The Cobra Event

The sun had risen by the time Alice Austen finished a cup of coffee and a sweet roll in Gerda Heilig's kitchen. She put her boots and her knife pack into a knapsack and went out onto First Avenue and turned south, walking quickly. She was entering a complex of hospitals lined up on the eastern side of Manhattan, overlooking the East River, like ships at dry dock — New York University Medical Center, with a number of research institutes; Bellevue Hospital; the Veterans Administration Hospital; and other medical institutions. At the northeast corner of First Avenue and Thirtieth Street, she turned up the steps of a gray building, number 520. It was six stories tall — small for this part of Manhattan. It had dirty aluminum-framed windows. The first story of the building was covered with blue glazed bricks, the color muted by dirt and dust. The building was the Office of the Chief Medical Examiner of New York City. The front door was locked, and she pushed the night buzzer.

A tall, somewhat overweight man in his sixties let her in. He had curly white hair at the temples and was going bald on top. He was dressed in a green surgical scrub suit. 'I'm Lex Nathanson,' he said. 'Welcome to the O.C.M.E. — the ugliest building in New York.' The marble walls of the lobby had a peculiar brownish, mottled, streaky color. It reminded her of a cancerous liver, sliced open for inspection. On the liverish wall ran a motto, in Latin, in metal letters:

'How's your Latin, Dr Austen?' Nathanson said.

'Hmm. Let's see… "Speech quiets the place where Death is happy…"? That can't be right.'

He smiled. 'It means, "Let conversation cease, let the smile flee, for this is the place where Death delights to help Life."'

'"Where Death delights to help Life,"' she murmured as she followed Nathanson into his office, a big, uncluttered room located near the front door.

A man stood up to greet her. 'Glenn Dudley,' he said. 'Deputy chief medical examiner.' He shook Austen's hand. Dr Dudley had a massive grip and a tight mouth. He was a handsome, muscular man of about fifty. He had black hair and a square face, and he wore square metal-framed eyeglasses.

Austen opened up her green federal notebook, her epi notebook. She wrote Nathanson's and Dudley's names on the first page. 'Could I have contact phone numbers for you?'

'Are you a forensic pathologist?' Glenn Dudley asked.

'No. I'm a medical pathologist,' she said.

'You're not trained in forensics?'

'I have worked on forensic autopsies,' she said. 'I know basically how it's done.'

'Where?' Dudley asked.

'In the Fulton County medical examiner's office, in Georgia. The C.D.C. has a relationship with them.'

'Are you board certified?'

'Not yet,' she said.

Dudley turned to Nathanson and said in a flinty voice, 'They don't even send us a certified pathologist.'

'I'll be taking my boards next year.' She concentrated on her green notebook.

Nathanson said, 'Well — as I imagine Dr Mellis told you, we've had two very unusual deaths. The girl who died yesterday, and a similar incident five days ago. The first case we noticed —'

'I noticed,' Dudley said.

'— Glenn noticed, was an unidentified homeless man. He was known locally as Harmonica Man. He was about sixty years old, and he used to ride the subway cars playing a harmonica. He had a cup and he asked for handouts. He went all over the city. I live on the East Side, and I actually remember seeing him riding the Lexington Avenue local. He died a week ago at the Times Square subway station, on the southbound platform of the Broadway line, if you know where that is.'

'I don't know New York very well,' Austen said.

'It doesn't matter. He died in grand mal seizures,' Nathanson said.

'It was a spectacular death,' Dudley said. 'The guy seized in the middle of a crowd, he's screaming, he bit off his tongue, he bit his hands, and he had a hemorrhage. He was D.O.A. at Bellevue. I did the autopsy, and found his tongue in his stomach. The Fire Department E.M.T. squad reported that he arched his back and froze and died on the platform that way, having eaten his tongue, and with a massive bleed from the mouth. He was with a friend of his — another homeless guy named…' He flipped through the case folder, glancing over the file. 'Named Lem. No last name given. When I did the autopsy, I found that this Harmonica Man was an alcoholic with cirrhosis of the liver, and he had varicose veins in the esophagus. A vein had burst in his esophagus. That was the source of the bleed from the mouth, that plus bleeding from the tongue stump. He had brain swelling and brain damage, with hemorrhage in the midbrain. It could be a poison, a toxin. But nothing came up with the toxicology.'

'What got my attention,' Nathanson said, 'was the form of the seizure — that curvature of the spine.'

'That's less important, I think, Lex,' Dudley said.

'It's known as an arc de circle seizure,' Nathanson went on, in a thoughtful way. 'I looked into this. The arc de circle seizure was identified by the nineteenth-century French neurologist Jean-Marie Charcot. It's a fake seizure. A real seizure doesn't make the spine curve. But the two decedents weren't faking — they were dying.' He turned to Austen. 'This second case has gotten into the news media, and we're under some pressure to come up with answers.'

'So you called the C.D.C., Lex — and you listened to Walt Mellis with his theories. He's a nut,' Dudley said.

Nathanson shrugged and flashed a smile at Austen. 'You're not a nut, are you, Doctor?'

'I hope not,' she said.

Dudley stood up suddenly. 'Let's get going.' He picked up a manila file folder that had been sitting on an empty chair. 'We can talk in the morgue.'

They stepped into a freight elevator. It went to the basement of the O.C.M.E. On the way down, Nathanson turned to her. 'How old are you?'

'Twenty-nine.'

'Kind of young for a fed,' Glenn Dudley remarked, standing behind them.

'It's a training job,' she said.

The morgue was in the first basement level, next to the receiving garage. A mortuary van had just pulled in, and a couple of dieners, or morgue attendants, were unloading a body covered with a sheet of blue paper. The attendants transferred the body to a mortuary gurney known as a pan, which is a sort of metal trough on wheels. The pan was shaped like a trough so that fluids would not drip out of bodies onto the floor.

The receiving garage was crowded with bright red Dumpsters marked with biohazard symbols, spiky threelobed flowers. A sign on the wall said:

Nathanson approached a man dressed in a green scrub suit. 'We're ready, Ben,' he said. 'Let me introduce you to our C.D.C. investigator. This is Dr Alice Austen. And this is Ben Kly. He'll be the attendant. Ben, we're keeping quiet about Dr Austen's presence here.'

'Sure,' Kly said, and smiled. His name rhymed with 'fly.' He and Austen shook hands.

Ben Kly was a slender man of medium height, an Asian-American with dark, creamy skin. He had a quiet voice. 'I'll be with you in a second,' he said. He wheeled the pan with the body on it into the hallway.

They pushed through a pair of battered swinging doors into the morgue, where they were enveloped by a thick smell, sour and penetrating — a smell as old as the world. It hung in the air like a liquescent fog, and seemed to coat the back of one's mouth. It was the smell of bacteria converting meat into energy. The bacteria were liquefying human meat and giving off gases. In the Manhattan morgue, this smell rose and fell and changed day by day, depending on the weather and events around the city, but it never went away. The Manhattan morgue emitted an endless Gregorian chant of smell.

It was Charles Darwin who first understood that evolution is caused by natural selection, and that natural selection is death. He also understood that vast amounts of death (vast amounts of natural selection) are required to effect a small permanent change in the shape or behavior of an organism. Without huge amounts of death, organisms do not change over time. Without death, life would never have become more complex than the simplest self-copying molecules. The arms of a starfish could not have happened without countless repetitions of death. Death is the mother of structure. It took four billion years of death — a third of the age of the universe — for death to invent the human mind. Given another four billion years of death, or perhaps a hundred billion years of death, who can say that death will not create a mind so effective and subtle that it will reverse the fate of the universe and become God? The smell in the Manhattan morgue is not the smell of death; it is the smell of life changing its form. It is evidence that life is indestructible.

The morgue was ring-shaped, with a central rectangular core where bodies were stored inside crypts. You circled around the core to gain access to a particular crypt. The walls were made of bricks painted a pale green. The crypt doors were made of stainless steel. Various smaller rooms led off from the main room. Some of these smaller rooms were for holding severely putrefied bodies, so that the smell would not fill the morgue area.

'There's the ladies' room,' Nathanson said, pointing to a door off the morgue. 'You can change in there.'

It was cleaner than most rest rooms in morgues. Austen found a shelf holding fresh surgical scrub suits. She removed her street shoes and took off her blouse and skirt and changed into the scrubs. Then she put on her Mighty-Tuff boots, and laced them up.

She found Nathanson, Dudley, and Kly in a storage room on the other side of the morgue, putting on the next layer of clothing. The storage room was full of metal shelves holding biosafety equipment. They put on disposable surgical gowns over their scrub suits. Over the surgical gowns they tied heavy plastic waterproof aprons. They put surgical covers on their shoes, surgical caps on their heads.

Glenn Dudley pulled a disposable button mask down over his nose and mouth. It was a soft cup made of biofilter material, like a surgeon's mask. It had a blue button in the center. His voice came out of the mask. 'Hey, Dr Austen, where's your space suit? I thought you guys from the C.D.C. have to work in space suits.' He laughed behind his mask.

'I've never worn one,' she said.

They put on plastic safety glasses, to prevent blood or fluid from splashing into their eyes. Dudley didn't need safety glasses, since he was already wearing eyeglasses. They put on rubber surgical gloves.

Then Glenn Dudley fitted a glove made of stainless-steel chain mail over his left hand. The chain-mail glove indicated that he was going to be the prosector — the leader of the autopsy, the person who did the cutting. In the New York O.C.M.E. the prosector wears a metal glove on one hand; it is a sign of medical authority and, more important, a safety measure. Most accidental knife cuts during autopsy occur on the pathologist's nondominant hand. In most people that's the left hand. You hold the knife in your dominant hand, so accidental cuts usually occur on the nondominant hand. You wear a chain-mail glove on your nondominant hand.

They put on heavy yellow rubber dishwashing gloves over their surgical gloves. Dudley drew a rubber glove over his metal glove.

'The decedent is in 102,' Ben Kly said.

They followed Kly through the morgue as he wheeled an empty pan around the ring-shaped room to a stainless-steel door, crypt number 102. Inside, lying on a tray, was a white body pouch. A stale odor came out of the crypt.

'Dr Austen, the smell doesn't affect you?' Nathanson asked.

'It's a little stronger than what I'm used to.'

'They do them fresh in hospitals,' Ben Kly remarked, rolling out the tray. A human form gave shape to the white pouch.

Nathanson said, 'Manhattan is not like other places. People come to Manhattan to live alone. It means they often die alone. We handle a surprising number of putrefied bodies. What you are smelling is the stench of loneliness, Dr Austen.'

Kly took the shoulders, grasping them through the pouch, while Dudley took the feet. In one expert motion they lifted up the body and transferred it to the pan. Kly wheeled it over to a floor scale and read the dial. 'A hundred and eighteen pounds,' he said, writing it on a clipboard.

He pushed the gurney through a pair of doors into the autopsy room.

'Welcome to the Pit,' Kly said.

The autopsy room was seventy feet long, and was partly underground. In it stood eight stainless-steel autopsy tables, lined up in a row. This was autopsy central for Manhattan, one of the busiest autopsy rooms in the world. Four of the tables had pathologists working at them; they were in the process of laying out bodies, preparing to go to work; some had begun cutting. The Pit was a gray zone, a place neither definitely hot nor definitely safe. It was somewhere in between. An ultraviolet light on the wall shed rays into the room that were supposed to kill airborne pathogens, viruses and bacteria. On the floor, air-filtering machines hummed, cleaning the air of infective particles that might get into the lungs of the pathologists.

Ben Kly halted the pan next to an autopsy table and set the brake. He unzipped the white bag.

Kate

Her eyes were closed, the eyelids puffy. She had had a streaming bloody nose, and the blood had run over her chin and pooled in the hollow of her throat. Someone, probably a busy nurse, had attempted to wash her face, but the washing had not been thorough.

People are fastidious by nature, and have a hundred ways of grooming their bodies and keeping order about their persons. When a person dies, the ways of grooming vanish. The first impression one has of a dead person is of disorder — unkempt hair, purposeless limbs, blotchy moist skin with specks of dirt on it, eyes half open, a faint meaty unwashed smell.

