The Rationing

61.

I FELT THE SAME IRRATIONAL SURGE OF NATIONAL PRIDE AS everyone else, only mine was mingled with dread. I watched video clips on my phone of Cecelia Dodd’s family leaving the hospital after a visit. Cecelia’s daughter and her husband walked out with their twin daughters, no more than three or four years old. Each little girl was clinging happily to a large stuffed animal, as if it had been just another visit to see Grandma. The look on their parents’ faces, the puffy eyes and the tear-stained cheeks, told a different story. Neither Cecelia Dodds nor her family ever commented publicly on the political drama unfolding around them, but that night her daughter did stop to address a cluster of reporters. She had one arm draped over each daughter. “I want her to see them grow up,” she said. “My mother deserves that.” Whether she meant it or not, the message was clear to me: A lot of people are going to miss a lot of graduations and weddings.

If the China offer was really off the table, our best hope was to make more progress on the virus side. The NIH fatality projections were bouncing all over the place. The last time the President had spoken to the nation about Capellaviridae, he had suggested we could weather the Outbreak without any incremental deaths. That was an optimistic statement at the time; as I sat there on a bench looking out on the Capitol Mall, it was impossible. The Atlanta Braves pitcher was not likely to point at the flag when people started dying in Atlanta hospitals from diseases that should have been easily treatable.

The President had no long-term plan. He later admitted as much. The flight to Canberra was an impulsive political gesture. He could have declined the Chinese offer from Washington. The other signatory nations of the South China Sea Agreement were all comfortable postponing the signing ceremony. There was no logical reason for the President to order Air Force One to make that low, flamboyant loop over the runway before accelerating “west.” The President’s critics on the far left were merciless, blasting everything from his jingoism to the wasted fuel. They were right—and utterly wrong. True, there was no reason to fly Air Force One across the Pacific. What that misses, however, is how the President was constructing an edifice of political support for whatever he would have to do next, even without a political party to depend on. The Senate Majority Leader, a dependable ally to begin with, was complicit in the decision to fly to Canberra and was now even more firmly bound to the President.

Meanwhile, the Speaker of the House was continuing her self-immolation. As soon as the U.S.-China Friendship Agreement became public, her comment that we should “take seriously” what the Chinese have to offer was played over and over again, juxtaposed against the most egregious and the pettiest of the Chinese demands. This was totally unfair, of course, as the Speaker had made her comments before the terms of the agreement were known. No one seemed to care about the finer points of context in this case, however. The Speaker’s ascent had been built on self-interest, calculation, and power; those who crossed her over the years found themselves stripped of committee assignments or facing a well-financed primary opponent. Unlike the Senate Majority Leader, she had no deep pool of goodwill to draw upon during a rough patch. Machiavelli may have written that it is better to be feared than loved—the Speaker was definitely feared and unloved by the House rank and file—but that assumes one can hang on to power. Machiavelli did not live through the early 1990s when Eastern Europe Communist despots were toppled and citizens rushed through the streets knocking over their statues. (The leaders themselves typically fared worse than the statues.) The Speaker was no East European dictator, but the larger point still holds. Her power had been kicked from beneath her, at least temporarily. Meanwhile, the President’s support had surged to over 90 percent after the Air Force One show; most House members (never that popular) rushed to pledge their public support to the White House.

So yes, when Leonard Creelman went on This Week and pointed out that the President had used seventy thousand gallons of jet fuel (“an abhorrent carbon footprint”) just so he could “impress people eating hot dogs at baseball games,” he was absolutely correct. It is also true that a solid majority of Americans felt a powerful urge to punch Leonard Creelman in the face. (Even 53 percent of self-described progressives “supported” or “strongly supported” the President during the Outbreak, up from less than 20 percent during most of his tenure.) Meanwhile, the Tea Party, normally eager to lambaste the President for every nickel of public money he spent (that jet fuel is not free), was eager to have yet one more reason to blame China for America’s problems.

It is crucial to recognize two things. First, in just a matter of hours, the President had fortified his political position and gained the support of most Americans for whatever he would do next. Second, he had no idea what he was going to do next.

62.

THE PRESS WAS ALWAYS A STEP AHEAD OF THE PUBLIC, AT least the print reporters were. While the video of Air Force One doing a loop over the Honolulu base and accelerating west was played repeatedly on tablets, and watches and eyeglasses, the more enterprising reporters grasped what must inevitably come next: we were going to run out of Dormigen. The NIH projections had never been public, but any reasonably intelligent person could connect the dots. We had a shortage of Dormigen; the Chinese offer was off the table; at some point “the constraint would become binding,” as the scientists like to say. And then what? The media was aware that the White House had “a number” with regard to likely deaths, and enterprising reporters redoubled their efforts to get it. As usual, the Internet was awash with bogus projections and reports.

On board Air Force One, the President basked briefly in the glow of his dramatic takeoff before confronting the same reality I was contemplating on the park bench. What now? The Dormigen supply across the country had finally been secured, though it was still uncertain where the stolen drugs would end up. As the President flew toward Canberra, the NIH projections were showing a range of likely fatalities from forty thousand to a hundred thousand. There was no full-blown Dormigen rationing in place yet. In theory, everyone who really needed the drug was still getting it, but the protocols for prescribing Dormigen had been tightened sharply to help make the existing stock go further: no prescriptions when another antibiotic might work; no prescriptions for non-fatal infections likely to heal on their own; no prescriptions for secondary infections among terminal patients; and so on. The video communications equipment on board Air Force One had been repaired during the long stop in Honolulu. (This was one small factor in the President’s decision to fly toward Australia; he was now as well equipped on the plane as he would have been in the Oval Office.) The Communications Director was urging the President to make another address to the nation, seizing on his surge in popularity to prepare the country for the possibility of fatalities. The President was noncommittal, presumably still hoping that those of us in the scientific community would pull an antidote out of a hat.

In fact, the first preventable fatalities had already happened. While all eyes were on a weakening Cecelia Dodds, other people were dying. An eighty-three-year-old man had been admitted to a hospital in Tucson with a severe case of pneumonia. He would normally have been prescribed Dormigen on admittance, but with the new protocols in place the emergency room physician prescribed a traditional antibiotic as a first line of treatment instead. The man’s condition worsened almost immediately and he died before he could be switched to Dormigen. In Atlanta, a much younger man, African-American, died in an emergency room after being denied Dormigen when he arrived unconscious in an ambulance. His mother gave a tearful press conference in which she alleged that her son had been denied the lifesaving drug because he was a young black male. The controversial civil rights leader Latisha Andrews rushed to Atlanta, where she planned to organize a protest against “Dormigen discrimination,” but before she had even landed at the airport it was widely publicized that the young man had suffered a massive stroke, not any kind of infection, and would not have benefited from Dormigen.

And then there was Larry Rowen, the smarmy Los Angeles nurse who inadvertently set in motion a massive law enforcement dragnet that would recover over twenty thousand doses of stolen Dormigen. Rowen was an aspiring actor who had moved to Los Angeles ten years earlier from Moline, Illinois, hoping to capitalize on his nursing background by getting himself cast in a medical drama. He was short and pudgy, with thinning reddish brown hair, a wispy little mustache, and a severe wandering eye. Rowen learned quickly that he did not have the looks to thrive in Los Angeles; he was further disappointed to discover that his nursing background offered no casting advantage in medical dramas. (As the balance of this incident will demonstrate, Larry was no genius.) Rowen supported himself in Hollywood by working at an exclusive plastic surgery practice in Brentwood and doing two night shifts a month at a twenty-four-hour clinic in Pasadena. It was in the former that Rowen developed a deep antipathy for the stars and starlets coming in to have their breasts, lips, calves, chins, and butts improved. And it was in the latter where he had access to Dormigen during the stretch when the supply was still unsecured.

Having stolen a thousand doses of a drug that was potentially more valuable than heroin, Rowen soon realized that he had a problem: he had no distribution network. There is a reason that drug kingpins offer a big cut to the street gangs that push their stuff; one cannot sell heroin (or stolen Dormigen) without finding customers, and it is hard to find customers when the product is illegal. Rowen had two additional challenges. First, the window during which his stolen Dormigen stash would be valuable was very small (and could close, if the government found some fix for the crisis). Second, as noted earlier, the man was no genius. He may have had a social conscience on par with the typical drug dealer, but he was not nearly so clever. Rowen—who remains fodder for late-night comedians—envisioned a scenario in which he could strike back at the Hollywood establishment while simultaneously enriching himself.

