The Deep Zone

AUTHOR’S NOTE

This is a work of fiction, pure if not simple, so any resemblance between the novel’s characters and real persons is coincidental.

On the other hand, any resemblance between everything else that happens in the book and true life is real.

During the height of the Iraq War, so many wounded soldiers contracted Acinetobacter infections that Army doctors started calling it “Iraqibacter.” Military officials at first said that ACE in Iraqi soil was responsible, but that turned out to be untrue. In fact, soldiers were being attacked by a new ACE in the military’s own hospitals. No one knows, or will admit to knowing, how it came to be there.

Soldiers do routinely use tampons as emergency wound compresses.

According to the National Institutes of Health, two million people acquire bacterial infections in U.S. hospitals every year. Some ninety thousand die as a result, a number that has sextupled since 1992. (And those are only the deaths attributed to such infections; the true total is almost certainly much higher, for the very reasons Mr. Adelheid discussed with Al Cahner in this book.) Each year, more and more such infections occur.

Seventy percent of these infections are resistant to at least one of the drugs most commonly used to treat them. Others are rapidly developing multiple resistances. “Various strains of bacteria that cause serious diseases, like meningitis and pneumonia, could mutate to the point that all of our available therapies are ineffective,” said John Powers, an antimicrobial expert at the Food and Drug Administration, in 2006. And some bacteria are already resistant to all drugs.

Toward the end of the nineteenth century, biologists discovered that bacteria are nature’s counterterrorists: in the proper conditions, some bacteria become able to kill their fellow bacteria. Understanding this, scientists identified, isolated, and distilled these bacterial ninjas into what we today know as antibiotic drugs. Their development was one of the greatest boons science ever delivered to humankind. That was the good news.

The bad was that most antibiotics used today are derived from one soil-based order of microorganisms known as Actinomycetales (Ac-tin-o-my-CEET-al-ees). Relying on this one order produced a generation of miracle drugs, but ultimately that has worked against us. Antibiotics benefit from inbreeding no more than humans do.

Indiscriminate use of antibiotics in everything from soap to sheep to farm-raised salmon has made it easy for bacteria to acquire resistance. And there is something else: perhaps more than any other organism, bacteria have a unique ability to exchange DNA not only with their own species but with others as well.

MDRAB, multiple-drug-resistant Acinetobacter baumannii (Ah-si-NEET-o-bac-ter bough-MAN-ee-eye), is a highly drug-resistant bacterium with yet another personality quirk that makes it inordinately dangerous. ACE may be the “great communicator” of all bacteria, able to pass on immunological mutations with speed that, in evolutionary terms, is lightning fast. When Don Barnard tells Hallie Leland that geneticists discovered, in ACE, the greatest number of genetic mutations ever found in a single organism, he is speaking the truth. They actually did, in 2005.

Antigenic shift, which produces the killer species of ACE, is a recognized evolutionary phenomenon.

Moonmilk is a real extremophile that lives in wild caves. A number of microbiologists believe that subterranean extremophiles are our best hope for developing new strains of antibiotics for use against microbes that, like ACE, are resistant to all existing drugs. Some—notably Dr. Hazel Barton, of Northern Kentucky University—have already synthesized new antibiotics from deep-cave extremophiles.

BARDA does exist and manages Project BioShield, which supports “advanced development of medical countermeasures for chemical, biological, radiological, and nuclear agents.”

Several supercaves are found in southern Mexico: Huautla and Cheve are two of the most famous. Cueva de Luz is another character in the book, a combination of Cheve, Huautla, and several other such giants. These caves contain all the bizarre horrors described in the book, though no one cave—as far as we know—contains all of them.

Many—perhaps most—native peoples with sophisticated cultures dating back to prehistory truly believe that caves are sentient living beings.

Soldiers in Iraq and Afghanistan are using BADS, the boomerang anti-sniper detection system developed by DARPA. “Gecko Gear” was created by DARPA, which refers to it as Z-Man Tools and continues working in a “thrust area” called BIM, for biologically inspired materials. The DARPA devices are a bit different from those depicted in the book, but both operate on the same principle. While still experimental, the tools are thought to be deployed with certain special operations units today.

Soft robots that use “jamming skin enabled locomotion” to shape-shift and conform perfectly to, say, human hands and feet were developed by a private company called iRobot.