Her teeth were visible in a grimace behind shredded lips. The teeth were stained with brownish blood. Her hair was russet, shining and beautiful, wavy hair. With a start, Austen saw that the girl's hair was the same color and texture as her own hair. There were two rings in her left ear.

'Her name is Catherine Moran,' Nathanson said. 'Our medicolegal investigator talked to some of her teachers yesterday. They called her Kate.'

Ben Kly unzipped the pouch completely. The dead girl was wearing a short hospital gown, as if for modesty.

Dudley opened the investigator's report, a collection of sheets of paper in a manila folder.

'Case number 98-M-12698,' Dudley said, reading from the file. 'She collapsed in a school classroom.' His eyes glanced rapidly over the report. 'Mater School, on Seventy-ninth Street. She became extremely ill in class. Yesterday. About ten-thirty in the morning. She fell to the floor. She was grimacing and biting her lips — biting herself, chewing her lips and swallowing them — grand mal seizures — heavy nosebleed — sudden unexplained death. Yeah, and they reported she went into a hard tonic seizure at the end. Superficially, the case looks like Harmonica Man — you've got the wild seizures, the hard clonic tensing of the spine, the bleed, the chewing. She was D.O.A. at New York Hospital. It made the news last night.'

'You've got a homeless man and a young woman from a well-to-do background,' Nathanson remarked. 'That in itself stands out. There's no obvious connection between them.'

'Drugs,' Dudley said.

'It's almost like there was a demon inside them,' Ben Kly whispered.

'Want to call in a priest, Kly?' Dudley said.

'I'm a Presbyterian,' Kly answered.

'The hospital did a blood and spinal workup?' Austen asked.

'They didn't run any tests — she was pronounced dead,' Dudley replied.

Dudley and Kly lifted the girl out of the pouch and transferred her to the autopsy table. The inside surfaces of the pouch glistened with droplets of black blood. They stretched her out on her back, on the heavy steel mesh of the table, with water running underneath the mesh. They removed the gown. Her breasts were small. Her body was young.

The appearance of Kate's body disturbed Austen. The truth was that the girl looked very much like her. She could be my younger sister, Austen thought, if I had a younger sister. She reached out and took the left hand of the girl in her gloved hand. She lifted the hand up gently and looked at it. The fingernails were delicate.

'Someone could have given her a hot load, Lex,' Dudley said.

Austen frowned, puzzled.

Nathanson explained, 'A lethal dose of bad drugs, Dr Austen. A hot load. Dealers do it when they want to get rid of a customer.'

'That would make it a homicide, but it would be hard to prove,' Dudley said.

Nathanson suddenly said, 'Dr Austen — I'd like you to be the prosector for this one. You can do the autopsy.'

'But I came here to observe.'

'I think your insights into this case could be interesting,' Nathanson said. 'Ben, she'll need a chain-mail glove. You'll use your own knife, I assume.'

She nodded.

Kly got her a chain-mail glove. She put it on her left hand and replaced the yellow rubber glove. She opened her prosection pack and removed her steel knife.

'Glenn will help you with the forensics, and he'll sign the documents,' Nathanson said.

Nathanson left to make his rounds in the Pit. He passed by the autopsy tables one by one, stopping to chat with pathologists, having a look at each of the day's cases. As she watched him walk away, Austen felt that he had been sizing her up from the moment they met. From the beginning, he had been thinking of turning the autopsy over to her, but he had held off making the decision until the last possible moment. She watched him out of the corner of her eye.

Dudley said to Austen in a low voice, 'I never saw the point of Lex's calling the C.D.C. It was something he wanted to do, not me. You will follow my direction. Is that clear?'

'Yes.'

'The last thing we need around here is a C.D.C. trainee who's carrying on her education in public.'

Ben Kly pretended not to hear a word of this. He took up a rubber hose and rinsed the girl's body gently with running water.

Across the tables, the day's work had gotten under way. A flash went off on the other side of the room. A photographer was standing on a ladder, taking pictures of a shooting victim, a young Hispanic man who had been caught in a heroin deal gone bad. They had peeled off his bloody clothes and hung them to dry on a hat stand, and a pathologist was writing on tags with a Magic Marker and tying the tags to the clothes, while a New York City homicide detective stood by and watched. Another table was getting a lot of attention. On it lay a naked woman. She was marked with bruises about the chest and head, she appeared to have a fractured skull, and there were deep stab wounds in her belly, which was very large. Eight months pregnant, she had been beaten and stabbed to death by her husband. A fetus had apparently died of stab wounds inside her. Someone at another table said, 'Who's got the loppers?' A hot smell of intestinal contents filled the air, a smell that resembled the foulest diarrhea. There was the murmur of voices, as pathologists chatted with one another across the tables. The Pit was one of the beating centers of life in New York City, essential to its daily existence, yet unseen and unimagined by most people who lived in the city. The case of the girl who had collapsed in school was not getting much attention from the other pathologists.

Dudley called over the photographer, who took a few pictures of Kate Moran. Then Austen and Dudley together did an external examination.

In the bright fluorescent light, they looked at the skin. They rolled the body sideways and examined the girl's back, then rolled her so that she was resting on her back again. When a baby is born, the attending pediatrician examines the baby's genitalia, to check for malformation. At the other end of life, the pathologist performs a similar examination. Austen parted the girl's legs and looked carefully there. She saw a string and some blood. The girl had been having her menstrual period. Pulling the string, she removed the tampon and looked at it, turning it over in her gloved hands. It bore a few spots of bright red blood.

An experienced morgue attendant, or diener, can help find things. Ben Kly pointed to the girl's nose. 'Lot of mucus there.'

Austen looked. Coming out of the girl's nose, along with the blood, was a slick watery fluid, a fair amount of it. 'You're right,' she said. 'It looks like she had a cold.'

'She has a cold,' Kly commented.

'What?' Alice said, looking at him.

'You know how a cold survives in a dead body?' Kly said. 'I've caught colds from bodies. Cadaver colds are the worst. I think that cold gets mean sitting in that body, saying, "This guy is dead. Get me out of here."'

'I wonder what else you guys catch,' Dudley said to him.

'Hey, I've worked in the morgue for seven years,' Kly replied, 'and my immune system is like a rock by now. Nothing can get past it. Except every October I get my cadaver cold, as regular as an alarm clock.'

Austen wanted to inspect the girl's mouth and tongue. She opened the mouth and grasped the tongue firmly with a forceps, and pulled the tongue partway out of the mouth.

Her mouth was stained with partly coagulated blood. Austen moved the tongue sideways. 'She bit her tongue and lips,' she said. 'There are molar cuts toward the back of the tongue.' She had shredded her lips with her front teeth, it seemed, and a portion of lip was missing. But that was not all. The inside of the mouth had the wrong texture and color, but the blood obscured it. Austen bent over and looked very closely, and now she saw something. The inside of the mouth was shining with blisters. They were very dark. They were blood blisters, it seemed.

Next came the examination of the eyes. Gripping the eyelids delicately with a small forceps, Austen rolled them back one at a time.

The inside of the eyelid was peppered with small red dots.

'She's got inflammation of the conjunctiva,' Austen said.

Now she looked at the eye. The iris was blue-gray, but with a hint of golden yellow. Austen bent down until her face was inches from Kate's, and she stared into the pupils, left and right. In the cornea was reflected the blue glare of the overhead fluorescent lights and her own face, with the mask over her mouth and nose, and the safety glasses over her eyes. Pathology, above all, is the act of seeing. Seeing with understanding leads to diagnosis. Austen continued to stare into Kate's eyes, trying to understand what she was seeing, trying to recognize a pattern. Her eyes had an abnormal color, she thought. There seemed to be a ring of yellowish shiny pigment inside each iris — a pupillary ring, with flamelike offshoots. It had formed a kind of iridescent circle fringing the black dot of the pupil. The ring had a metallic sheen, like the wing of a tropical butterfly, with a predominantly yellowish cast, and it made the pupil look as if it had caught fire.

'These eyes seem unusual, Dr Dudley. What do you think of the color in the iris?'

'Huh.' Dudley bent over to look. 'It's natural color. The conjunctiva's inflamed.'

'But she has pupillary rings in the iris. Like some kind of crystalline or metallic deposit. I wonder if this is copper. She could have copper poisoning. These rings in the iris could be Kayser-Fleischer rings. That's a copper deposit in the eyes. It's a sign of Wilson's disease—'

'I know what that is,' he said, looking at her. 'Nope — no way. Rings from copper poisoning, Dr Austen, would appear on the outside rim of the iris. This golden coloration is on the inside of the iris, near the pupil. It's normal eye color.'

The girl had had a bloody nose. Austen decided that she wanted to look inside the nose. 'Do you have an exam light?'

Kly found a standard examination light and handed it to Austen. She pointed the light into Kate's nostril and looked.

The nasopharynx is like a cave inside the head. This cave was clogged with congealed blood. Then Austen saw it: blood blisters in the cavity. They gleamed in the light.

'Wow,' Austen said. 'There's a blistering process.' She thought: the bloody nose could be a broken blister.

'Let me look,' Dudley said. He took the light. 'Yeah. What the hell is that?'

'She has similar blisters in her mouth. This looks like an infectious-disease process, I think.'

'Yeah. Or hemorrhages. This could be a toxin, a poison of some kind. Go ahead and open her,' Dudley said to Austen.

Ben Kly prepared a fresh scalpel, snapping a clean blade onto the handle, and he handed it to Austen. She inserted the scalpel into Kate Moran's right shoulder. With a quick, careful, deft motion she ran the scalpel down from the shoulder and underneath the young woman's breast, then across her rib cage, bumping over the ribs. She reached the point of the sternum, where the ribs come together at the top of the abdomen, and from that point she cut straight down the abdomen, heading for the navel. She made a detour around the navel, still cutting. She stopped the cut when it reached the pubic bones of the pelvis, at the top of the pubic hair. As the skin of the abdomen parted, a strong whiff of feces filled the air.

Now Austen made a second cut, starting at Kate's other shoulder and running down and across her chest to her sternum, where the cut joined the first cut. The two cuts thus formed a Y. The points of the Y were in the shoulders and the joint of the Y was at the bottom of the rib cage. The shaft of the Y ran down over the abdomen to the pubis. Her skin gaped open, the yellow body fat revealed.

'Ephphatha,' Ben Kly said softly.

'What was that?' Austen said, glancing at him.

'Ephphatha. It's a good-luck word. It's what Jesus said when he threw a demon out of a deaf-and-dumb man. He stuck his finger into the guy's ear, and he put a dab of his spit on the guy's tongue. Then he said, "Ephphatha." It means, "Be opened." And the demon came out.'

'The Lord guides our diener's hand,' Dudley remarked.

'He guides our prosector's hand,' Kly said quietly.

Using the scalpel to cut away fat and tissue, Alice Austen gently pulled back the underlying tissue of the girl's chest. She reflected (laid back) the large flaps of skin, exposing her rib cage. She laid the skin of the chest backward and inside out, like a blanket, over the girl's face. The breasts were turned inside out, the breast tissue seen from the inside, white and milky in color, while the outside of the breasts lay upon Kate's face.

Kly handed Austen a pair of lopping shears — the kind gardeners use to trim branches — and she cut the girl's ribs. The ribs gave off cracking sounds as they broke. Then she lifted away the chest plate, the central section of the rib cage. She laid the chest plate-on the table.

Austen reached into the chest cavity with her fingers and gently pulled the lungs away from the heart, which was encased in a membrane. 'I want to get a blood sample,' she said.

'You're going to take a blood sample from the heart?' Dudley said sharply. 'If you're testing for infective agents, you'll want to take blood from the leg, not the heart. Don't you know that?' He went on to say that the heart would be contaminated with many kinds of bacteria, and thus it would not give a reliable biological sample of blood.

Austen turned red. 'Okay,' she said.