Yes, Larry Rowen sought to trade his stolen Dormigen for cash (from rich men) and sexual favors (from beautiful women). “I wanted them to respect me,” he explained at his arraignment. Rowen’s advertisement in the Hollywood Reporter intimated as much: Safe, plentiful supply of Dormigen. Only the rich and beautiful need apply. Yes, he really ran that ad. And yes, FBI agents arrested him one day after it appeared. According to court documents, however, he had already sold six doses of Dormigen and at least two of the buyers were women. The identities of the buyers were kept confidential—sealed by the court. Anyone who really needed Dormigen at that point could still get it. We had not run out yet. The good news is that Rowen’s clumsy sales effort inspired law enforcement to mount a nationwide sting operation. It was not terribly difficult to pose as buyers, track the Dormigen back to its illicit source, and arrest the dirtbags like Larry Rowen who were selling it.

As the President flew toward Canberra, I became involved in an unfortunate communications snafu. Jenna and I did not see a movie, but we did continue our walk, still trying to piece together the mysteries of the colored binders. Jenna graciously invited me back to her apartment, where we continued our conversation. It was clear to both of us that I needed sleep more than anything else. I had been awake for fifteen hours. The radio and television interviews had been exhausting. My mind was moving at three-quarters speed. I took a nap and made the unwise decision to turn off my assorted communications devices, thinking it would just be a short power nap, fifteen or twenty minutes. The timing could not have been worse; several members of Congress showed up at the NIH office and demanded a personal briefing from the Director and me. There are a hundred reasons why members of Congress should not show up in the middle of a crisis and expect answers, not least because it wastes valuable scientific time. Still, there they were, sitting in the Director’s office, expecting answers from those of us whose time would be better spent generating those answers.

The Director tried to reach me while I was sleeping. Tie Guy filled in for me and answered the basic questions. The important thing to recognize is that nothing about this unfortunate incident affected our scientific approach to the Outbreak. No time was lost. If I had not carved out some hours to refresh myself, I would have been answering basic questions for some of the Speaker’s congressional minions. Their pride was wounded—this I understand—and I was remiss in turning off my devices. But the finding by the Outbreak Inquiry Commission that “the top NIH adviser went AWOL at the peak of the crisis” is just political hyperbole.

In fact, I stepped out of the shower reinvigorated and with a plan for moving forward. I turned on my secure phone and saw the series of frantic messages from Tie Guy and the Director. I was still wrapped in a towel when I called Tie Guy back. “Where the hell are you?” he answered.

“I just needed some sleep,” I said truthfully. “And I have an idea.”

“Well, if you want to explain it to six members of Congress, they just left.”

“That’s a waste of our time right now,” I said.

“Not yours,” Tie Guy answered angrily, though he was already starting to simmer down.

I shared my unorthodox thought: “Maybe we just need to expose these people to the dust mite. Have you thought about that? Right? If the pattern is—”

“Of course I thought of that,” he interrupted. “How could I not think of that?”

I ignored him and continued. “Capellaviridae turns virulent when people with the virus are no longer exposed to the dust mite that carries it. So maybe the dust mite is preventive somehow?”

“Yeah, that’s one possibility,” Tie Guy agreed. “But how? And why? I sent that idea up the chain yesterday afternoon but I can’t get anyone to bite.” Tie Guy had been curt before, even rude, but this was the first time he sounded patronizing, or maybe just angry.

“What’s the harm of trying the dust mites?” I asked.

“That’s what I said,” Tie Guy replied, still peeved. “But think about it. If someone has the virulent form of Capellaviridae, they can still be treated successfully with Dormigen. Who would want to forgo that for some experiment with dust mites?”

“But what’s the worst thing that could happen if we try?”

“The worst thing that could happen is that the dust mites have no effect and people get sick enough so that Dormigen is no longer effective and then they die.” He changed his voice slightly, imitating the NIH bureaucrats with whom he had obviously discussed this: “The NIH will not do a human trial when a safe, proven alternative exists and we have no theory or evidence to suggest the alternative treatment will be effective.”

“You asked yesterday?”

“Yeah, right after I saw the data on who is becoming sick,” Tie Guy explained.

“But that was before they knew about the Dormigen shortage,” I pointed out. “Everything is different now. We have a safe treatment, but it’s going to run out. What’s the harm in testing something that might work?”

“That’s true,” Tie Guy conceded. “But we still need a theory. We have to have some explanation for what’s happening here. Why would people get sick from Capellaviridae when they are no longer around dust mites? And why would reintroducing dust mites make them healthy?”

“If it works, we can figure out the theory later,” I said.

“We don’t have time to do any meaningful trial,” Tie Guy declared. “Capellaviridae is not fatal most of the time anyway, so it would take a long time to figure out if the dust mites have any real impact. Besides, I think it’s a dead end. There’s a confounding variable out there that we haven’t figured out. The data are right, but we’re not hearing what they are telling us.”

“Why can’t we just test the dust mites?” I insisted. “We need a Jonas Salk.”

Tie Guy’s tone turned caustic. “Really? Tell me how that would work.”

My mind worked slowly as I tried to figure out why Tie Guy sounded so dismissive. Salk was the inventor of a polio vaccine. Like other successful vaccines, it works by introducing a weakened form of the virus to the subject, whose body then creates antibodies to fend off the full-strength version of the disease. Salk offered himself and his family as test subjects. As my mind ground away slowly, Tie Guy continued, “Why don’t you give yourself the virulent form of Capellaviridae and then try the dust mite cure?”

My mind caught up to him: We still had no understanding of when or why the virus turned virulent, so even the notion of exposing someone to the harmful form of the virus was beyond us. I couldn’t test the dust mite cure on myself because I did not know how to make myself sick with the virulent form of Capellaviridae in the first place. “I’m a little worn down,” I said.

“The media stuff looks awful,” Tie Guy said, finally betraying some sympathy. There was a brief pause and then he asked, “Don’t you think the Chinese are going to pony up the Dormigen in the end?”

He had never asked me about any deliberations beyond the science. At that point, I had not been privy to the discussions on Air Force One, but I had heard enough at the White House to know that the President would likely refuse any offer that required abandoning the South China Sea Agreement. I took a seminar on negotiations in graduate school, a class where we broke down in pairs and did mock exercises. One of the things I learned is that sometimes there is not a deal to be had. Fifteen different pairs of negotiators read a set of secret instructions—half of us were banana plantation owners and the other half were fishermen—and somehow we were supposed to figure out how to split limited water resources in our village. All fifteen teams returned to the classroom ninety minutes later, and not one of us had managed to come to agreement. There just wasn’t enough water. That was what we were supposed to learn from the exercise.

Tie Guy’s question was instructive to me. He was a hardheaded analyst if there ever was one, and here he was assuming optimistically that everything would work out okay. That may be a unique American gift, this ongoing optimism. It all works out in the end. How else can one explain what happened at that Washington Nationals game? The President of the United States gives the middle finger to the country offering us the Dormigen that would get us through the crisis, leaving us in a situation where thousands of people might die unnecessarily. The Atlanta Braves pitcher points at the flag, causing people to get to their feet and cheer for nearly five minutes. Why? Because they believed it would work out okay.

There are two things I do not understand about that baseball game moment, even now as I write. First, Americans despise politicians. Faith in government has been trending down for forty years. The approval rating for Congress is routinely in single digits. Even politicians can get an easy laugh by bashing politicians, or better yet “government bureaucrats.” Our funding at NIH had survived more or less intact because we did work with counterterrorism implications, but my colleagues working on dementia or diabetes or heart disease had no such luck. Their budgets were all lower than they had been back at the turn of the millennium. Who did all these folks eating hot dogs at the Nationals game think was going to bail them out? Should I go back to the NIH, where teams were working around the clock, and yell, “Hey, everybody, it’s after five! Time to go home. This is government work”? What little we did know about lurking viruses came from research mostly funded by government grants. Who else cares about a lurking virus until it’s too late? When I told people I was a government scientist—at a party or my college reunion or among my parents’ friends—they would often make a wisecrack about studying the mating habits of potbellied pigs, intimating that my work was a waste of their hard-earned tax dollars. This, by the way, was often coming from someone who was marketing dandruff shampoo or doing research for a hedge fund, as if fighting bad hair or further enriching rich people were some kind of high calling. (Yes, that is a bit of a rant, but given my role in this whole debacle, I am entitled to some venting.)

