquid, which was 195 degrees Celsius below zero.

Samantha turned back to the body. It was a gruesome specimen. A prominent Baltimore businessman had returned six days ago from Cochabamba, Bolivia, in his Gulfstream VII. Previous to his flight, he'd been febrile, with myalgias, weakness, and chills. Though the symptoms had quickly become gastrointestinal-he'd been beset with abdominal tenderness and diarrhea-he'd decided to fly anyway. After takeoff, the man had been stricken with vomiting, and spontaneous bleeding from his nose, gums, and the whites of his eyes. Johns Hopkins Hospital received warning while the plane was midair, the pilot calling ahead to have an ambulance waiting at the airport. The reports worsened as the plane approached Baltimore, and the Chief of Staff at Hopkins had reached Samantha at her campsite in the Catoctins. They'd agreed to have the plane diverted to a stretch of Highway 15 near Fort Detrick, so that the businessman, and his wife, pilot, and flight attendant, who were showing early symptoms, could be quarantined at Level Four.

Samantha had raced home to treat them, but the virus had reached high titers in the businessman's blood, and the coagulopathy had already been far advanced. The antiserums they stored in the banks that coun-teracted other forms of BHF were not working on this mutated strain, nor had ribavirin.

Samantha had taken fluid and tissue samples from the businessman while he was still living and inoculated cell cultures with them, allowing the virus to replicate until the cell cultures contained viral antigens. The pilot's and flight attendant's condition continued to deteriorate, but the wife had recovered from her fever on the second day, which meant she'd probably produced antibodies that had fought off the virus. Sure enough, her serum showed the presence of immunoglobulin G antibod-ies, indicating an older infection from which she'd previously recovered. The IgG had enabled her body to combat her reexposure to the virus.

Samantha drew blood from her to isolate these antibodies, then spun down the blood in a centrifuge to separate the antiserum. The antiserum was added to the inoculated cell cultures, then washed down to remove everything that didn't specifically bind to the antigen. Next, she'd added specially tagged antibodies that allowed her to see, under ultraviolet light, that the antiserum had indeed bound to the antigen, strongly indi-cating that the antibodies in the wife's blood were manufactured to com-bat this specific virus.

Samantha had managed to isolate enough of the antibodies to fight off the virus in six of seven rats she'd infected. Each of the surviving rats had replicated the antibodies, which she'd been able to extract from them, isolate in larger amounts, and, using advanced genetic manufac-turing techniques, replicate on an even larger scale.

Samantha was now awaiting clearance to passively immunize the pilot and flight attendant with the experimental antiserum. Top brass from PHS and the FDA were meeting next door, deciding whether or not to approve the experimental plan of treatment. If the patients had to wait for the antiserum to clear the usual PHS paperwork labyrinth, they would surely die within the week.

Samantha forced herself to concentrate on the task at hand-per-forming a full autopsy on the body of the businessman, who had died that morning. She tried not to think about the decision being made next door that would determine the fates of two people. The body on the autopsy table was grotesque. Old, fading lesions peppered the armpits, and the gums were a bloody, suppurating mess. The mouth was caked with blood.

Samantha dug into the open cavity with renewed vigor. She continued to sing; her lab tech continued to sweat.

"So the itsy bitsy spider climbed up the spout again…"

A woman in a white lab coat tapped on one of the windows. "Sammy!" she called out.

Samantha couldn't make out what the woman was saying, so she set down the autopsy instruments and shuffled to the window, awkward in her space suit. "What!?"

The woman leaned forward and shouted something, but Samantha couldn't hear over the hum of the air blowers. She leaned forward until her hood was inches from the glass. "What?" she mouthed.

The woman shook her head in exaggerated fashion. "They voted no," she yelled, enunciating each word for Samantha's benefit.

Samantha closed her eyes tightly. She tried to count to ten to quell her rising temper, a device her youngest had learned from his kindergarten teacher and in turn imparted to her, but by the time she reached four, her mind was rife with images of the fever that was sure to befall the pilot and flight attendant. The sweats, the shaking, dappled bruises taking shape under the surface of the skin. Because of legal concerns, the PHS and FDA were going to send them to their graves, wrapped in red tape.

Samantha turned to the lab tech. "Take over," she said. She banged on the glass. "I'm scrubbing out."