Dudley had a look of satisfaction on his face. He handed Austen a syringe. She slid it into the femoral vein of the girl's leg in the groin area. She found the vein on the second try and withdrew a small amount of blood and squirted it into two jars of blood-culture fluid, which is the color of beer. Any bacteria in Kate's blood would grow in the liquid and could be observed and tested.

Then she lifted out the heart and lungs. She laid them on a white plastic cutting board. She sliced open both lungs with her knife. The lungs were heavy and dark. Kate had inhaled blood from her nosebleed. But the blood in her lungs was not enough, Austen thought, to be the cause of death. Not enough blood to drown the lungs.

With blunt scissors, she cut open the heart and examined the chambers, and she snipped open the coronary arteries. Kate Moran's coronaries and heart were normal, unremarkable.

She cut away one-inch chunks of heart tissue and lung tissue, and dropped them into a large glass jar full of formalin preservative, a clear, poisonous fluid that looks like water. This jar was known as the stock jar. It would be sent to the O.C.M.E. histology lab, where slices of the tissue in the jar would be prepared for viewing through a microscope. Austen also prepared a separate toxicology container, a plastic container with no preservative in it. The O.C.M.E.'s toxicology lab would test the samples in this container for toxins and drugs. She dropped raw pieces of lung into the tox container.

Now Austen reached into the abdomen, feeling around among the intestines. She removed the small intestine, pulling it out like rope, foot by foot, cutting the membranes that held the masses of intestines together. There was a sour reek, and a quantity of chyme squeezed out of the small intestine, like toothpaste coming out of a tube. Chyme is a soft gray paste that looks like oatmeal. It is partly digested food from the upper intestine, food that has not yet met the bile and darkened. She placed the small intestine in a cylindrical steel wash tank full of running water that sat at the end of the autopsy table. The tissue seemed healthy and normal.

She found the liver and pulled it up to look at it. The liver appeared normal in color: dark reddish brown. She removed the liver and weighed it on a scale over the table. 'Liver's thirteen hundred and fifty grams.' She put it down on the cutting board and sliced it quickly, then dropped a sample of liver into the stock jar, and another piece of liver into the tox container. She cut open the stomach and looked inside at the contents. Kate Moran had not eaten in a while.

Austen lifted the bowel out, holding it in both hands, loosely folded. This she handed to Ben Kly. He placed the bowel in the wash container and squeezed it and rinsed it, like hand laundry. Masses of feces floated away in the wash water and swirled down the drain. A stench of feces filled the air.

The body cavity was open and almost empty now, a red gaping cave of ribs. The girl's face was not visible. It was still covered with the blanket of chest skin.

Kly was standing close to Austen, looking into the body cavity.

'Find her soul, Ben?' Dudley said.

'It's gone to a better place, Doctor,' Kly answered.

There were still the pelvic organs to remove. These are the organs that are tucked inside the pelvis (the hip bones). The pelvic organs open out through the natural openings between the legs.

Austen reached down through the abdomen, low inside the girl's pelvis, and grasped the vagina and rectum with her left hand (her chain-mail hand). With her right hand, she inserted a scalpel deep down into the pelvic area. Working delicately by sense of touch, she cut through the base of the rectum, through the vagina, and she cut away the bladder at the base of the urethra. As she was cutting, she pulled steadily. Nothing happened. She pulled harder. The bundle of organs were suddenly freed, and they came out of the body with a bubbling squelch. The sound is known as the pelvic slurp, and it is caused by a suction drawing air inward as the organs are pulled out of the pelvis.

Austen lifted out the block of pelvic organs: the rectum, vagina and uterus with the ovaries, and the bladder. They hung together in a single baglike unit, a sac of organs that weighed about five pounds and wobbled and pendulated in her gloved hand. She placed the mass on the cutting board. It was soft, and spread out like jelly.

She began to feel cold. She wished they didn't keep the air quite so cool in here. She cut the pelvic organs apart from one another with scissors. She opened the bladder. It was empty.

Austen turned her attention to the kidneys. They were lying on the cutting board. She trimmed the kidney fat off them, and then she sectioned a kidney with her knife. The kidney fell in half.

It was unusual.

She saw delicate golden-yellow streaks of color in the renal pyramid, in the center of the kidney. This was abnormal. The kidney should be a dark reddish-brown color, not golden and streaky. So often in an autopsy, color carries meaning. A golden kidney, that was unusual.

'Look at this, Dr Dudley.'

The two pathologists bent over the kidney. Austen sectioned the other kidney, and found golden streaks in it, too. She cut chunks out of both kidneys and put the chunks in the stock jar and in the tox container.

'That yellow tissue is dead,' he said. 'Those are uric acid infarcts, looks like to me. That tissue was killed by deposits of uric acid crystals.'

'She seems healthy. Why would she have a lot of uric acid in her blood?'

'Maybe it's not uric acid. It could be a toxin. That would cause the blistering in the kid's mouth. Maybe she was getting chemotherapy for cancer. That would blast the kidneys.'

'But there's no sign of cancer.'

Austen turned her attention to the rest of the pelvic organs. She separated the rectum from the uterus, snipping through the membrane that joined them. She placed the rectum on the cutting board and split it with scissors, opened it up, and flattened it out, smoothing the rectum with her fingers.

She placed the vagina, uterus, and ovaries on the cutting board. She split the vagina with a knife. The inside of the vagina was speckled with a few blood blisters. Several had broken; perhaps that was what had stained the tampon. She snipped open the uterus with scissors. The tissues were in an early menstrual stage.

Austen sectioned one ovary with a scalpel. The girl's ovary fell apart under her blade. Cells in the ovary can become an adult human being. Looking at Kate's ovary gave Austen a deep feeling, and made her conscious of her own pelvic organs, her unknown future, the probability or hope that someday she would become a mother. This was the girl's motherhood being laid apart under the knife, a future that had ended like a door slamming shut. The tissues of the ovary were unremarkable.

She caught Ben Kly's eye. 'Cranial contents,' she said.

'Okay.' He lifted up the girl's head and placed it on a hard rubber head block. The head block is an H-shaped chunk of black vulcanized rubber. It is used in autopsies to hold up the head and get it off the table, so that the skull can be cut open. He removed the chest skin from her face.

Austen took up a scalpel. She bent down to the level of the table and looked at the side of the girl's head, judging the best place to start the incision. With one hand, she lifted up the russet hair to get it out of the way. She put the scalpel on the skin just above the ear, pushing the tip straight in until it touched bone. Then, slitting the skin rapidly, she made an incision over the top of the head, a coronal incision running from ear to ear, cutting through the scalp. The scalp tissue parted with a slurping sound. It looked like the lips of a mouth opening across the top of the head. Some blood dripped onto the table, forming red puddles on the steel.

Now she gripped the scalp and pulled it forward, peeling it off the skull. There was a faint ripping sound as she pulled. The scalp lifted away very easily. She pulled the scalp and hair forward and then down over the face. As she did this, the whole face was compressed like a piece of rubber. Kate's eyes opened and sagged downward, and her face collapsed, creating an expression that seemed as if she were experiencing the deepest grief in the world. The scalp was now reversed and hanging down from her bare forehead bone, covering her eyes, so the wet, glistening, red inner layer of the scalp was on the outside, like a hat pulled down low. Her hair was underneath it, like a rug turned upside down and lying on her face. A brush of matted hair stuck out from underneath the reversed scalp. This hair hung down and covered her nose and mouth. Then Austen pulled the scalp down off the back part of the skull, down almost to the top of the neck. This revealed the glistening-wet ivory-colored dome of her skull.

It is the task of the morgue attendant to open the skull. Ben Kly took up a Stryker saw and plugged the cord into a socket under the table. A Stryker saw is a power tool with a cutting blade that moves back and forth, rather than spinning around. Kly switched the saw on, and it gave off a chattering whine. He adjusted his safety glasses — you want to make sure your eyes are protected if you are using power tools that throw blood and particles around. The Stryker saw dug into the skull.

A cloud of mist appeared in the air around the girl's head. It drifted and coiled and snaked up from the blade of the Stryker saw, moving like cigarette smoke, and there was a sudden, sharp smell of bone. The 'smoke' was bone dust. It had a piercing odor, strong and unpleasant. It resembled the smell that occurs in a dentist's office when a high-speed drill is cutting into a tooth — a smoky, bony, warm, bloody, wet stench.

Kly grimaced, bearing down hard on the Stryker saw. The cut circled the head. He finished the cut at an angle, making a V notch in the forehead. The notch was so that he could fit the skull bone back on properly afterward, matching the shape of the cut.

Then he took up a steel T-shaped bone chisel. He inserted it into the saw cut, and twisted the chisel. There was a cracking sound. He put it in another place and pried again. More cracking sounds came from the skull. He pried gently, here and there. Then he lifted off the top of the skull. It was a section of bone known as the calvarium. He held it in his hands, upside down. The calvarium was a dish of bone the size and shape of a soup bowl. It was the top of the girl's skull. A pool of blood had collected in the bottom of the calvarium. It was a bowl of blood.

'Calvary,' Kly said in a dreamy way. 'The Place of the Skull.' He placed the bone on the autopsy table, where it rotated slowly.

'You read the Bible too much,' Dudley remarked.

'I don't read it enough,' Kly answered.

He had exposed a gray, leathery membrane that covers the brain, a membrane called the dura mater. Austen continued from that point. She ran her hand over the dura, feeling the membrane. It seemed tight and swollen to her, but that was hard to tell. She took up blunt scissors and carefully cut the dura mater, snipping it away. She peeled it back. The folds of the brain came into view.

The brain was swollen, bulging like a strange forest mushroom. It had an eerie, abnormal, pearlescent color. It was a color that neither pathologist had ever seen in brain tissue before.

'Whoa,' Dudley said.

Austen's heart thudded in her chest. This is a destroyed brain, she thought. She felt a mixture of fear and excitement.

'Flattened folds,' Dudley said.

The folds of the human brain are ordinarily deep and sharply grooved. This brain had turned a silvery color and had puffed up like a balloon. The folds of the brain had been smashed up and pressed flat into the dura mater. The brain was smoothed, swollen, and flattened — as if the wrinkles had been pressed with an iron. This was a technical term, an ironed brain. It was almost as if the brain had exploded, bursting against the inside of the skull.

Austen touched the brain surface. It was very, very soft, like gelatin that had not set properly. The brain was a destroyed mess, almost liquefying. How to remove it? It could fall apart.

Gently, Austen pushed the fingers of her left hand, the chain-mail hand, in around the frontal lobes of Kate Moran's exploded brain. She was feeling her way behind the bones of the forehead, trying not to tear the brain. She pulled the brain back slightly with her left hand, and then, with her right hand, working entirely by sense of touch, she slid a scalpel down low under the front of the skull. With the blade she began probing for the optic nerves, the nerves that connected the brain to the eyes. She couldn't see the scalpel blade, and so she felt around with it, using her sense of touch. She found the optic nerves and cut them. She wiggled the brain and it loosened.

The removal of a person's brain seemed to Austen more of a violation of the person's dignity and privacy than any other procedure in the autopsy, because the brain is the most personal part of the body; the only body part that studies itself. Alice Austen felt that the life of a human being has a sacred quality. She did not know if she believed in the soul; that seemed a difficult question to answer. But she believed in the sacredness of human life. One very important way to honor life is to try to find out how it ended.

Austen pulled the brain backward, rolling it and lifting it. This brain is impossibly soft, she thought. Finally she had lifted the brain enough to gain access to the top of the spinal cord. With a quick angling slice of the scalpel she cut the spinal cord, and the brain fell into her hands.

Cradling the organ in her cupped hands — it was hugely, abnormally heavy, engorged with fluid, and so jellylike it threatened to slop apart — she placed the brain in the scale pan and weighed it.

'Oh, wow. Sixteen hundred and twenty-five grams,' she said. It was a superfat brain.

Keeping her hands cupped around the brain, she lowered it to the cutting board. Then she turned the brain over, upside down. She let it go, and it spread out under its own weight, like a blob. It flowed over the cutting board like a bag of water, it was so soft.

It was a spotted blob.

The underside of the brain was speckled with tiny red spots.