Second, things do not always work out okay. That is just an objective historical fact. Have these people not read about the Civil War? I am no historian, but I know enough to recognize that Americans could see that crisis coming for forty years before the shooting started at Fort Sumter. There are historical examples of when politicians did things that caused needless deaths and suffering (World War I, Vietnam). There are historical examples of when politicians did not cause the problem but were unable to stop the devastation (the Spanish flu pandemic, the opioid crisis). There are examples of when politicians were heroic and successful but the social cost was still enormous (World War II). In any event, I do not understand how anyone could make even a cursory examination of American history and just assume that the Outbreak was going to turn out okay. As I stood wrapped in a towel in Jenna’s apartment, I did not believe the President and the Chinese were going to come to a deal. In some ways, the President had backed himself into a corner with his cowboy-like takeoff from Honolulu. For their part, the Chinese would lose face (and all the diplomatic prestige that came with it) if they walked away from most of the bold demands in the “Friendship Agreement.” The two parties might have reached some agreement if the negotiations had been conducted in private, but that ship had sailed. (Or, to keep the metaphor correct, that plane had flown west.) The likelihood of some scientific breakthrough was getting less likely by the hour. Tie Guy was correct: we had run out of time to do even a simple clinical trial.

I dressed and sat down next to Jenna on the couch in her tiny sublet apartment. I had known her for a mere three hours. It was clear that there was some connection between the two of us, though I had not told her I was still living with Ellen. I could try to explain that my relationship with Ellen was already over but that would make me sound like a lecherous sixty-year-old telling some young thing that his marriage had been “dead for a long time.” The fact is that I felt much better with Jenna sitting next to me on that couch. Not coincidentally, her instincts regarding Capellaviridae were good. I appreciated having a fellow Huke acolyte to share ideas with. In the back of my mind—lurking there, if you will—I was convinced that his approach was fundamentally correct. Our best hope was to “think like the virus.” There had to be some reason for the pattern we were seeing—some reason that Capellaviridae or the dust mite benefited in the long run from making people sick. As Huke told us repeatedly, “It’s all about evolutionary advantage.” So why couldn’t I figure that out? What organism was getting what advantage from this bizarre pattern we were seeing?

I decided to walk home, in part to clear my head. Jenna offered to walk with me. I demurred, in part to avoid having to explain: (1) to Ellen, why I had invited a coworker up to our apartment; and (2) to Jenna, why I could not invite her inside for a drink of water after she had walked twenty blocks with me.

63.

I WALKED ALONE, MY MIND STILL IN A FOG. BY THE TIME I reached home, the sun had gone down and my neighbors were returning from work. I said hello to the older woman who lived in the unit above us; I could never remember her name, but I did recall that she did something for United Airlines. As I exchanged small talk with her, it dawned on me that I had left the apartment that morning without my keys. I buzzed my own apartment, hoping Ellen was home, while also kind of hoping she was not.

Ellen buzzed me up. When I got to the door of our apartment, she was standing in the doorway waiting for me. “Oh, my goodness, how are you doing?” she asked. This was the first time we had spoken since I had run out of the apartment before dawn with no explanation. Once the news of the Outbreak became public, the late nights and cryptic comments over the previous days finally made sense to her.

“I’m okay,” I said unconvincingly.

“What’s going to happen?”

“I have no idea,” I said with much more conviction.

“Did you see the news about Cecelia Dodds?” she asked.

“Of course.”

“I did a term paper on her in high school,” she offered.

“You and a lot of other people,” I said.

“It’s horrible.”

“Yes.”

“Do you want something to eat?” she asked.

“I just need to think.” I turned on the television and was surprised to see that the Outbreak was not the top story on Headline News. The President was still flying westward, so there was nothing new to report there. Two things had happened that afternoon to distract attention, if only for a few hours, from Capellaviridae. First, the country music star Tigue McBride (remarkably, the name he was born with) died in a fiery car crash somewhere in West Texas. I am no country music fan, but even I knew that Tigue McBride was a known “bad boy” with a history of substance abuse and broken relationships. He ran his pickup truck into a tree with a seventeen-year-old girl (unnamed because she was a minor) in the front seat. Tigue (thirty-eight years old and married to the B-actress Rhyme Marr—not her born name) was killed on impact; the unnamed minor was in critical condition. Country music fans were scandalized and devastated; everyone else saw the irony in the fact that McBride had died in circumstances that sounded like one of his songs. The news was full of speculation about whether McBride was drunk (yes, it would turn out) and why he was driving on the back roads of Texas with a seventeen-year-old girl who was not his daughter (still not clear).

The second story sucking up airtime was a bizarre kidnapping in Germany. An aggrieved scientist with some serious mental health issues had stormed the podium at a political rally near Munich. Before anyone knew what was happening, the guy jumped up onstage with what looked like a small syringe. There was video of all this, which explained part of the appeal of the story. The crazed scientist, who had been fired from his university post some years before, had a long white beard and frantic eyes. As the startled crowd looked on, the scientist poked the speaker, the CEO of a major agribusiness company, with the small syringe, jamming the pointed end through the man’s suit into his upper arm. The CEO looked more perplexed than pained after he had been poked in the arm. There was no shooting or gore. Local police stormed on the stage and the wild professor left willingly with them.

That, however, was when the story took a turn for the bizarre, as all the news channels were reporting. Once in custody, the scientist explained that he had injected the CEO with a slow-acting toxin of some sort for which only he would be able to provide the antidote. The mad scientist reportedly sat calmly in the police station, explaining to officers that if they wanted the CEO to live, they would have to honor his demands. The former professor had been in the chemistry department at a university in Berlin; there was no doubt that he had the expertise to concoct some fatal formula. Experts had no idea what it might be, however. The scientist intimated that he had used some combination of snake venoms. The CEO was rushed to a hospital, where he developed nausea and a mild fever. Needless to say, he was frantically urging authorities to do whatever it would take to procure the antidote.

The scientist, sitting in the police station, made what he said would be the first of several demands: He wanted an ice-cream cone—a strawberry ice-cream cone, to be more precise. And he wanted to walk freely with police officers to get it. He did not want them to bring his ice-cream cone to the station, and he did not want to walk to the ice-cream parlor in handcuffs. This demand set off a wave of protest and debate in the law enforcement community, not just in Germany but around the world. Germany had a strict policy against publicly negotiating with terrorists; the mad professor’s act had been declared terrorism, mostly for the lack of a more appropriate description of his bizarre behavior. Would it violate Germany’s policy to give the guy his strawberry ice cream? German police officers argued that giving their suspect ice cream was not radically different than giving a suspect a cup of coffee or a cigarette to encourage cooperation.

Right-wing pundits everywhere argued that acceding to the ice-cream demand would encourage the “terrorist” to make more outrageous demands. This prompted the FBI Director’s now-famous retort, “If we give him an ice-cream cone now, we can always say no if he asks for the release of one hundred Hamas prisoners in the future.” There was a robust debate in the media over whether torture would be appropriate in this kind of situation—the poison equivalent of the “ticking bomb” that U.S. presidential candidates are always asked about—but Germany forbade torture under any circumstances, so as a practical matter this was a nonstarter. Meanwhile, the CEO, growing more ill by the minute, was apoplectic that he might expire for lack of a strawberry ice-cream cone.

The story was packaged beautifully for global attention: the mad scientist perpetrator; the privileged CEO victim, waiting anxiously for the antidote; the bizarre ice-cream cone request. The situation grew weirder still when authorities realized that strawberries were not yet in season and none of the ice-cream shops in the neighborhood had strawberry ice cream. When informed of this snafu, the scientist apologized for being difficult and said that chocolate almond would be fine. CNN’s Jake Tapper would later say this was the single most bizarre news development he had ever reported on air. Camera crews followed the scientist and police as they strolled several blocks to a small ice-cream shop, where a terribly nervous young girl with bad skin stood behind the counter. (All of the customers had been cleared out.) The police commissioner asked her for a scoop of chocolate almond ice cream.

“Might I have two scoops?” the scientist interjected.

“Of course,” the police commissioner replied. (Even this decision would be debated later, with one semi-hinged Fox pundit declaring that it validated his assertion that giving in to the ice-cream request would lead to escalating demands.) The poor young ice-cream clerk stood there paralyzed. The police commissioner said more emphatically, “Two scoops of chocolate almond, please.”

The young girl stammered, “In a cone or a cup?”

“A cone, please,” the scientist answered politely. As she scooped, her arm trembling visibly and with millions of people watching live around the globe, the scientist reached into his pocket and put a one-euro coin in the tip jar. By this time, his family had contacted authorities to inform them what they were already beginning to suspect, namely that the man was unbalanced but harmless. The syringe had been rushed off to a laboratory for analysis, and just as the mad scientist was finishing the last of his sugar cone, a laboratory official called police to tell them it contained nothing more than saline. The CEO’s nausea (he had been vomiting repeatedly) was entirely psychosomatic, which one can understand given the circumstances.