The uniformed and suited men and women sat around a large confer-ence table, sipping coffee and talking. A plate of Krispy Kremes sat untouched on a silver tray. Folders were stacked around the pitchers of water, and a single telephone sat at the end of the table, before an older woman in a gray Chanel reproduction. The others were just rising to leave when Samantha banged through the doors, a metal briefcase bal-anced on her hand like a cocktail tray.

She slammed the briefcase down on the table and opened it. Two syringes filled with liquid lay in the spongy bedding.

The older woman stood, her expression hardening. A rose blush col-ored her cheeks one shade short of absurd. "Samantha, we knew you'd be difficult about this, but we can't be expected to approve a treatment of this magnitude for humans based on animal experiments alone. There are precedents, legal complications. Maybe next week, we'll be able to get the results back from the autopsy and run some experi-ments…" Her voice faded as Samantha unbuttoned and rolled up her shirt sleeve. "What are you…"

Holding the first syringe vertically before her, Samantha smiled sweetly. "Bolivian hemorrhagic fever," she said. "New strain." She bit the tip protector off the needle and spit it onto the floor.

Two women fell back into their chairs. "Jesus Christ," one of the men cried, covering his nose and mouth with his tie.

Samantha deftly ran the needle into her arm, sinking the plunger.

"Goddamnit," the older woman cried. "Where's her senior officer?"

Two people crept around the table, backs pressed to the walls, and fled the room.

Samantha raised the second syringe. "My antiserum," she said. She shot it into her arm, just below the mark the last shot had left.

The older woman's lips were quivering with anger. "Well, you've done it this time," she said. "This cowboy routine of yours is going to land you in a heap of trouble."

"Yippee kay yay," Samantha said.

The woman leaned over and hit a button on the phone. "Get her in the slammer."

The slammers, run at Biosafety Level Four, were in the medical section, just beyond the hot suites. Two-room units with locks only on the out-side, the slammers each had two beds. Crash doors led to small operating rooms; in the event of a medical emergency, doctors could enter the slammers in full space suits. The survivors of the Bolivia trip had been individually quarantined in three of the units since their arrival at Fort Detrick.

As the slammers' main function was to isolate and observe people who'd been exposed to hazardous agents, each featured an enormous window running the length of one wall. A cluster of technicians and virologists crowded around the Slammer Two window. Inside, Samantha sat on the bed, humming to herself.

One of the virologists, an overweight man with a bushy beard, clasped his hands and shook them in the air. "All right, Sammy!"

She stood and bowed, and went to the far wall and pretended to run against it, like a hamster on a wheel. The crowd outside cracked up. Then, she grabbed a coffee mug from the counter and ran it across the length of the window, as if drawing it across prison bars. More howls. Finally, the crowd began to dissipate, but not before her colleagues called out their good-byes.

Samantha sat on the bed and lowered her head into her hands, thinking of the week before her. She'd been instrumental in developing a new test that could detect early BHF-specific antibody response in twenty-four hours-a test she'd soon take. If it showed that the antibodies were present in her blood, they'd have to clear the antiserum for use on the pilot and flight attendant. Even so, they'd need to hold Samantha for at least a week to be certain that the antibodies had cleared the virus from her body. She felt fine so far, but it was way too early to tell anything. Placing the palm of her hand across her forehead, she closed her eyes. The antiserum would work; she was convinced her methods were sound.

She glanced down at her watch and shot to her feet when she noticed the date. December 25. She had three children and a nanny waiting for her at home by a half-decorated tree, and she wouldn't be out of the slammer until New Year's. A sudden rush of guilt flooded through her. They hadn't had time to unwrap gifts this morning, and she'd promised she'd be home before dinner. How could she do this to her children?

Crossing to the telephone on the counter, she asked the operator to patch her through to home.

Kiera almost didn't hear the phone ringing over the blare of her stereo. She lay on her stomach sideways across her bed, flipping through Cosmo Girl, kicking her one leg lazily in the air behind her. Her skin was dark, betraying her Guatemalan heritage, and a chevron scar remained on her abdomen from the liver transplant she'd received as a five-year-old when she'd first entered the country nine years ago. Her walls were adorned with colorful posters: Timmy Mandalay sulking on a rocky shore; Daddy Trippilicious decked out in gangsta garb; the Ebola virus blown up to 10Kx magnification.

The song ended, and she heard the shrill ring of the phone. She stood, hopped over to it, and answered, having first to unearth it from beneath a mound of clothing. "Yeah?" The expression on her face changed to one of weary irritation. She lowered the phone, pressing the mouthpiece to her shoulder.

"Mom's in the slammer again!" she shouted.