She stared at the spots. They were small red speckles, tiny, less than a millimeter across. They were starlike hemorrhages. Yet there had been no general bleeding in this brain, no massive hemorrhage. It was a glassy, swollen brain speckled with red spots.

When a person gets measles, the skin erupts with red spots. The brain, when infected with a virus, also can become spotty.

She became aware of the fact that she was alive and this brain was not alive. But it might have something alive in it. 'I see a lot of small bleeds,' she said to Dudley.

Austen began trying to make a diagnosis. The word diagnosis in Greek means 'knowing through.' In a successful diagnosis, you search through possibilities, casting them aside, ruling things out, until at last there comes a sensation of a click, a locking in place, and the fragments of a puzzle snap into a clear picture.

She was missing something. What was it? She moved around the table, to reposition herself for further examination of the brain. In doing so, she brushed against the calvarium — the top of the skull — which was lying upside down on the table, with the pool of blood in it. It was getting in the way, so she picked it up in order to move it to a different place, and it slipped from her already slippery fingers. It hit the blood-covered metal of the table with a clang, and a fine spray of blood droplets went into the air.

'Damn!' Dudley said, drawing back.

There were tiny spots of blood on his eyeglasses.

'Good technique,' he said.

'I'm sorry. I'm very sorry.' A wave of nervousness swept over her, and her stomach clenched. 'Did you get any in your eyes?'

'No. Fortunately. That's why we wear eye protection.' He had a cold look on his face.

There was nothing to do but keep going. Looking at the brain, she saw the effects of brain swelling. The brain is encased in a hard skull, and when it swells, through injury or infection, it has nowhere to go. So it destroys itself. The brain puffs up with fluid — in the way any injured tissue does — and it crushes itself.

The swelling brain pushes downward on the deep structures at the top of the brain stem, especially on the midbrain. The midbrain is an old brain, a primitive brain. It contains nerve branches that control basic functions such as breathing and heartbeat, and it contains the nerves of the face; it also contains the nerves that govern the action of the irises of the eyes in response to light. If you crush the midbrain, these nerves are destroyed. The pupils dilate and become fixed, breathing ceases, and the heart stops beating.

Austen saw deep grooves in the underside of the brain. These grooves were a sign of rupture of the brain: the brain had almost literally burst. It had changed shape as it puffed up and died. The moving finger had written its message on Kate Moran's mind: she could not have been saved by any medical procedure. This was a hopeless case. By the time the girl collapsed, she was doomed. As the brain crushes itself, the blood pressure can shoot sky high. This is a shock response known as the Cushing reflex. It happens in the moments before death. The brain must have blood, and as the swelling begins to close off the arteries that supply blood to the brain, and as pressure in the brain rises, the body drives up its own blood pressure to meet the rise in brain pressure. The body is trying to drive blood into the brain at all costs, because if the blood supply to the brain is lost, the brain stops functioning in a matter of a few seconds. Thus there can be a tremendous terminal spike of blood pressure. As the patient approaches death, the systolic blood pressure soars as high as 300. Normal systolic pressure is about 120. The sudden spike in blood pressure during a Cushing reflex can trigger hemorrhages, sudden bleeds anywhere in the body. The pressure soars, the pipes burst. The patient starts to bleed, the patient dies. That, Austen thought, was the cause of the girl's bloody nose. Her blood pressure had spiked, causing a hemorrhagic nosebleed at the point of death.

'This could be a virus infection of the brain. It led to brain swelling, which was the immediate cause of death,' Austen said. 'It triggered a Cushing reflex with a bleed from the nasopharynx.'

Dudley looked at her. 'Fine. We have an unknown brain virus that caused a nosebleed. Is that what you're trying to tell me?'

'This scares me. I've never seen anything like it. I want to section this brain,' she said.

'The brain's a mess,' Dudley said.

'I want to try.'

'Go ahead.'

She dipped her knife in the water of the rinsing tank, to wet it and make it slippery. She laid the edge across the brain, in a coronal section, as if going from ear to ear, and she sliced downward crisply in a smooth motion. She sliced again and again, her knife moving quickly, making slices that were about the thickness of slices of bread.

The brain slimed apart. As her knife hit it, it slumped into a kind of glassy, red-gray mush. Austen ended up with a slippery jumble of bloody-wet brain tissue that seemed to gleam with a pearlescent color under the lights. It spread out in a soupy mess on the cutting board.

'You've ruined it!' Dudley said.

Austen said nothing. She was tempted to warn him to back off.

'You've turned the kid's brain into roadkill!'

'I'm sorry, I'm doing my best.' She sliced through the deep brain structures. Again, the tissue almost melted under the knife. Inside the girl's midbrain and pons medulla, she found what she was looking for: small weeping hemorrhages. These secondary weeping bleeds were areas of bloody discoloration, the result of tearing and crushing of the brain structures as the brain squeezed down upon them.

Ben Kly carried a glass jar over to the table. It was full of formalin. Using her knife as a paddle, she scraped and scooped the pulpy brain off the cutting board while Kly held the jar under it. The brain coddle plopped and splashed into the liquid, and floated in distorted fragments.

'Something destroyed the girl's central nervous system,' she said.

The Chief

'So how did it go?' Lex Nathanson asked, half an hour later. Austen had found him in the death-reporting area, reviewing some new cases.

'It was bad,' she said. She had changed out of her scrubs and back into her street clothes, but she noticed — in a vague kind of way — that she smelled like Kate Moran. That would last for hours, unless she took a shower, and she did not have time for a shower.

They went into Nathanson's office, and he slid open a drawer of his desk and took a cigar from a box and put it in his mouth, and then rummaged around for something. 'Where in the hell is my cutter?' He held up a second cigar. 'You want one?' he said.

Austen grinned. 'No, thanks.'

'Yeah? You're sure? These are twenty-buck cigars. If this vice of mine bothers you, please say so, okay?'

'It's not a problem.'

He had found his cutter, and he notched the end of the cigar. He struck a wooden match, and, not holding the cigar in his mouth, but in his fingers, he toasted the end, rolling it gently in the match flame until the end of the cigar turned gray. 'I'm afraid I am not an example to young people. Not only are these cigars a vice, but I have too much yellow abdominal fat. When they autopsy me — and I will insist on it — they will find a rat's nest of problems, I'm sure. It is true that pathologists do not always learn from the lifestyle disasters they see on the autopsy table.' He drew on the cigar. A soft and mellow tobacco smoke infused the room. 'Anyway, Winston Churchill smoked approximately sixty thousand cigars during his lifetime, and he lived to be ninety-one. Tell me what you found.'

Austen described the findings: blood blistering in the external openings of the body, including the mouth, nasopharynx, and eyelids. Golden streaky damage to the kidneys. Fatal brain swelling.

Nathanson looked at her quizzically. 'Go on. Tell me about the C.N.S.' The central nervous system.

'The destruction was massive.'

'How so?' he asked.

'The brain was devastated.' She tried to summarize it. 'The brain was puffed and swollen and had lost its physical integrity. It almost literally collapsed when I sectioned it. It had a shiny, glassy, reflective coloration that I've never seen before. The brain had turned into a kind of — how can I describe it? — like some kind of glassy pudding. She had a severe nosebleed, and she bit her tongue and mouth and lips very severely. She also showed signs of a common cold — streaming mucus exudate from the sinuses. There were golden pupillary rings in the irises of the eyes, with flamelike offshoots. It made the pupils look as if they were on fire. The total effect was — well — frightening. It made me think of a virus infection involving the central nervous system and possibly the tissues of the mouth and eyes and other openings of the body.'

'We don't have the capability to test for a virus here.'

'You don't have a lab for that?'

'No. We send biosamples over to the city health department's lab. They test for bacteria. They don't test for viruses.'

'We can do it,' Austen said. 'May I send some samples down to C.D.C.?'

'Sure. Give them to Walt with my regards.' He gave her a sharp look. 'How are you getting along with Glenn?'

Austen took a moment to reply, and she framed her answer carefully. 'He's straightforward in his views.'

'Boy — you're quite a diplomat.' Nathanson drew on his cigar. 'Glenn's being a pain in the neck. If he gets to be too much of a pain, let me know and I'll kick his ass for you. But I imagine you can handle yourself, Dr Austen.'

She nodded and said nothing.

He went on, 'Glenn's having a bad time in his personal life. His wife recently left him. She took the children with her. He had been having an affair with a younger woman. But Glenn is a colleague and a valued member of my staff.'

'Of course.'

'Do you want to continue with this investigation?'

'Yes, I do.'

'Really, I don't want to impose on you. I could turn this over to the health department.'

'You're not imposing on me, Dr Nathanson.'

He smiled broadly. 'All right, enough of this "my dear Alphonse." Whaddaya need?'

'Well — I'd like to look at all your recent case files.'

'Sure. What else?'

'I'll need a telephone. Also a map of New York City.' There was a pause while he smoked his cigar. 'That's all you need?'

'Epi work is pretty simple,' she said. She looked out the window of his office. There wasn't much to see, only the brick wall of the next building, but she observed that it had begun to rain. 'I forgot to bring a raincoat.'

'I'll get you one of our slickers. And you'll need an office, won't you?'

'I guess so.'

They gave her a tiny office, almost a closet, on the third floor. Someone brought her a bright yellow rain slicker. Across the back in black letters it said, ^'OFFICE OF CHIEF MEDICAL EXAMINER.' It was a disaster raincoat, meant for protecting workers from blood and body fluid splashed around a disaster site, as well as from rain. It smelled of sweat.

The room was the office of a staff pathologist, a woman who was away on maternity leave. The office's one window looked out on the blank wall of a parking garage some feet away. It was a nicer room than her digs in the C.D.C., anyway. She wondered why epidemiologists inhabited the world's worst offices. She taped a map of New York City to the wall. With a pencil she marked an X on the map: at the location of the Mater School on Seventy-ninth Street, where Kate Moran had died. She marked another X on Times Square, where Harmonica Man had collapsed. The marks showed the location of death. They did not show where the victims had been exposed. If indeed they had been exposed to anything. If this was an outbreak of an infectious disease or a rash of poisoning, Harmonica Man was the first identified case. He was therefore what was known as the index case. Kate Moran, who died less than a week later, was the second case. There was no obvious connection between the two cases. It was not necessary for Austen to know what had killed them in order for her to begin an investigation. As Dr John Snow knew, epidemiology can proceed without any knowledge of the nature of the disease-causing agent.

Deeper

Kate Moran's tissues were being processed in the O.C.M.E. histology lab, and they would not be ready for viewing for about a day. In the meantime, Harmonica Man's tissues could be examined, and Austen called for samples, giving the case number to a technician. 'Those slides have been checked out by Dr Dudley,' he said. So she went down to Glenn Dudley's office on the third floor and found Dudley sitting at a small table, staring into the eyepieces of a doubleheaded microscope. This is a microscope with two sets of binocular eyepieces, so that two people can look at a specimen at the same time.

'What do you want?' Dudley said without looking up.

'I wanted to take a look at the tissues of the first case.' He grunted and kept staring into his microscope. Austen sat down across from Dudley, facing him, and looked into the other set of binocular eyepieces. She saw a field of brain cells. It was a thin slice of Harmonica Man's brain tissue.

'It's from the underside of the temporal lobe,' Dudley said. 'The area of the hippocampus. It seems damaged.' She let her gaze relax. She wandered through fields of cells. She saw threadlike neurons, which are the nerve cells that send signals in the brain. She saw other types of brain cells, and she saw white matter, which is a fatty substance in the brain. She came to a damaged area, where she began finding red blood cells. 'I think I'm getting into a bleeding spot.'

'Nothing else? Okay, I'm zooming.'

The scene jumped. The cells were magnified more strongly. 'Look at these cells,' he said. 'Zooming again.' The scene jumped forward. They were on a voyage, running deep into the brain of Harmonica Man.