The mad scientist was transfixing. The video clip of him ordering ice cream was viewed over twenty million times. The phrase “Might I have two scoops?” entered the lexicon; young people used it in an ironic way in all kinds of circumstances. There was even a temporary surge in the popularity of chocolate almond ice cream. More serious people recognized the cleverness of the scientist’s fake scheme: infecting a victim (or millions of victims) and then using the antidote as leverage. The press clamored for evidence that the Capellaviridae was not a similar terrorist plot, leaving the Communications Director with the impossible task of proving a negative. “We have no evidence whatsoever that any human actors are involved in any criminal actions related to Capellaviridae,” he declared at an impromptu press briefing at the rear of Air Force One. “None. No ransom request, no biological evidence—nothing.”

“But it’s possible?” a Fox reporter asked.

The Communications Director, who had been sleeping even less than the President, snarled back, “Look, it’s possible this virus came to earth on a secret spaceship from Mars. I can’t prove it didn’t.”

Upon reading this exchange, a new and very young Ukrainian correspondent failed to recognize the Communication Director’s use of satire to make his point and reported earnestly back to her national news wire that the White House now believed it was possible that aliens may have introduced Capellaviridae to our planet. Several Ukrainian radio stations reported the story before the State Department set them straight. Meanwhile, the Onion—still the best source for real fake news—found dark humor in the Outbreak. The headline of the most recent issue proclaimed, “God Says Capellaviridae Is Punishment for Bears Not Winning Super Bowl.” The Bears had lost to the Broncos in a Super Bowl blowout a few months earlier; the Bears coach was a very religious man who wore that religion on both sleeves. Before the game, not only did he lead his team in prayer on the sidelines, but he told reporters, “I am certain that the Man Upstairs will lead us to victory.” In fact, God allowed the Bears defense to give up over five hundred passing yards and forty-one points. The Onion had been mining this humor trove for some time, beginning with the first headline after the game: “Man Upstairs Apologizes to Bears Fans for Crappy Pass Rush.”

Ellen was understandably eager to talk about what was happening. She was curious about the work I had been doing, and, like everybody else, she wanted to know how worried she should be about Capellaviridae. “I get it now,” she said, which I took to be an all-purpose apology for our squabbles in recent days, most of which had to do with my absences and general lack of attention. I wanted to sleep more than anything else, but I realized I owed Ellen at least a cursory discussion of the situation. “You met the President?” she asked.

“Just about every day,” I said.

“What’s he like?” she asked. I did my best to describe the President and the other senior officials with whom I had been interacting. Ellen had relatively little curiosity about my work but great interest in the people I had been doing it with. If I had been less exhausted I might have been more charitable, but I remember wondering if Ellen was going to have me describe their outfits, including the designers.

At about this time, I got a short text from Jenna: “Did you see the ice cream cone thing?”

“Sorry,” I said to Ellen. “I have to reply to this.” I felt awful in that moment, knowing I had exploited the situation to flirt with someone I had known for less than twelve hours. At the same time, I realized—and Jenna would later tell me that she had realized—that those three hours beginning on the bench were more than just three hours on a bench. Jenna was the person I wanted to be speaking to at that moment. I texted back: “Amusing but also a reminder that the guy with antivenom gets the ice-cream cone!” In hindsight, this was not as clever as I thought it was. (I have no future career with the Onion.) I went to bed thinking about Jenna and knowing that I should have been thinking about Ellen. But that is not the larger point here. I also went to bed with the German mad scientist on my mind. I remember thinking, The guy with the antivenom gets the ice-cream cone! was the kind of chippy thing Professor Huke would say.

In fact, it was exactly the kind of thing that Huke would say. Because it finally got me thinking like a virus (after eleven more hours of sleep).

64.

THE PRESIDENT AWOKE SHORTLY BEFORE AIR FORCE ONE touched down in Canberra. The exuberance of his exciting takeoff to the west had dissipated; the senior staff realized there was no plan once they arrived in Australia. As expected, the Chinese had made a new offer via the U.S. Embassy in Beijing, but they were still demanding that the U.S. walk away from the South China Sea Agreement, as well as an array of other unacceptable concessions. The press—both on board Air Force One and back home—had moved beyond the U.S.-China showdown and were asking the right questions: When would the Dormigen supply be exhausted? Who would be given priority as the supply ran out? And what would be the public health implications? The President asked for basically the same information upon landing. The Chief of Staff gave him a short briefing. “The Dormigen supplies have been secured,” she said, consulting the notes on her yellow legal pad. “We have tightened the prescription criteria so that no one is getting Dormigen who does not absolutely need it. That seems to be working okay.”

“Cecelia Dodds?” he asked.

“She’s still in intensive care. It’s a nasty infection. She’s tough and they’re doing what they can.”

“Tell me if she gets worse.”

“I will.”

“What about this high school principal in Arkansas?” the President asked, waving a copy of his daily press clips (a compilation of news stories from around the world that the White House Press Office felt would be of interest to the President). The Washington Post–USA Today had run a front-page story about a fifty-three-year-old man who arrived at a hospital with failing kidneys. He was correctly diagnosed with a raging kidney infection. He also had a serious heart condition that got less attention. Per the new guidelines, he was started on a traditional antibiotic rather than Dormigen. The infection responded to the antibiotic, as doctors had hoped, but his failing kidneys put unexpected strain on his heart and he died of a heart attack. The man, Paul Gannett, was a prominent member of the local community and his death had been a shock. Hence the national news story.

“He should have gotten Dormigen. It’s going to happen,” the Chief of Staff said. “Even that may not have saved him.” The President nodded in acknowledgment and she continued. “At the current run rate, the Dormigen supply will be exhausted in about five days.”

“How many deaths?” the President asked.

“The low end of the projection is now forty-five thousand.”

“What’s the top end?”

“A hundred and fifty.”

“Jesus.”

The Communications Director had been sitting in on the meeting. He interjected, “The NIH has been working up some new numbers. There is a way to dress up the figures—”

“They’re dead. How do you dress that up?” the President snapped.

The Communications Director, impervious to the President’s tone, continued. “Most of the projected deaths are people who are already old or ill.”

“So they don’t count?”

“Kind of. I was talking to one of the senior guys at NIH. He explained something to me that’s kind of intuitive, if you think about it. Most of these people were going to die anyway, right?”

“Get to the point,” the President said wearily.

“If we measure incremental deaths over a longer period of time, say a year or two, the number is going to be a lot lower.” The President frowned, took a bite of toast, and said nothing. The Communications Director continued, “The number of deaths will spike when we run out of Dormigen, but then the death rate will be below average for the next three to six months. That means over the next year, the number of incremental deaths will be much, much lower—close to zero.”

“People aren’t really being killed by the epidemic, they’re just dying early,” the President said sarcastically. “Why don’t you call Cecelia Dodds’s grandchildren and explain that to them? ‘She won’t be at your wedding because she died early.’”

“This is straight from the NIH,” the Communications Director said defensively.

The Chief of Staff said, “People are going to go to the hospital, they’re going to be denied Dormigen, and they’re going to die. It doesn’t matter how we tally the deaths, that reality is not going away.”

The President added, “Maybe Hallmark can do a new card: ‘Sorry for your loss, but she was going to die in the next twelve to eighteen months anyway.’ I can send one to the Dodds family.”

“I’m just trying to get through today,” the Communications Director said, displaying some impatience of his own.

The cable news stations had developed fancy graphics and names for the crisis: the Dormigen Countdown; the Dormigen Debacle; and so on. The new NIH projections had not leaked, but some of the old ones had. The media had a decent idea of when the Dormigen supplies would run out, as well as a crude projection for the virulence of Capellaviridae. Overall, their estimates were not wildly wrong, no doubt because some of the concerned scientists on our team were feeding information to the press. The President also suspected the Speaker had been strategically leaking information to create support for the China option before that deal blew up and made her collateral damage. In any event, the public would soon have a more refined sense of the situation. Congress had (rightfully) demanded a full briefing on the situation. With the President in Australia, the Acting HHS Commissioner was tapped to do the congressional briefing. That briefing would be private, but anything said in there would leak immediately. The Communications Director recognized the White House needed to get out in front of the leaks to put its own spin on the situation. (Hence his reference to just getting through the day.) The President would do a national television address immediately after the “closed” congressional briefing.

The President’s senior advisers were feeling the same sense of doom that had descended on me the day before. At previous junctures in the crisis, we could imagine developments that would bail us out: Dormigen from allies; China; a scientific breakthrough on the virus. Each of those options was now gone, or dwindling away. The bravado of the takeoff to Australia had bought some political breathing space, but it had done nothing to improve Cecelia Dodds’s condition. The hourly update from that Seattle hospital now became a barometer of the nation’s future. Meanwhile, the press had begun to ask what the President could accomplish in Australia. And whatever goodwill the President had amassed by standing up to China would dissipate immediately as Americans began dying in serious numbers. The Chief of Staff would later describe the mood as “an oppressive anxiety as we internalized the reality of what was likely to happen.”