There was something wrong with the cells. A neuron, a nerve cell, is a long thread with branches. Somewhere in the middle of the thread there is a bulge. Inside the bulge there is a dot. The dot is the cell's nucleus, where the cell's genetic material is stored, its DNA. The nucleus of a cell looks like the yolk of a fried egg. It contains the chromosomes, which are pods of coiled protein that hold the cell's DNA intact. Austen did not like the way these brain-cell nuclei looked.

'The cell nuclei are abnormal,' she said. 'Would you zoom again, please?'

The scene jumped. The nuclei were bigger.

'That's the highest magnification,' Dudley said.

It was hard to know what you were looking at. Life at the cellular level is complicated. There seemed to be structure in the cell nuclei — structure that didn't belong there. Then she saw something. It was something she had never seen before, not even in a textbook. There were objects sitting in the cell nucleus. Things. Maybe this was something normal. Maybe the stain in the cells had brought out some feature that was explainable. It was hard to tell.

'What is this, Dr Dudley?'

He grunted. He didn't have any answers either.

The objects in the nucleus were shiny, glittery, angular crystals. They had a mathematical shape. They were bulging with many facets, like angular soccer balls. They were far too large to be virus particles. Virus particles are invisible in a regular microscope.

The light broke apart in the crystals and seemed to shimmer.

'This is like nothing I've ever seen before, Dr Dudley,' Austen said.

'It's weird,' Dudley replied, sounding unsure of himself. 'This must be some kind of chemical compound. There's some new drug hitting the street.'

'Maybe these crystals are lumps of virus in a crystallized form,' Austen said.

'Lumps! Lumps of virus. Don't be an idiot,' he snapped. And he continued to stare into the microscope in silence.

Union Square

A cool and gentle April rain was passing over New York City. Alice Austen stared out the window of her office at the O.C.M.E., watching water run down the blank wall. Then she put on the yellow disaster raincoat, shouldered her knapsack, and took a taxi to Union Square.

A television van from Fox Channel 5 was double-parked on the street in front of the Morans' building. A young woman reporter spotted Austen's yellow raincoat as she rang the buzzer. 'You're from the medical examiner's office? What happened to Kate Moran? Was she poisoned? Was it a murder? Can you tell us anything?' Behind her trailed a video man.

'I'm sorry, but you'll have to talk to the chief medical examiner,' Austen said. The buzzer sounded, and she slipped inside.

The girl's parents, Jim and Eunice Moran, sat holding each other's hands on a couch in the living room. They seemed devastated. A large black-and-white photograph in a steel frame — a portrait of Eunice Moran by Robert Mapplethorpe — leaned against the wall across from the couch. In the photograph Mrs Moran was wearing a soft white wool turtleneck sweater, and she looked thoughtful and elegant. In real life she was haggard, her eyes red from crying.

The housekeeper, an older Irish woman, retired to the kitchen, her footsteps padding on the oak floor. Austen heard sounds of her weeping.

Austen knew that people who are in the throes of grief can have unpredictable reactions to an epidemiologist asking questions, and she very gently identified herself as a doctor with the Centers for Disease Control in Atlanta, working with the city medical examiner's office. When Kate's parents understood that Austen had been dispatched to New York to investigate the death of their daughter, they spoke freely with her. The conversation was difficult, because at times Jim and Eunice Moran lost their ability to speak. Kate had been an only child. The parents' life stretched ahead of them into a future that was more empty than they could have imagined.

They knew there had been an autopsy — in a case of sudden unexpected death an autopsy is required by law, and they had been notified. Austen chose not to tell them that she had performed the autopsy. 'Your daughter's body was released to the funeral home an hour ago,' she said. 'However, because of the risk of possible infection, the city has ordered a cremation. The funeral home was instructed to take universal biohazard precautions. I called them myself and spoke with them, and they know how to do that.'

'What do you mean, biohazard precautions?' Eunice Moran said. Her voice sounded like breaking glass.

'I'm sorry. Your daughter may have had a contagious disease.'

'What kind of disease?' Mr Moran asked.

'We don't know. We don't even know if it was contagious. What I'm here to do right now — I know it's hard — is, I need to ask you some questions about what your daughter did and where she went during the past days and perhaps weeks, while your memory is fresh. We want to try to find out if she was exposed to something.'

Mrs Moran held her husband tighter. Finally she said, 'We'll try to help you.' She nodded at a chair. 'Please sit down.'

Austen sat on the edge of the chair. 'Can you think of anything Kate did lately that might have exposed her to something infective or toxic? Did she travel in a foreign country recently?'

'No,' Mrs Moran said.

'Was she receiving chemotherapy for cancer?'

'Kate? No!'

'Was she taking any strong or potentially toxic medications?'

'No,' Mrs Moran said.

'Did she receive any vaccinations recently?'

'No.'

'Did she eat any shellfish or unusual foods? Visit any unusual places?'

'Not that I can think of,' Mrs Moran said.

There was silence.

'Had she been outdoors in the woods, hiking or camping, where she could have been bitten by a tick?'

'No.'

'Did Kate have a boyfriend?'

They weren't sure. They said that Kate had been going out with someone her age, a boy named Ter Salmonson.

Austen wrote the name down in her green epi notebook and got his phone number from Mrs Moran.

'She broke up with Ter, I think,' Kate's mother said. Austen asked if they could carefully review Kate's movements over the past two weeks. The parents were vague. Kate's life had been quiet. She had friends, but she wasn't a heavy socializer. She was a fan of rock music, and her parents had forbidden her to go to certain music clubs, but there had been no real trouble over that.

'There's another question. This is hard for me to ask. Do you know if Kate used drugs?'

'Absolutely not,' Mr Moran said.

'She didn't smoke pot or anything?'

'I don't know — I don't think so, no,' Eunice Moran said.

Kate took the subway to school every day. She would come home late in the afternoon. She'd go into her room, listen to music, talk with friends on the telephone, do her homework, have supper, do more homework, sometimes surf the Web and send e-mail, go to bed.

'I've been very busy with my work,' Jim Moran said. 'We haven't done much as a family together lately.'

'Did she go anywhere recently?'

'The only thing I can think of is her art project for Mr Talides, her teacher,' Mrs Moran answered. 'It's a construction thing or something, and Kate was going around buying her boxes and things — when?' She turned to her husband.

'I don't know,' Mr Moran said.

'Last weekend, I think. She was buying things in SoHo and on Broadway and at the Sixth Avenue flea market, I guess. Mr Talides was —' Mrs Moran's voice cracked. 'I can't stop thinking — I'm sorry — he tried to save her.'

'Do you know, did he attempt C.P.R.?

'He had forgotten what to do, that's — that's what he told me when he called. He was very upset.'

Austen made a note to herself to interview the art teacher right away. He might have been exposed. On the other hand, she was beginning to get an uncomfortable feeling that this could turn out to be a wild-goose chase, that she had been pushed into some kind of hopeless problem by Walt Mellis. An unsolved outbreak. One of those blips that never gets explained.

The telephone rang. The housekeeper, whose name was Nanette, answered. It was a priest calling about the funeral arrangements. Austen could hear Nanette saying, 'There won't be a wake, Father, no, no, the health authorities have forbidden…'

'Do you mind if I look around the house just a little?'

The parents didn't answer.

'Sometimes looking can be helpful. Also, would you mind if I took some photographs?' She removed her electronic camera from her knapsack. 'May I look in the kitchen, and in Kate's bedroom?'

They nodded, somewhat reluctantly.

She went into the kitchen first. Nanette hurried out as soon as Austen entered, almost hiding her face from her. It was a pleasant kitchen, with gray stone counters and a huge stove. She opened the refrigerator.

Austen did not think this was a food-borne illness, but she could not be sure, and there was, too, the issue of whether Kate had consumed a poison. She moved a few things around in the refrigerator. She photographed as much of the food as she could. Milk, some fish in paper. She opened the paper. It was salmon; it smelled fresh. Red-tipped lettuce. A bottle of French white wine, half finished. She sniffed at the wine. It seemed okay.

Then she went into a hallway. Down the hall was a door standing half open. It led to Kate's bedroom.

It was a beautiful room, with bare brick walls, illuminated by a skylight. It was cluttered with a teenager's life. There was an unmade bed, a poster for Phish on the wall — the drummer Jon Fishman strutting onstage wearing a dress. There was a poster of a Vermeer painting: a young woman playing the clavichord. In the closet she found baggy jeans, tight silk tops, little strap dresses, a short leather jacket. Kate must have been sensitive and hip, somewhat arty. There was an old bureau. A maple box containing odd bits of junky jewelry. There was a desk with a computer, and a table piled with bric-a-brac. There were joke dolls, a row of flutes and pennywhistles lined up next to each other, made of wood, plastic, reed, and steel. In the center of the table stood a dollhouse. This had to be Kate's art table. There were small antique boxes, large new metal boxes. Small metal cans and tubes. A can that said, 'Twinings Earl Grey Tea.' Plastic containers of all shapes and colors. Delicate boxes made of wood. Everything was well organized and ordered.

Austen had been wondering about the issue of drugs. She opened the drawers in the desk and opened some of the boxes, looking for drug paraphernalia. There was nothing like that to be found. She began to rule out Dr Dudley's hypothesis that Kate might have been a drug user. This was not the bedroom of a druggie.

Kate had had quirky taste and an unusual sense of color and shape. Austen switched on her electronic camera and began to take photographs of the room. The light from the skylight gave everything a cool radiance. Momentarily she felt as if Kate were standing in the room with her; it could not be so, but she felt the existence of a world next to ours. That world was real, in a sense, for Kate was present in the arrangement of the objects, which had not been moved or touched since her death.

Austen opened up a box. Inside it was a mechanical toy beetle. It stared at her with sad green jeweled eyes. She put it down in the spot where she had found it, reluctant to move Kate's arrangements. In another box was a miniature cast-metal car. The camera focused automatically. She began shooting everything. There was a box full of bird feathers: from blue jays, a cardinal, a crow, and a banded feather that she thought might have come from a red-tailed hawk, but she wasn't sure. There was a box made of wood with a polygon painted on it. She tried to open it but it had a puzzle catch she couldn't figure out, so she took a picture of it. She photographed a sharp-looking jagged metal spring. She photographed a chunk of green malachite. An old skeleton key in a padlock. The skull of some small bird, maybe a sparrow. An amethyst geode. Then there was the dollhouse. Kate seemed to be taking it apart. She stepped back and took a picture of the dollhouse. She took a picture of the whole room. She wondered if she would ever look at these pictures again. They might hold information. Or maybe not. She jotted a few notes in her green epi notebook.

Tracking

Austen followed the same route to school that Kate had taken every morning: she walked to Union Square and then took the subway to the Upper East Side, trying to get a feel for Kate's world. The Mater School was situated in a quiet, wealthy neighborhood, among town houses. Austen arrived there at three o'clock in the afternoon. The headmistress, Sister Anne Threader, had ordered a morning assembly and chapel, and then had canceled classes but had kept the students in school for a day of reflection and prayer. She had dismissed school shortly before Austen arrived, but some of the students had elected to stay, and Sister Threader had seen no way to argue with that. She was a tiny woman in late middle age, with straight white hair and piercing eyes. She wore a pale blue dress rather than a nun's habit. 'Kate was a much loved person here,' she said to Austen. She led her to the art room. Three students were there, sitting around, doing nothing. They were subdued, in, shock, and had been crying.

'Where is Mr Talides?' Sister Anne asked them.

'He went home,' one of the students said. 'He was feeling really bad.'

'I'm so angry, Anne,' another young woman said to the headmistress. It was Jennifer Ramosa. She had been crying with rage about that which she could not change.

'God understands your feelings,' Sister Anne said. 'He loves Kate as you love her, and he understands your being angry.'

'I saw her die,' Jennifer said. Her voice trembled. Sister Anne took Jennifer's hands. 'Life is a mystery, and death is a mystery when it occurs. When you are reunited with Kate you will have answers, but for now what we need to be asking is what Kate would want us to do.' Austen felt the question herself. What would Kate want of her?

'Kate never got a chance,' Jennifer said.

'We don't know that,' Sister Anne said. She suggested that they all pray.