“I need to draft remarks for the congressional briefing,” the Communications Director said. He looked around the room for some general guidance to get him started. Curiously, the Strategist had gone missing. The President’s more substantive advisers typically considered the Strategist an irritant, not just because of his irreverent demeanor, but also because he was a constant reminder of the messiness and tawdriness of politics. He was the one who explained impatiently why high-minded policies would have “absolutely no fucking support” in most of the Midwest, or how information could be cleverly spun to obscure, confuse, or persuade. He had famously called the Secretary of Energy a “total moron” for using the word “tax” to describe the administration’s carbon tax proposal. One might assume that the word “tax” was an accurate and efficient way to describe a policy that was, in fact, a tax on carbon emissions. “It’s a pollution fee,” the Strategist yelled during a staff meeting. “Tell the jackasses at the EPA to stop calling it a tax.”

“Which part of it is not a tax?” a young economist from the Council of Economic Advisers had made the mistake of asking. The Strategist had literally thrown a bundle of papers across the conference table at him.

“Read that, you smug prick!” the Strategist screamed. Behavior aside, the public opinion data he had thrown across the table confirmed his point. Only 23 percent of the American public supported a carbon tax. But when the exact same policy was described as a “fee on polluters,” support climbed to 68 percent. “If you want to sit alone in your office doing mental masturbation, go back to Harvard,” the Strategist told the young economist (who was from Stanford). “If you want to improve American energy policy, don’t use the word ‘tax.’ Not fucking ever.”

The more cerebral members of the President’s team bristled at the manipulation, clinging to the politically naïve notion that a policy was just a policy, regardless of the words one used to describe it. They would appear on the Sunday morning talk shows, awkwardly trying to explain how the President’s proposed tax on carbon was not a tax. The host would probe relentlessly: “If the government imposes a charge on the emission of carbon, how is that not a carbon tax?”

The Secretary of Energy or the Chair of the Council of Economic Advisers or the head of the EPA would parry uncomfortably: “What we are proposing is a fee on polluters.”

“What’s the difference between a tax and a fee?”

“A fee is a charge levied on some activity, such as registering a car. The most elegant part of the President’s proposal is that the biggest polluters will pay the largest fees.”

“How is that any different than the income tax, where those with the highest incomes pay the most in taxes?”

“Because this is a fee, not a tax.”

And so it would continue. The cerebral advisers would apologize to their erstwhile academic colleagues for such silliness. The fact that the Strategist was generally right on these matters was no salve for wounded academic dignity. Congress eventually passed a modified version of the “carbon emissions fee,” with many members declaring to their constituents that they were supporting it because it was not a tax.

Now, with the Communications Director trying to put a positive spin on a minimum of forty-five thousand deaths, the senior advisers were looking for some guidance from the Strategist. “He needed some rest,” the President said, explaining the absence unconvincingly.

“We all need some sleep,” the Communications Director said. “Can we at least test the language?”

The Chief of Staff, sitting nearby but not following the conversation, said to no one in particular, “It’s my daughter’s birthday.”

The President ignored her. “Just draft a straightforward statement,” he instructed the Communications Director.

“Excuse me,” the Chief of Staff said as she got up and walked out of the cabin.

The Communications Director looked around the room. “We’re talking about a minimum of forty-five thousand premature deaths. What am I supposed to say?”

“We need to prepare the country for the worst,” the President replied. He outlined a rough plan. The Acting HHS Secretary would brief Congress on the basic details: the state of our Dormigen supplies; the nature of Capellaviridae; the steps that had been taken to minimize the adverse effects of the Outbreak. Those details would be released to the public immediately following the briefing and the President would address the nation after that. “This is the reality of the situation,” the President stated. “We shouldn’t try to sugarcoat it.”

He was right, of course. How could one put a positive spin on an outbreak that might kill over a hundred thousand people—however weak, old, or sick those people may be? The advisers who had been working around the clock to avert this moment were loath to concede that their efforts had been fruitless. “I still think we need to pay attention to how we explain this,” the Communications Director said, implicitly probing the Strategist’s absence.

“He’s not here,” the President said tersely. “Just do your job.”

The Secretary of State had also gone missing, but her absence would not be noted for some time.

65.

I AWOKE FEELING DIFFERENT THAN I HAD IN DAYS. I COULD remember my dreams, one of which had been about a giant chocolate almond ice-cream cone. If I had been in a soap commercial, I would have danced around the bedroom singing about how refreshed I felt. I reached for my phone on the bedstand; there were eighteen texts from various people at the NIH headquarters. I had told the NIH Director that I needed a morning to sleep and think. She agreed it was a good idea, but as the Dormigen deadline drew nearer without any meaningful progress on our part, the staff had begun to confuse motion for progress. Only one of the texts required any real input from me; the others either boasted of some new activity or posed questions with answers that were self-evident. Ellen had already gone to work. She left a note at the foot of the bed wishing me a good day and telling me that she had made an omelet that I could heat up in the microwave. “Sorry if I have not been as supportive as I should be!” it concluded, with a little smiley face. That just made me feel bad, particularly as I texted Jenna before leaving the apartment.

I put the omelet in the microwave and wandered over to the window while it heated up. We lived on the fourth floor, high enough to get a decent sense of the activity below. Three boys in Catholic school uniforms hustled along the sidewalk. They had to be late, I thought. Across the street, a bakery truck was double-parked as two guys unloaded trays of bread onto a trolley and wheeled it into a small convenience store. The initial panic of the Outbreak had given way to normalcy, mostly because people could not see anyone getting sick around them. This stiff upper lip was less about resolve in the face of adversity and more about a failure to imagine how bad things could get when the Dormigen supply was depleted, a contingency that most people now did not think was going to happen. The White House had also worked aggressively to make Capellaviridae seem less scary. Acting on the recommendation of the Strategist, senior officials had compared Capellaviridae to influenza at every possible turn. (To be more accurate, they compared it to “the flu,” which focus groups found far less scary than “influenza.”) For example, the day before, with the press clamoring for projections and details, the Communications Director had declared during an interview, “It is crucial to remember that even if untreated, Capellaviridae is no more harmful than a serious case of the flu.”

This statement was both technically accurate and entirely misleading. The public had no conception of how serious a bad strain of influenza could be. Before the advent of Dormigen, a nasty global influenza outbreak could kill a million people, including tens of thousands in the United States. There were a few media references to the Spanish flu outbreak of 1918, one of the worst pandemics in modern history, but “the flu” was the image cemented in most minds. Ironically, most Americans still believed that Capellaviridae could be contracted via contact with other humans (like the flu), but the initial panic over the disease had subsided. Schools were open again and attendance at public events was drifting back toward normal. (The Washington Nationals stadium had been only about a quarter full during the spontaneous burst of patriotism in response to the President’s takeoff from Honolulu.) I watched the guys unloading bread for a few minutes and then retrieved my omelet when the microwave made its loud, annoying beep.

I do not want to overdramatize what happened next. I was hungry enough that I made short work of the omelet. I was getting up to make some toast when I got a text from Jenna. “Good sleep?” it said. I was elated to hear from her, and like anyone who has ever flirted by text, I carefully crafted my reply: “Excellent. Ice-cream cone later?”

I waited nervously for the response: “Definitely. See you at NIH?”

Jenna’s text had pushed that crazy German terrorist incident to the front of my mind. The ice-cream cone is what had made it so bizarre. What I realized explicitly as I sat at the dining room table was that the eccentric scientist was entirely protected as long as he was the only one who could procure the antidote. That was his innovation.

Other terrorists plant bombs and demand ransom, but the strategy has limitations. The bombs must be in a population center, which increases the likelihood that they are detected and defused. Or the area can be evacuated, rendering the bomb harmless (to people). Meanwhile, the terrorist is always at risk of being killed by the authorities; they do not need him alive to deactivate his explosive device. By introducing an unknown pathogen, however, the perpetrator guarantees his safety, particularly if the antidote is not commonly known. What was so surreal about the German scientist asking for his double-scoop ice-cream cone was his certainty that the authorities would not harm him. He could stash the antidote anywhere—in a safe-deposit box or buried in a public park—and the authorities would likely never find it if he were killed. In fact, we now know that the CEO, feverish and throwing up from his psychosomatic illness, was pleading with German authorities: “Do not kill him! I need him alive!”