Finally the headmistress said, 'This is Dr Alice Austen. She is here to try to find out what happened to Kate.' 'I'm a doctor working with the City of New York,' Austen said.

'Kates was one of my best friends,' Jennifer Ramosa said. 'I can't believe she's gone.'

'I think she would want us to find out what happened,' Austen said. Then she said, 'May I look around the room?'

She poked around the art room while the girls watched her, and Sister Anne spoke quietly with them. Nothing seemed unusual. There were coffee cans gobbed with paints. Tubes of gesso, canvas on stretchers. Kate's project area had been a table in the corner. On it stood more of Kate's things and a very large construction that looked like a house, sort of a dollhouse, but larger and more complicated.

Austen turned and faced the students. 'Did the art teacher, Mr Talides, get close to Kate when she was ill?' Two of the girls nodded.

She turned to the headmistress. 'Do you have his home telephone number?'

It was late afternoon on Thursday now, still the first day of Austen's investigation, and rush hour was beginning. It was about thirty hours since Kate Moran had died, thirty hours since Peter Talides had been in close proximity to Kate during the agonal phase of her illness. If Talides had been infected with something, he would probably still be in the incubation period, and he might well be asymptomatic, showing no signs of illness. Austen did not think that an infectious agent would cause any but the most subtle sign of illness during thirty hours or so. But she wanted to get in touch with Talides, have a look at him, and to keep track of him.

She got on the N train headed for Queens. Twenty minutes later she stepped off the train at the elevated station at Grand Avenue. A set of dilapidated iron stairs debouched into a bustling neighborhood of small markets, dry-cleaning shops, hair parlors, a Greek restaurant, a gas station. She tried to figure out where to go. She walked a few blocks into a quieter neighborhood and found herself in a small park. There were some Doric columns and a bronze statue of a man in a robe. Curious, she went over to the statue. It was Socrates — him all right, with his misshapen face and bushy beard. Under him were engraved the words 'Know thyself.' The name Talides — she realized that this must be a Greek neighborhood. It began to dawn on her just how exquisitely local are the neighborhoods of New York City. She was looking at a biological system of bewildering complexity.

She kept going, turning up a side street. Peter Talides lived in half of a small duplex house made of brown brick. She rang the front doorbell.

Talides opened the door immediately. He was a pudgy man, with a kindly, sad face. His living room was also his studio. There were canvases stretched on frames, coffee cans holding paint and water, paintings piled up against the wall. The colors were bold and vibrant.

'I apologize for the mess,' he said. 'Please sit down.' She sat in a threadbare easy chair. He sat on a swiveling stool. He sighed a deep sigh. He seemed on the edge of tears.

'I'm very sorry about what happened,' she said. Peter Talides thanked her for her concern. 'My life is the school and my painting. I live alone. I have no illusions about my talent. But-' He pulled out a handkerchief and wiped his nose. 'I try to make a small difference with the kids.'

'Can you describe what you did to try to save Kate?' 'I — ' He sighed. Long pause. 'I tried to remember how to give rescue breaths. I couldn't remember… how… I had the lessons, but I couldn't remember — I'm sorry, this is very difficult for me.'

'Did you put your mouth to her mouth?' 'Very briefly, yes.'

'Was there blood?'

'She had a — bloody nose.'

'Did any of the blood get on you?'

His voice trembled. 'I had to throw away my shirt.' 'Could I look at your face more closely?'

He sat on the stool, uncomfortable and embarrassed. She looked at him carefully.

'Do you have a cold?' she asked.

'Yes. Runny nose. Stopped-up sinuses.'

Austen took a deep breath. 'Have your eyes been bothering you?'

'Yes. They bother me when I have a cold or allergies. I have frequent allergies.'

'Can you describe the sensation in your eyes?' 'It's nothing. Just itchy. runny. Like an allergy.' 'I'm concerned.'

'About me? I feel okay.'

'I can't give you an exam — I'm not a clinician.' She did not mention to him that she also did not have a license to practice medicine in New York, and so she was barred by law from doing a patient exam. 'I'd like for you to go to a hospital emergency room with me. We'll get a medical team to work you up.'

He looked startled.

'But it's probably nothing,' she said.

'I really don't want to go to the hospital. I feel okay.' 'If you don't mind — may I just look at your tongue?' She didn't have a tongue depressor. But she reached into her knapsack, felt around, and found a small case. From it she removed a penlight. She switched it on and asked him to say 'ah.'

'Ahhh.'

'Well, your tonsils are a little reddened. It looks like you have a cold,' she said. 'Could I–I'm sorry — could I just look at your eyes?' He was reluctant. He seemed very nervous now.

She went around the room, closing the venetian blinds. Then she did what was called a swinging flashlight test. She pointed the beam of light first into one pupil and then into the other. The color of the irises seemed completely normal. He had deep brown eyes. She watched the responses of his pupils to the beam of light. She thought she saw a delayed response. That might be a subtle indication of brain damage.

This is ridiculous. I'm overreacting, she told herself. There's no clear evidence that Kate had an infective disease. There's been no human-to-human transmission.

She said, 'If your cold changes in any way, would you please call me?' And she gave him her cellular-phone number and the number at Kips Bay. 'Call me anytime, day or night. I'm a doctor. I expect calls.'

On her way back to the subway station, she wondered if she had done the right thing. As a lieutenant commander in the United States Public Health Service, Alice Austen had the legal power to order a person into quarantine. Even so, officers with the C.D.C. virtually never invoke this power. It is C.D.C. policy for field medical officers to work quietly, to avoid drawing attention to themselves, and to refrain from doing anything that might create a climate of fear in the public. She glanced at Socrates. He had no advice to give, except that she know herself.

Unknown

Back at Kips Bay that night, Alice Austen felt exhausted, and also ravenously hungry. You forget to eat during investigations. She found a Thai take-out restaurant and brought back boxes of food to her room. Mrs Heilig gave her a disapproving look as she carried them into her bedroom. She sat at a desk and ate noodles and lemongrass chicken with her Boy Scout knife, fork, and spoon set. Meanwhile, she telephoned Walter Mellis at home on her cellular phone. She did not want Mrs Heilig to overhear the conversation, and she had a feeling that Mrs Heilig would try to listen if she could.

'So what's up?' Mellis said.

'Walt — this thing has me scared. It could be an unknown infectioe agent that destroys the brain. It would be a virus, not a bacterial infection. I think — ' She stopped. She put her hand to her forehead. It was covered with sweat.

He was silent on the other end of the line. ,

'I think we may have done a hot autopsy this morning. Without strong biosafety containment.' There was a pause. 'Good Lord!' he said. He hadn't really expected anything like this.

'I'm going on observation, Walt.' She explained her findings, the rings in the eyes, the swollen, glassy brain covered with red spots, the blood blisters in the mouth and nasopharynx. She mentioned the unidentified lumps of material that seemed visible in the brain cells of the index case, Harmonica Man. 'If it's an infectious agent, it's really bad.' she said.

'No lab results from the second case, the girl?' he asked.

'It'll be another day.'

'What lab is doing the work?' he asked.

'I wanted to talk with you about that. The city health department's lab is testing for bacteria. But it can't test for viruses — they just can't do that.'

'Look, if you think this is serious, then we need to get samples here to C.D.C. so we can start doing some testing.'

'That's what I wanted to arrange with you.'

'I'll take care of it through Lex. How soon can you return?' he asked.

'I don't know. I still have some street work to do.' 'What kind of street work?'

'You were the one who preached John Snow at me.' There was a pause while she ate Thai noodles.

'All right,' he said.

She took a long shower, collapsed into the carved bed, and pulled the blankets up to her chin. When she was a girl, around ten years old, and the family was vacationing in a little resort motel on the seashore of New Hampshire, she had sometimes had trouble falling asleep. Her parents had put her on a folding steel cot in a room with her younger brother. She had loved to curl up with a Nancy Drew mystery book, her head nestled in the pillow, which smelled faintly of mildew and the sea. She had read all of the Nancy Drew mysteries as a girl. This made her think about her father, living alone now in Ashland, near the lake. I've got to call Dad, she thought.

She could hear Mrs Heilig padding around the kitchen, and then a television went on. For a long time, she could not fall asleep. Her window looked out on First Avenue. Late into the night, sounds of traffic came through the glass, trucks rumbling, taxis honking, the occasional ambulance heading for one of the emergency rooms. The normal sounds of the city. She thought: this can't be as bad as it seems. I haven't shown any connection between these two cases. The Moran girl's death may not have anything to do with Harmonica Man. The traffic moved on the avenue like blood swishing through an artery.

The Ladies' Room

Mark Littleberry was standing over Hopkins in the cloud of dust left by the truck containing the portable lab. He was holding a plastic sample tube. Without a word to Hopkins, he grabbed the swab out of his hand and jammed it into the tube. 'Truck sample number onel' Littleberry put the tube in his shirt pocket.

Hopkins stood up, brushing dust off. 'Did you get a look, Will?'

'Yeah. What was it?' 'It was-'

The minders arrived and crowded around. They seemed almost hysterical.

'What was in that truck?' Littleberry demanded. 'I shall inquire,' Dr Fehdak said.

Littleberry let loose a stream of unprintable language. The Kid's face darkened. He spoke in Arabic.

This was nothing, Dr Mariana Vestof said. It was a routine delivery of a vaccine.

'I shall try to get information on this,' Dr Fehdak said. 'Why did one of the men in the trucks speak Russian to me?' Hopkins asked.

'You must be mistaken,' Dr Fehdak said. Hopkins and Littleberry looked at each other. 'The inspectors need a rest room!' Littleberry suddenly shouted. 'According to the terms of Security Council agreements, inspectors are to be accorded private use of rest rooms whenever they ask for them.'

Hopkins and Littleberry were led back into the building. When they arrived at the door of the rest room, they noticed that some of the minders were snickering. Others were jabbering on their radios.

'I think it's a ladies' room,' Littleberry said to Hopkins. 'Just go in.' They closed the door after themselves and locked it.

Dr Azri Fehdak was in a state of shock. He was seeing his life pass before his eyes. Hopkins had noticed one of the foreign advisers. And Fehdak wasn't certain, but he thought he had seen Hopkins holding a swab inside the truck. He wondered if Hopkins had taken a photograph. It would be virtually impossible for these two inspectors to convince the United Nations that they had seen anything of a military nature. But the swab… if anything was proven, Dr Fehdak was likely to be shot by his own government, for having allowed U.N. inspectors to take a swab inside that place.

Dr Mariana Vestof looked grim. 'That rest room is for the female technical staff,' she said. 'It is not for those men.'

'Perhaps they are nervous,' Dr Fehdak said.

One of the minders, an intelligence official named Hussein Al-Sawiri, pounded on the door. 'Everybody healthy?' he asked.

No answer.

The Kid rattled the door. 'It's locked,' he said. 'They locked it.'

The ladies' room was gleaming and antiseptic, set with green and white tiles.

'This whole situation is gonna blow sky high,' Littleberry said. 'I did not expect to find a truck. We have to do this fast.'

Hopkins stripped off his rubber gloves and put on a clean pair. Then he placed the Halliburton case on a sink. He crouched down until he was staring at the Halliburton, looking at a small optical lens near the handle. He brought his right eye close to the lens. The system recognized the pattern of blood vessels in his retina as that of 'Hopkins, William, Jr, Reachdeep.' Any attempt to open the case without the eye-key would cause the self-destruct process to initiate.

The locks inside the case slid open, and he lifted the lid. Meanwhile, Littleberry placed his Halliburton case on a sink, and it popped open.

The two Halliburtons contained biosensors. They were used by the United States Navy for sensing and analyzing biological weapons. A normal laboratory that does this occupies several rooms full of machines.

'I'm gonna do a hand-held Boink, real quick,' Littleberry said. From the suitcase, he lifted out an electronic device about the size of a paperback book. It was a palmsized biosensor. People called it a Boink because it let off a pleasant chiming sound if it detected a biological weapon. The Boink had a screen and some buttons and a sample port — a little hole. The Boink could test for the presence of twenty-five different known biological weapons.