These thoughts rushed through my mind as I sat at the dining room table. One can quibble with my analysis of terrorism, but that is not the point. My mind turned almost immediately to Capellaviridae and the North American dust mite. The most perfectly adapted species find some way to make themselves valuable to the broader ecosystem, thereby helping to ensure their own survival. Think about those little birds that perch inside the mouths of crocodiles and clean their huge, dangerous teeth. Everybody leaves happy. Evolution has a way of creating these synergistic relationships: bizarre creatures that interact in mutually beneficial ways. But what if nature had served up something different in the case of the dust mite, Capellaviridae, and humans? What if their relationship was something more akin to that of the German CEO and the mad scientist: extortion? Wouldn’t it be possible—and entirely consistent with everything we know about evolution—for one species to essentially hold another hostage? You continue to provide for my basic needs or I will kill you. Nature offers up innumerable examples of toxins and venoms wielded by bizarre creatures either to hunt prey or to protect themselves from predators. Couldn’t such weapons be wielded more creatively?

This rush of thoughts was not as clearly articulated as I have described them here. Rather, it felt like a half-formed idea engulfing my brain, like seeing an exam question that you know you can do but have not yet figured out. Or encountering a person you recognize in the street and searching your mind for her name. You know it’s coming. “It’s on the tip of my tongue!” my grandmother used to say (more and more as she got older, sadly). I was certain in that moment that the key to understanding lurking viruses was lodged in my subconscious, working its way toward somewhere else in my brain where I could put some form around it. I did have two concrete thoughts in the moment, however.

First, I had an example—admittedly hypothetical—that I would use repeatedly in the coming hours to make myself understandable. Imagine there is a venomous snake, I would tell the Chief of Staff and others. This snake leaves its hole in the ground in the day or night to hunt lizards, which it paralyzes with venom. But the danger of leaving the hole is that the snake exposes itself to predators, such as a hawk that can swoop down and grab the exposed serpent in its talons. There is a trade-off: the snake needs to hunt, but it exposes itself in doing so. This is standard Discovery Channel stuff.

Now let’s suppose that over the course of thousands of years, nature serves up a variation of that snake, a more “clever” species (if we are going to be anthropomorphic about it). This snake slithers into the hole of its prey, where scores of lizard eggs have just hatched. The “old” edition of this snake, the less “clever” one, would gobble up the baby lizards, enjoying one very fulfilling meal. Next week it will have to hunt all over again, once again exposing itself to all the predators aboveground. But the “clever” snake—again, somehow evolved over tens of thousands of years, maybe longer—finds a strategy that is nature’s equivalent of room service. Rather than eating the baby lizards in one glorious meal, the “clever” snake uses them to eat for a lifetime (or at least a couple of weeks); it holds them hostage, doing no harm as long as the adult lizards bring it food. This is nature’s equivalent of a guy who moves into your house, puts a gun to the dog’s head, and says, “No one gets hurt as long as you feed me well and do my laundry. Also, we’re going to need to order the premium cable channels.” (Remember, nature has no 911.) In my hypothetical “clever” snake example, both species derive an evolutionary advantage. The snake obviously benefits from getting fed without having to expose itself to predators; the lizards are also more successful as a species in the long run because: (1) the baby lizards do not get eaten; and (2) the snake interloper scares off other predators (e.g., other snakes).

As I have mentioned repeatedly, this example was entirely hypothetical. (When some jackass staffer at the National Security Council started asking me questions about whether lizards really live in holes, he was obviously missing the big picture.) The point is that I had developed a theory that could potentially explain the behavior of lurking viruses in a way that was entirely consistent with evolution. Why and how could the same virus live harmoniously with its host in some cases while causing serious illness or death in others? Perhaps it depends on whether the host is delivering what the virus needs to thrive. And if not… well, every once in a while you have to shoot a hostage to keep everyone in line. Or, in my hypothetical “clever” snake example, if the adult lizards stop bringing food, the baby lizards become dinner.

My second concrete thought as this amorphous theory surfaced in my brain was that I had to call Professor Huke. I was finally “thinking like a virus.” I was reasonably sure I had an answer worthy of one of his final exams, but I wanted to be sure before sending it up the scientific chain of command, let alone passing it along to the President of the United States. I found Huke’s home number in my phone and dialed. His wife answered promptly. “He’s off running errands,” she said.

“Do you have a sense of when he’ll be back?” I asked, trying to steer a path between urgency and rudeness.

“He was going to Home Depot, but usually that means he’s going to stop at the driving range,” she said. I remembered the driving range, a decrepit little place with mats and nets at the end of a huge strip mall (near the Home Depot). There was a soft-serve ice-cream cart in the parking lot that was popular with Dartmouth students.

“Does he carry a cell phone?” I asked.

“May I ask who’s calling?” she replied, more curious than suspicious. I apologized and explained as briefly as I could why I needed to reach her husband. “Oh, yes, you visited us,” she said. “Richard really enjoyed speaking with you. He does have a mobile phone, but I can see it right here on the dining room table. I keep telling him there’s no point in having a mobile phone if all he’s going to do is leave it at home.”

Huke called back about a half hour later. “I went to the driving range. The course opens this weekend,” he said, as if he needed to explain his whereabouts. “So how bad is this Capellaviridae?”

“Not terrible in the grand scheme of things,” I said truthfully. “It acts like a virulent strain of influenza.”

“That can be pretty bad,” he said.

“True, but the Dormigen gap is not that big. We’re only looking at about a week without it.”

“Yes, I’ve read about how they are trying to stretch out what they’ve got.”

“I’m calling because I want to bounce a hypothesis off of you,” I said. “A theory of how lurking viruses might work.”

“Very exciting! Okay, I’m listening,” he said. I explained the thoughts that had been percolating through my brain that morning, including the example of the venomous snake and the baby lizards. I also explained some of the patterns that Tie Guy had observed, such as the fact that Capellaviridae was most likely to turn virulent in areas where there had been the most aggressive efforts to eradicate the North American dust mite.

“That’s certainly enough to get you a plump research grant,” he answered, “but there are still a lot of things to be worked out, even if you’re right.” And then, after a moment: “How long do you have?”

“Days,” I said. “Not even a week.” Huke did not answer right away. His silence signaled the obvious: we needed years, or at least months, to turn this thought into anything practical—and even that assumed I was racing along the right track. “Here’s what I’m thinking,” I continued. “When people become sick with the virulent form of Capellaviridae, we need to reintroduce them to the North American dust mite.”

“Hmm.” Huke was silent as he tried to follow my line of thinking. Eventually he said, “You are thinking that this dust mite fights back somehow, using Capellaviridae?”

“Yes.”

“But you don’t know how. Just that Capellaviridae turns virulent when the dust mite disappears,” he said.

“Yes. Either because the dust mite gets exterminated, or because people move from an area where the dust mite is endemic to a place where it’s not. In both cases, when there are no North American dust mites, the virus can turn virulent.”

“There’s no harm in testing it, is there?” Huke asked.

“Well, it might be hard to persuade people who are sick with Capellaviridae that the cure involves letting them get bit by the same dust mite that gave them the virus in the first place.”

Huke laughed. “Do you think it was easy persuading people that injecting them with a weakened polio virus would protect them from polio?”

66.

THE PRESIDENT WAS OPENLY AND SHOCKINGLY DISMISSIVE OF many members of Congress. Part of that stemmed from his animus toward the Speaker, which had only deepened since the beginning of the Outbreak. “You don’t have to be a genius to win an election,” the President told me once after I had expressed amazement when a congresswoman from Arizona declared that it was still an “open question” as to whether germs cause disease. “That’s not the craziest thing I’ve heard,” he said, turning to the Chief of Staff. “What’s the name of that guy from Tennessee who kept introducing bills to ban witchcraft in schools?”

“I don’t remember his name, but he served eight or ten terms,” the Chief of Staff said.

“Then he got arrested for sexual assault.”

“No,” the Chief of Staff corrected him. “That was the guy from Kentucky.”

“With the wooden leg.”

“I don’t think it was wooden, but yes, he had a prosthetic leg.”

The President turned to me and explained, “He ran a campaign saying he’d lost his leg to an IED in Afghanistan. Turns out he was never in the Army. He lost his leg in a drunk-driving accident on a motorcycle.”

“He still got elected,” the Chief of Staff added.

“He served a bunch of terms. Didn’t he get reelected after he was arrested?”

“I think so,” the Chief of Staff said. “He had to give up the seat when he was sentenced. There was a special election.”

“That’s right,” the President said.

“How does someone get elected with a fake war record and then reelected after being arrested for sexual assault?” I asked.