Littleberry took the small tube that contained the truck sample from his pocket. He took out a disposable plastic pipette. It was a little droplet-sucker. He sucked up a droplet of the sample liquid and dropped it straight into the sample port in the Boink.

Then he waited a moment. He stared at the readout screen. He was hoping to hear a chiming tone. There was silence.

'Damn!' he said. 'What, Mark?'

He was staring at the readout screen. 'No reading. It didn't boink. I've got a blank screen here.'

'All right, Commander. Should I run Felix?' 'Yeah. Quick.'

There was pounding on the door. 'Is somebody ill in there?' It was Hussein Al-Sawiri, the security man. 'It's just taking a little time,' Hopkins replied. He took the truck sample tube over to his Halliburton case, which held a device called Felix, a black box the size of a big-city telephone book. It was a biosensor device known as a gene scanner. It was controlled by a laptop computer, and it could read the genetic code of an organism very fast.

Hopkins lifted the laptop from the Halliburton and placed it on a window ledge. Working very, very quickly, his hands moving fast, he ran a data cable back to the Felix black box and started the computer. The computer's screen turned on and glowed. It said:

Hopkins hammered in his password. 'Come on, come on,' he said.

Using a pipette, Hopkins dropped a bit of liquid from the sample tube into the sample port in the Felix black box. He tapped the keys of the laptop computer.

'P.C.R. amplification has started, let's hope,' he said to Littleberry.

He stared at the screen. More pounding on the door.

'Not finished!' Littleberry shouted.

'Amplification of the DNA is completed,' Hopkins whispered. 'The DNA's moving onto the chip.'

The door began to shake. 'Open up!' Hussein Al-Sawiri shouted.

'This is a United Nations toilet facility,' Littleberry yelled over his shoulder.

Hopkins gestured wildly to Littleberry. 'We've gotta start beaming,' he hissed.

From his suitcase Littleberry removed a black panel about the size of a notebook. It was attached to a cable. It was a special satellite transmitting antenna. He plugged it into the laptop computer while Hopkins tapped the keys.

'We're getting sequences!' Hopkins said.

Running cascades of letters appeared on Felix's screen, combinations of A, T, C, and G. The combinations were sequences of raw genetic code from a life-form in the sample.

'Beaming it up, Scotty!' Hopkins said.

Felix was beaming chunks of DNA code into the sky through the transmitter panel. Overhead, a communications satellite operated by the U.S. National Security Agency was picking up the genetic code of the organism, whatever it was.

'I think we're going to get some matches here,' Hopkins said. 'Hang on.'

Felix was matching the DNA sequences with some sequences stored in its memory, trying to identify the organism. The names of viruses that it was supposedly 'seeing' in the truck sample began to appear on the screen of the laptop.

'Humpty Doo virus? What is this?' Hopkins whispered. Then the screen said:

The screen went blank. The system had crashed. 'You jerk!' he said to Felix.

'What happened?' Littleberry whispered. 'I think it's giving me gobbledygook.'

The pounding on the door became very insistent. Will Hopkins reached down to his belt and pulled the Leatherman tool out of its case. He opened it to alligator pliers and a screwdriver. From his pocket protector he pulled out a Mini Maglite flashlight. He hunched over Felix and lifted off the smooth black top of the box. Inside was a mass of tiny threadlike tubes and wires. He started pulling out wires, shining the flashlight in, twirling the screwdriver.

'Will―' Littleberry said.

'The system isn't going to work perfectly every time.' 'Put that suitcase together, Will. We've got to call on the radio for help.' , Hopkins held up a metal object the size of a peanut. 'That's a pump. I think it's malfunctioning.'

'Enough. Shut the case.'

'Mark — That was a bioreactor in the truck. And there were some crystals. That's what I took the swab from.' 'Yeah? What do you mean, crystals?'

'Well, they were kind of flat, sitting in trays, clear…'

'Shit. That sounds like some kind of viral glass. Those bastards are making viral glass.'

'Inside a truck?'

'That's the whole problem.' 'Where was it going?'

'Who knows? The U.N. will never see it again.' Hussein Al-Sawiri had been talking on a shortwave radio to the Iraqi National Monitoring Center in Baghdad. 'There has been a decision. If they want to lock themselves in a toilet, they can stay there.' Several minders reached under their jackets and drew guns.

Outside the Al Ghar facility, the UNscoM convoy had arrived. The vehicles were lined up on the access road to the plant. In the lead vehicle, Dr Pascal Arriet, the chief inspector, was talking on two radios at the same time. The Iraqi guards had closed the gate. They were pointing their guns at the UNscoM convoy.

'These people! They have not acted under my instructions. They have disobeyed my direct orders!' Arriet said to the radio.

It turned into a standoff. The Iraqi security people wanted to break down the door and place the two United Nations inspectors under arrest. What held them back was the Iraqi government's desire not to annoy the United Nations any more than it already was annoyed at Iraq, even though everyone agreed that the two inspectors had acted in a manner that was not acceptable by international standards of behavior. The day dragged on into evening, and the evening dragged on into night. The UNscoM convoy of vehicles remained sitting on the road outside the plant. The inspectors carried food and water with them in their vehicles, but they were angry and exhausted, and wanted, above all, to go home. The rules did not allow them to leave without Hopkins and Littleberry, and the Iraqis were determined not to let the inspectors go. They announced that all samples and all equipment belonging to the inspectors must be forfeited to Iraq.

'Quit fooling with your machine,' Littleberry said to Hopkins. 'You need to get some sleep.' Littleberry was lying on the floor with his head on his Halliburton briefcase for a pillow, and every muscle in his back ached. Hopkins sat cross-legged with his back against the wall. Felix was spread out in pieces across the floor in front of him. He held the flashlight in his teeth. 'I'm convinced the problem is in this pump,' Hopkins said.

'Christ,' Littleberry said. He could not fall asleep. Late into the night, as the shortwave radio squawked and chattered, and Iraqi security agents continued to pound on the door of the bathroom at odd intervals, he stared at the ceiling and thought of his wife and the boat he had just bought in Florida. 'This is the last time I am ever going to stick my head in a weapons plant,' he muttered.

A few hours later, early on Friday morning, Littleberry was talking on the shortwave radio, which hadn't worked very well ever since Hopkins had removed a part from it. 'We've got a deal shaping, Will.' The terms had been worked out by teams of negotiators. The two American inspectors would be allowed to leave Iraq, but the United Nations would disown them. They would be stripped of their U.N. status. Pascal Arriet was pleased to do this. They would have to surrender all their biological samples and equipment — namely the suitcases — ,to Iraq. And all transactions would be videotaped.

Littleberry and Hopkins agreed to the conditions of the deal, and by sunrise two helicopters had been dispatched from Kuwait City to pick them up. The disgraced inspectors emerged from the bathroom and were marched at gunpoint outdoors, in front of the plant. They stood within view of the U.N. convoy but were held inside the security fence. There, while they were videotaped by both the United Nations people and by Iraqi minders, they handed over both Halliburton cases and all their swabs and samples.

There was a shuddering sound in the sky. Two aging white helicopters appeared, coming from the south. They were Hueys, bearing U.N. markings. They touched down beside the UNSCOM vehicles. Dust filled the air.

'We made a mistake. We are very sorry,' Littleberry said to Hussein Al-Sawiri.

The Kid was holding one of the sample tubes. 'Is this a sample from the truck?' he asked.

'Yes. The only one.'

Fehdak's face showed no expression, but in his mind he was heaving a terrible sigh of relief. This may save my life, he thought.

The guards patted down Littleberry and Hopkins exceedingly thoroughly and in a very personal way. Eventually they were satisfied that the two U.N. inspectors no longer possessed any sample material. No swabs, no tubes, no evidence. The guards opened the gate. Littleberry and Hopkins walked through.

Pascal Arriet leaped out of his car. He was shaking with rage. 'Idiots! You are finished! You are fired by authority of the secretary general.'

'I'm sorry, Pascal,' Littleberry said. 'We failed. We found nothing.'

'You Americans are demented!' Arriet said. 'You threaten Iraq continuellement. You are ruining everything. Get out of here. Leave now!'

'We apologize,' Hopkins said. 'We are very sorry.' He and Littleberry climbed into one of the waiting helicopters.

Then they were in the air, leaving Al Ghar straight below.

'Wow,' Littleberry said, and leaned back.

Some of the Iraqi guards were pointing their guns at the helicopter, but nothing happened. Hopkins and Littleberry looked down on a long line of white cars in front of the plant, a gray roof studded with vent stacks, a wide brown land, stretches of green irrigated fields, and_ in the distance the brown arc of the Euphrates River. 'Florida, here I come,' Littleberry muttered.

Sitting in the Huey beside them was a man in khaki civilian clothing wearing a voice headset. He shook Hopkins's hand. 'Major David Saintsbury, United States Army. I'm from USAMRIID. Fort Detrick, Maryland.' He turned to Littleberry. 'Well, Mark,' he shouted. 'What happened?'

'We came so damned close,' Littleberry said on his headset.

'We got a very hot virus sample, we think,' Hopkins said. 'We started decoding the DNA and beaming it up on the bird, but the Felix crashed on us.'

'Too bad,' Major Saintsbury said. 'Of course, you had Navy gear. What can I say?'

The helicopter was shaking, the blades giving off the classic Huey thup, thup.

'But we got some partial DNA sequences,' Hopkins said. 'Man, these Iraqi biologists are doing scary things.' 'They're not the only biologists doing scary things,' Major Saintsbury said.

On the ground at Al Ghar, Hussein Al-Sawiri and Dr Azri Fehdak were holding the Halliburton suitcases, carrying them into the building. They were taking them to a secure place, where they could be retrieved by Iraqi intelligence. Fehdak was carrying Felix. Something was wrong. He placed the palm of his hand on the case. 'Ah!' he said, jerking his hand away. He put the case on the floor. 'It's hot.'

'Ayl' Al-Sawiri dropped his case to the floor.

Smoke began to boil out of both cases.

As they watched, the cases melted, and catalytic heaters destroyed them. The two Iraqis could feel the warmth on their faces.

Invisible History (II.)

During the 1991 Gulf War, Iraq is said to have come close to using anthrax on its enemies, the allied coalition forces. Anthrax is a bacterium, a single-celled organism that feeds on meat. Anthrax grows explosively in warm meat broth or in living meat. Modern armies consist largely of steel and meat.

Weaponized anthrax is made of anthrax spores. The spores are dried into a powder or made into a brown liquid concentrate. No one to this day (except the Iraqi government) knows what particular weapons production strain of anthrax Iraq possessed at the time of the Gulf War. It is believed to have been the Vollum strain. The Vollum strain of anthrax was first isolated from a cow near Oxford, England, before the Second World War. Vollum anthrax is the strain that the U.S. Army used for its anthrax warheads during the 1960s, before the United States ended its offensive biological weapons program in 1969.

Iraq signed the 1972 Biological Weapons Convention, but in conversations with U.N. weapons inspectors after the Gulf War, top Iraqi government officials said that they did not actually know if their country had signed the treaty. They said that it wasn't important, not a matter for consideration.

If Iraq had done a laydown of Vollum anthrax during the Gulf War, allied casualties might have been the largest in the shortest period of time sustained by any army in history. On the other hand, it might not have been too bad. No one knows what the Iraqi anthrax would have done. Some of the American troops were vaccinated against anthrax, with a vaccine that might or might not have worked. Most of the soldiers were taking antibiotics as a protective measure — antibiotics that might or might not have worked. Many were also equipped with breathing masks, which offer protection against biological agents — provided one knows that the agent is in the air. Vollum anthrax is susceptible to vaccines and antibiotics. Other strains of anthrax are hotter. An engineered strain of anthrax could be designed to elude vaccines and grow explosively even in the presence of antibiotics.

Weaponized anthrax spores end up sitting on the largest wet membrane in the body, the lungs. The spores land on the lung surface and hatch, and the organism quickly enters the bloodstream. Humans infected with weaponized anthrax may cough up a thick yellow-andred bubbly mess called anthrax sputum exudate. There is debate about what anthrax sputum exudate looks like if it's caused by a weaponized form of anthrax. Experts stress that a disease caused by a biological weapon may look very different from a natural disease caused by the same organism. In animals, anthrax sputum exudate is bloody and watery, rather golden yellow in color. It pours out of the animal's mouth and nose. Many experts say that anthrax exudate in humans forms a thick, gobby, foamy, bloody paste that sticks inside the lungs like glue. Anthrax sputum is streaked and marbled with bright red blood, which is hemorrhage from the lungs. Someone hit with weaponized anthrax probably would feel a cold coming on at first. You get a sniffle and a cough. Your cough becomes worse. Then there follows a kind of pause, a lessening of the symptoms. This is the anthrax eclipse, a phase in which the symptoms seem to lift for a while. Then abruptly the victim crashes and dies with fatal pneumonia and a bloody sputum exudate.

The experts call anthrax a 'classical' weapon. Anthrax is powerful, but it is far less efficient than many bioweapons. It seems to take about ten thousand spores of anthrax trapped in the lungs to make a person die. That is a large number of spores. With other military biological agents, a single spore or as few as three virus particles trapped in the lungs can cause a fatal biological crash in the victim.

In 1979, in the city of Yekaterinburg, Russia (then called Sverdlovsk), there was an accident at a Soviet biological-weapons-production facility known as Military Compound Number 19. The Soviets were making weaponized anthrax there by the ton. It was a full-speed military production, for the purpose of filling warheads and bombs, with shifts working around the clock. No one knows exactly what happened, but one credible story goes that the workers were drying anthrax and making it into a powder in grinding machines. A shift of day workers on the grinding machines discovered that the safety air filters (which prevented anthrax powder from going into the air) had become clogged. They removed the filters at the end of the shift and left a note for the night shift, telling the workers to install fresh filters. The night-shift workers came on duty but didn't see the note. They ran the anthrax grinding machines all night without safety filters. During the night shift, up to a kilogram (2.2 pounds) of weapons-grade dry anthrax spores were released into the air in the city of Sverdlovsk. They formed a plume that went in a southeasterly direction across the city. Sixty-six people crashed and died of anthrax. Many of them did not break with anthrax until weeks after the accident. The zone of human fatalities extended for about four miles downwind. Most of the dead civilians worked or lived within half a mile of the plant.

This suggests that anthrax is not very efficient as a bioweapon, since it took a relatively large amount of dry spores to kill a relatively small number of people. A kilogram of a more advanced biological weapon released into the air should be able to make a plume as long as fifty miles. If the plume cuts through a city, the deaths should number in the thousands or millions. A far larger number of deaths will occur if the weapon is transmissible — that is, if it's contagious and able to jump from one person to another in a chain of infection. Anthrax is not a transmissible weapon. You are not likely to catch anthrax by being in contact with an anthrax victim. Anthrax does not spread from person to person by a chain of infection. Other weapons — contagious weapons — are therefore more powerful, though they can go out of control. In the age of molecular biology, anthrax looks like a black-powder cannon.

After Iraq's defeat by the coalition forces in the Gulf War, inspection teams from the United Nations Special Commission — UNSCOM — spread out over Iraq. They found and destroyed most of Iraq's nuclear-bomb program and some of Iraq's chemical weaponry. Iraq's biological-weapons program vanished into thin air.

Iraqi officials always referred to their bioweapons program as the 'former' program. Yet it became clear, after a while, that Iraq had an ongoing biologicalweapons program. The program was moving forward under the noses of the U.N. inspectors. For example, the teams inspected a biological-production plant called Al Hakam, a factory situated in a desert area near the Euphrates River. Iraqi scientists told the U.N. that this plant was making 'natural' pesticides to kill insects. The UNscoM experts looked at the plant and believed the

Iraqis. After inspecting the equipment carefully, they saw no reason to ask Iraq to stop production at the plant. An older American weapons inspector, a man well beyond the age of retirement who in his day had been a leading scientist in the United States Army's biologicalweapons (B.W.) program, visited Al Hakam as a member of an UNSCOM team. He was mighty impressed. He said, 'They've got a helluva good B.W. plant here at Al Hakam. How can I prove it? I've just got a feeling, that's all.' He could not prove it, and he was frankly doubted by most U.N. experts, although he was one of the very few people in the entire UNSCOM organization who actually had hands-on professional experience as a biological weaponeer. Iraq, meanwhile, was making hundreds of thousands of gallons of brown liquid concentrate in this plant.

In 1995, one of the heads of Iraq's biological-weapons program, Babrak Kamal, suddenly defected and ended up in Jordan. Various intelligence agencies rushed to debrief Kamal, and Kamal talked. Fearing that he was telling everything about their bioweapons program, and in an effort to placate the United Nations Security Council, Iraqi officials suddenly disclosed that Al Hakam was, in fact, an anthrax weapons plant. The brown liquid was anthrax. UNscoM inspectors had been wrong about Al Hakam. The old Army scientist had been right. In June 1996, after a year of bureaucratic hesitation — during part of which time Iraq was allowed to continue operating the plant — the United Nations finally blew up Al Hakam with dynamite. Al Hakam is now eleven square miles of level ground. The many tons of anthrax that the plant produced have never been found. Unlike many bioweapons, anthrax can be stored indefinitely.

There was another revelation, this one more unpleasant. In the wave of panic following Kamal's defection,

Iraq also suddenly confessed that a French-built animalvaccine plant called Al Manal had been turned into a weapons facility dedicated to toxins and virus weapons. Al Manal is a modern Level 3 biocontainment virology complex situated in the southern outskirts of Baghdad. The Iraqis said that this plant had been used for an earlyphase genetic engineering program in virus-weapons research, and then, during the Gulf War, had been used to make large quantities of botulinum toxin — botulism, or bot tox, as military people call it. Bot tox is one of the most powerful toxins known. An amount of bot tox the size of the dot over this i would be enough to easily kill ten people. Bot tox is a nerve agent. It is one hundred thousand times more toxic than Sarin, the nerve gas that the Aum Shinrikyo sect released in the Tokyo subway. Iraq confessed to having made approximately nine thousand cubic yards of weapons-grade bot tox at the French-built plant at Al Manal. The bot tox had been concentrated twenty times over. In theory it was more than enough bioweapon to kill every person on earth a thousand times over. In a practical military sense it was enough to eliminate all human life from Kuwait.

The bioproduction lines at Al Manal had been built in 1980 by a French vaccine company called Institut Merieux, which is headquartered in Lyons. Merieux is owned by the pharmaceutical giant Rhone-Poulenc. Merieux was paid a great deal of money by the Iraqi government to build production lines at Al Manal that were ready for operation, and to train the staff in the use of the equipment. The purpose of the plant was to make vaccines for protecting animals from foot-and-mouth disease, which is caused by a virus. The plant was wildly expensive. Some experts claim that an effective animalvaccine plant could have been built at a tenth of the cost. However, Iraq had plenty of money to spend. The Iraqis needed a Volkswagen. Merieux sold them a tank.

At the time that Merieux was involved in Al Manal, Iraq was involved in a bitter war with Iran. This was the Iran-Iraq War (1980-88), during which,'in 1984, Iraq initiated the use of chemical weapons. In 1985, while Iraq was known to be using chemical weapons, French advisers from Merieux were working at Al Manal, training the Iraqi staff in how to make virus vaccines. To make a virus vaccine, you use bioreactors to grow strains of viruses. You can use the same equipment and manufacturing processes to make hot weaponized viruses. If the plant is equipped with high Level 3 biocontainment, virus weapons can be produced without too much difficulty or danger to the staff.

United Nations inspectors discovered that the buildings at Al Manal are made of bomb-resistant concrete, strengthened with large amounts of steel bar. The hardening goes deep inside the buildings. Al Manal has a kind of double-shell construction in which some of the inner biocontainment zones are themselves reinforced with steel. Did Merieux engineers notice that they were building the production fines in a 'hardened' facility? Did they speculate that Iraq might view the place as a potential military facility? Much of the production equipment at Al Manal came from European biotechnology and pharmaceutical companies: from France, Spain, Germany, and Switzerland. What did these companies know or guess? The chance that the public will ever find out is essentially zero.

Until 1990, five years after the French advisers left, Al Manal was apparently used for making animal vaccines, and it had a staff of civilian scientists. In the fall of 1990, however, when the Gulf War was imminent, a military staff suddenly took over the operation of Al Manal. The plant was then almost instantly converted to a bioweapons facility. All of the plant's production equipment was used for making bot tox, and the Iraqis ran double production lines. In a short time the plant was pumping out bot tox. Iraqi production scientists had no problems making the toxin. They knew exactly how to do it. They had obtained their strain of botulism through the mail from the United States. They had ordered it from the American Type Culture Collection, a nonprofit organization in Rockville, Maryland, that supplies microorganisms to industry and science. The seed strain cost Iraq thirty-five dollars.

One UNSCOM inspector who is an attentive observer of French behavior in Iraq sums up his view of Institut Mérieux's motives this way: 'The reality is that people just don't realize what can be done [with bioproduction equipment]. To Merieux at the time, their involvement with Al Manal was a successful commercial venture. Hey, if they can sell an extra ten fermenter tanks, open another bottle of champagne! It's the act of commerce that's important, and what happens afterward is someone else's responsibility.'

Al Manal has become the responsibility of the United Nations. As of this writing, the plant is standing, but much of its equipment has been destroyed. The buildings and infrastructure, including the bomb-hardened Level 3 biocontainment zones, have not been destroyed by the U.N. Al Manal is in excellent condition. The decisionmaking process in the United Nations is so flawed that an admitted virus and toxin weapons biocontainment facility can't be dismantled.

Inspectors have noticed that the Iraqis seem to be switching to small, portable bioreactors that roll around on wheels. The Al Manal bioweapons plant could go hot in a matter of days. All it needs is some more equipment. In the meantime, not a single drop of the nine thousand cubic yards of bot tox made at Al Manal has been found.

In fact, it is said that no Western intelligence agency has ever recovered a sample of a weapons-production strain of any Iraqi biological weapon. The U.N. inspectors have found empty biological bomb casings in Iraq, and they have obtained video footage taken by lraqi scientists of bioweapons tests conducted in desert areas — biological bombs going off, hot agents being sprayed into the air, a jet doing a line laydown. It is clear from the footage and the bomb designs that the Iraqis know what they are doing. It is just that the U.N. people haven't found the heart of any Iraqi bioweapons system, the life form itself.

In the years following the Gulf War, the biologicalweapons inspection process in Iraq continued to go forward, but it left important questions unanswered. The U.N. teams continued to monitor and search Iraq, but some of the individual team members began describing their efforts as a charade, or as just another job, for which at least they were getting some hazard pay. Other individuals on the teams were known to have taken personal risks to uncover information. There were indications that the Iraqi bioweapons program was very much alive, and was focusing more and more on viruses, on genetic engineering, and on miniaturization of the research and production processes — using tiny bioreactors that can be hidden in small rooms.

The French UNSCOM inspectors and officials always seemed to be at the center of conflicts with other UNscoM teams. It was quite clear that the French were no longer interested in discovering any more biological-weapons installations in Iraq. Some of the other inspectors would say, privately, that the senior French UNSCOM inspectors appeared to be acting on direct orders from their government to stop finding things in Iraq. The French government seemed confused. Most of the French political leaders were middle-aged men, relatively uneducated in advanced biology, and unable to grasp the seriousness of biological weaponry. French leaders seemed unable to conceive of the idea that the proliferation of biological weapons in the Middle East might be a direct threat to the safety of the French people. This was a situation that, to be sure, the French people knew nothing about. When a bomb goes off in a trash can in Paris and kills a dozen people, it is a problem. If the bomb were to contain a military virus, the problem might be uncontrollable.

But commercial interests are important in France, as they are everywhere. Not so long ago, Iraq had been a customer and friend of France. Iraq might be a customer and friend again. It is important to have good relations with one's customers and friends. Money makes friends. Money makes the world go around.