The President waved his hand dismissively, suggesting my question was as naïve as I felt it to be. “He blamed the press. Said it was fake news. All the usual crap.” Then he turned more serious. “People aren’t paying attention. That’s really it. Americans are busy driving their kids to soccer practice and designing iPhone apps and bashing government—until something like this happens, then everyone wants to know who’s going to fix the mess. Is there an iPhone app for this?” He picked the Chief of Staff’s phone up off the table in front of us. “Which button do I push to get more Dormigen? Is there an app to fix the Middle East? How about getting Newark schoolkids to read at grade level? Has Silicon Valley figured that one out yet?” An uncomfortable silence settled over the room. Then the President said, “They elected him again, didn’t they?”

“Who?” the Chief of Staff asked.

“The guy with the prosthetic leg who got arrested for sexual assault.”

“Yes, I think so. He ran when he got out of prison.”

The President threw up his arms, as if to say, “See!” And then after a moment, more seriously: “You can’t systematically ignore governance and then expect it to work well.”

I remember passing the Chief of Staff in the corridor hours later. She pulled me aside and said, “He’s tired.” I knew immediately what she was referring to.

“That doesn’t make him wrong,” I replied.

“No.”

Congress had certainly not distinguished itself in the hours since the Outbreak had become public. There had been a flurry of legislation introduced to nail the barn door shut: a bill to ban the outsourcing of Dormigen production; a bill declaring access to Dormigen “a basic American right”; a bill formally censuring Centera; and many others that had no chance of passing and would not have helped the situation even if they had. Then there was the bill demanding an investigation into Israeli involvement in the Dormigen shortage (introduced by the avowedly anti-Semitic “white Christian caucus”). This was the “teakettle” activity that the Senate Majority Leader had predicted at the beginning of the crisis—legislators presenting the illusion of action for constituents who did not know, or did not care, that introducing a bill is different than passing a law.

The President was not, however, dismissive of Congress the institution. He had a group of legislators whom he and the Chief of Staff referred to as “the adults.” Every once in a while, he would turn to her and say, “Let’s run it by the adults.” As best as I could infer, this was a group of ten or twelve senators and thirty or forty House members whom the President respected a great deal. The group, which studiously avoided publicity, had coalesced near the end of the Trump presidency when a handful of serious legislators across parties began to believe that American governance had become dangerously unhinged. Some of the more impressive legislators in each chamber—former governors and Rhodes Scholars and CEOs and even a Ph.D.—began meeting informally after yet one more threatened government shutdown. There was no formal membership, just a series of relationships among serious people who sought to transcend the rancor and futility that had engulfed Washington. There was no ideological litmus test; the group included several committed progressives and one hard-core libertarian. What the participants had in common was a genuine commitment to civility and an aspiration to govern. In that spirit, they called themselves the “Conventioneers,” after the delegates to the Constitutional Convention, the group of Americans who came to Philadelphia in 1787 representing an array of regions, interests, and ideologies and, over the course of a long, hot, arduous summer, managed to compromise their way to one of the greatest political documents ever written. No one ever told me why the President called them the “adults” rather than the “Conventioneers.” I do know that the Congressman from Kentucky with the prosthetic leg was not one of them.

The “adults” were not powerful enough to pass legislation by themselves. Too much of what had to be done in Washington involved medicine the country was not prepared to take. They could, however, derail the very worst ideas. They could also generate momentum for an idea whose time had come. The press and the nation’s opinion leaders respected their collective wisdom. Most of the members were sought-after guests on news programs, not because they yearned for the spotlight (many were openly disdainful of it) but because media outlets were keen to have guests who could offer a modicum of depth. (Ironically, the legislators most eager to get on such programs were typically the least-favored guests.) The Conventioneers were not miracle workers; they had to win elections like everyone else. Then again, so did the delegates to the Constitutional Convention. The President’s informal liaison with the “adults” in the Senate was the Majority Leader, who had earned that position because of his decades-long reputation as a legislative workhorse. In the House, the President typically called Gail Steans, a particle physicist who had run for her first term in Congress when she was well into her fifties.

The President reached out to the adults before his formal briefing to Congress, both to ensure their support and to get feedback on his proposed remarks. He contacted Representative Steans first. She was a feisty woman, short and wiry, with a husky voice, who seemed perpetually annoyed that human beings did not act as predictably as other elements in the universe. She had been elected as a Democrat but left the party and became independent when the Speaker started trying to tell her what to do. (After the President was elected as an independent, it gave cover to a small but influential group of legislators to ditch their party affiliations. Three senators and eleven representatives had also been elected as independents.) The scuttlebutt in the capital was that Representative Steans did not “play nice” with her Washington colleagues. That was misleading, as she was a delightful and courteous person who happened to have zero patience for political nonsense. “I’m too old for that crap,” she would often remark. In fact, she was well liked by her fellow Conventioneers, who often looked to her for guidance on scientific matters.

“How are you holding up, Mr. President?” Representative Steans asked when the President called her on the way to a town hall meeting in her home state of Maryland.

“I’ve had better stretches.”

“You wanted the job,” she said. This was a statement of the obvious and could pass for small talk, but there was a slight edge in the remark, as if to remind him that others in his seat had faced worse. “What’s the latest?” she asked. The President walked her through the situation: the amount of Dormigen left, the fatality projections, and so on.

“First thing,” Steans said, “you need to get yourself back to D.C. This whole flying west stunt has played itself out.”

“We’ll be wheels-up right after I give my address,” the President replied. He had met with the Australian Prime Minister and other Asian leaders while on the ground in Canberra. They had recommitted themselves to the South China Sea Agreement before posing for a group photo, fourteen heads of state effectively facing down Chinese hegemony in the region. The President did not land on an aircraft carrier—it felt wrong in light of developments stateside—but the group photo had been taken on one of the disputed South China Sea islands, which broadcast the same message to Beijing.

“Why don’t you speak from Air Force One in flight?” Representative Steans asked. “That will give you some extra drama. Very presidential.” Her tone was not facetious. Rather, she acknowledged the effectiveness of these political gestures even as she wished they were unnecessary.

“We had some problems with the broadcasting technology, but yes, I think I can do that now,” the President said. “What’s the tenor on the Hill?”

“A lot of noise, mostly. The Tea Party jackasses are talking about impeachment.”

“On what grounds?”

“Who knows, who cares?” Steans said dismissively.

“They all voted against any public funding for Dormigen in the first place,” the President complained.

“Of course they did. Government is the problem for those morons until they call 911 and no one answers. Ignore them. That’s a sideshow.”

“And elsewhere?”

“I think you’ve got decent support on Capitol Hill in the places where you need it,” Representative Steans said thoughtfully. “Other than the Speaker and her minions, I don’t think anybody thinks we should kowtow to the Chinese. We’ll see how that sentiment holds up when people start dying… Is there no better deal to be struck there?”

“We’ve been working that one hard,” the President answered. “They’ve come back with some better offers, but they all involve walking away from the South China Sea Agreement. I just don’t see them dropping that condition.”

“What about postponing it? President Xing could save face and we’d still get the agreement.”

“We tried that. No go.”

“What a waste,” Representative Steans said, sighing audibly. “People are going to start dying here and they’ll have warehouses full of Dormigen there.”

“World War I was a waste, too,” the President said. “If you think about the big picture, we need to push China toward becoming a more responsible global power. That’s why the South China Sea Agreement is so important. It’s like Germany and Japan after World War II. We need China as a force for good.”

“Hmm, I suppose that’s right.”

“We do have one more potential diplomatic option,” the President offered.

“Yes?”

“I can’t say anything more, but I’m cautiously optimistic.” Representative Steans knew better than to pry; the President was not one to play coy. After a brief silence, he offered, “We may have a breakthrough on the virus front, too.”

“What’s that?”

“The NIH folks can brief you better than I. My understanding is that they have some new insight into why the virus turns virulent.”[23]

“I wouldn’t expect too much on that front,” Representative Steans warned.

“Why is that?”

“We have, what, a handful of days until the Dormigen supplies run out?”

“My understanding is the scientists may be able to come up with some kind of antidote.”

“I’m skeptical,” Representative Steans said. “Scientific breakthroughs don’t happen in days. I certainly would not say anything about that in your remarks. What you need to be doing now is setting expectations for how bad it could be.”

“Cecelia Dodds is helping us with that,” the President said.

“What a needless tragedy,” Representative Steans said. “There’s nothing you can do?”

“I’ve tried.”

Representative Steans exhaled audibly. “That’s what we’re facing on a massive scale,” she said. “You don’t want to create panic, but complacency might be just as dangerous.”

“I understand.”

The President took her advice (reiterated by many others) that he should address the nation from Air Force One on his way back to D.C. The technology on board had been fixed and double-checked (and triple-checked after the President growled at the Chief of Staff, “It better fucking work”). The word went out that Air Force One would be departing shortly. As the last supplies were loaded on board and the doors were closed, the Strategist had not boarded. The Secretary of State had gone missing as well.

67.

THE NIH WORKING GROUPS WERE ENERGIZED BY MY THEORY of how lurking viruses might work, but the response was still less robust than one might think. The working hypothesis was that proximity to the dust mite was somehow protective against the virulent form of Capellaviridae. To stick with the earlier analogy, the dust mite is the extortionist; humans are the hostages; and somehow Capellaviridae is the weapon the dust mite uses to advance its own interests. One can imagine the dust mite holding the Capellaviridae “gun” to the head of its human host, saying, “As long as I stay fed and comfortable, nobody gets hurt.” If humans start to wipe out the pesky dust mite, however, things would turn ugly. (My hypothesis was that moving away from an area with dust mites to one without them somehow sent the signal that the dust mite was under siege, kind of like the protagonist in a western saying, “If I’m not back safely in an hour, kill them all.”)

“I understand all that,” the NIH Director told me, “but I need you to understand that it takes time to test a hypothesis that is still only half-baked.”

“Half-baked?” I asked incredulously. “Have we got any ideas that are fully baked?”

“I’m sorry, that was a poor choice of words,” she said. “I’ve been talking to people at the FDA all morning. A clinical trial typically takes months, if not years. You’re asking me to do something in days that usually takes years, and to be honest, it’s not even clear what we’re testing.”

I paused for a moment before responding. For most people, that involves some kind of cooling-off process. Unfortunately, I was heating up. “First of all,” I began, trying to project anger and seriousness without any hint of hysteria, “I’m not asking you to do anything. The people who are likely to die from Capellaviridae are asking you to do something. Second of all, what we’re testing here is really simple. Just expose people who’ve become sick to the North American dust mite. The hypothesis is that somehow repeated exposure to the dust mite protects against Capellaviridae turning virulent. I can’t tell you how or why that will work, and frankly we shouldn’t care at this point. We can figure that out five years from now and we’ll all share the Nobel Prize. We just need to try this very simple fix because we have nothing else.”

Now it was her turn to pause and sigh. “It’s not that simple,” she said in a tone that suggested I probably would not get it anyway, like a high school girlfriend who says pityingly, “Oh, you’ll never understand…”

“Which part of just letting people get bit by dust mites is not simple?” I asked angrily.

“Let’s start with ‘who,’” she said. “Who is in this trial? We have no federal protocol for this kind of situation. We have a treatment that is one hundred percent effective—Dormigen. Anyone who is sick now or becomes sick in the next few days will receive Dormigen. Meanwhile, we have a completely untested theory that involves exposure to biting insects—something that hasn’t even been tested on rats. Would you volunteer for that clinical trial? Would you enroll your children? ‘Oh, no, Bobby doesn’t need Dormigen, let’s try the biting-bug cure.’”

“That’s not fair—”

“I’m not done yet,” she snapped. “We can’t test this on people without their knowledge, obviously.” I was being reminded that the Director was tough and smart; one does not get to be the head of a federal agency without heavy dollops of both of those attributes. Also, she had had as little sleep as the rest of us, maybe less. “Now let’s talk about ‘how,’” she continued. “Even when Capellaviridae becomes virulent, the body fights it off about ninety-nine percent of the time. So to determine if a treatment is effective with any degree of statistical confidence, we need a huge sample. And I just finished telling you that we’re having some trouble finding anyone who would be in that sample.”

“I’m sorry,” I said, raising the white flag. “We’re on the same team here.”

“Then stop telling me how to do my job,” she said angrily. My apology worked to soften her tone, but she needed to wind down, like an engine that continues to run for a few seconds after the ignition has been turned off. “Also, I have to deal with that French asshole.”

“Giscard?” I asked.

“Yeah, he’s here.”

“Like in D.C.?”[24]

“Yeah, he took it upon himself to fly over when he heard the news,” she offered. “He got in last night.”

Lionel Giscard was—by science standards—a global celebrity. He was the lead author on not just one, but two of the key papers that led to the development of Dormigen. He had won about every major science award and was dusting off a place for the Nobel Prize medal (which is typically awarded near the end of one’s career). Within the scientific community, Giscard was considered a lecherous asshole, for lack of a politer way of saying it. He had been married four times; after his most recent divorce, he was photographed cavorting with a former graduate student of his who was younger than all of his children. His starter wife was a doctor; they had met at university. Each subsequent relationship involved a search-and-replace process in which he sought out the most attractive graduate student and made her the new Madam Giscard. He stunned a conference of microbiologists—I mean, left a room of two hundred just stone-silent—when he opened a talk on cell longevity by saying, “I must have found the key to eternal youth, because the woman I am married to never seems to get any older.”[25] There was not even uncomfortable laughter.

Giscard eventually found his way to Harvard, where the university built and funded a laboratory for him. This became a cause célèbre on campus, as Giscard’s pattern of behavior was already well established before Harvard recruited him. (Yes, he had married some of his protégés, but most of the attractive graduate students who had been the recipients of his amorous advances had no interest in becoming the next Madam Giscard.) He made it barely four months in Cambridge before a laboratory assistant alleged that he had pressed his body up against her and smelled her hair while she was looking at a microscope. This was a tough case to make, as people do bump into one another in close quarters, and sniffing hair (wildly parodied in the Harvard Lampoon) is not generally a firing offense. Still, Harvard’s president decided this was not a work environment that should be encouraged. Perhaps more important to the resolution of the situation, Giscard decided he was not happy at Harvard, either. In a remarkably telling comment, he told a reporter at the Harvard Crimson, “No one has ever complained before.”

There were no quibbles over Giscard’s scientific talent. He was not a brilliant theorist; rather, he had a brilliant ability—and I am not using the word “brilliant” lightly—to absorb a theory and digest it into smaller, more actionable pieces. This was his contribution several times over in the development of Dormigen. On the other hand, Giscard’s colleagues did quibble—more than quibble, actually—about his prodigious ability to appropriate credit for major breakthroughs. When teams of researchers were tackling similar problems at different universities, as is often the case in academe, Giscard’s papers always seemed to get published first, often with the results advertised to the press before the peer review process was complete. And when those papers were published, he always demanded to be first author, regardless of his actual contribution. It was not negotiable.

I would see all of this play itself out—every single one of Giscard’s extreme personality traits—over the next thirty-six hours.

68.

THE U.S. AMBASSADOR TO INDIA IS ONE OF THE UNSUNG heroes of the Outbreak. Early in the crisis, our request to the Indian government to “borrow” any excess Dormigen had been firmly rebuffed. The Indian Prime Minister was a prickly populist, keenly sensitive to being perceived as the junior partner in the U.S.-India relationship. He was facing an impending parliamentary election and feared that sending Dormigen to the U.S. would be perceived by the Indian masses as putting U.S. health interests ahead of India’s own massive challenges. Hence, the Indian Prime Minister had offered to sell Dormigen to the U.S. only for a ridiculous sum. Subsequent discussions had gone nowhere productive; State Department diplomats reckoned that India was not a likely source of Dormigen as long as: (1) the Indian Prime Minister was concerned primarily about his party’s electoral prospects; and (2) he believed that any assistance to the U.S. would be perceived by Indian voters as bad for India.

Once the Outbreak became public, however, American diplomats on the ground in New Delhi noticed a subtle undercurrent in Indian public opinion that presented an opportunity. It began with a newspaper column by a prominent journalist. If China is exploiting America’s desperate situation, the columnist asked, does this not represent an opportunity for India to transform its relationship with the United States? India and China, the world’s two most populous countries, had been eyeing each other warily for decades. They were each trying to lift hundreds of millions of people out of poverty, albeit with radically different approaches to governance and development. They had gone to war once, just a month-long conflict in 1962, but the border dispute that had precipitated the shooting remained unresolved. Three years before that, India had welcomed the Dalai Lama when he fled from Tibet; he has resided in northern India ever since—a constant source of irritation for Beijing. Over time, the India-China rivalry had morphed into an ideological battle: Democracy or autocracy? And, like two needy siblings competing for parental affection, each jockeyed on the world stage to gain a strategic advantage via its relationship with the United States. There was a strain of thinking in New Delhi—perhaps oversimplified but not necessarily incorrect—that China’s loss must be India’s gain. While China was being demonized in Washington for clumsily exploiting the crisis, would this not be a natural opportunity for India, the world’s largest democracy, to deepen its ties with the U.S., the world’s most powerful democracy?

These were the thoughts that Indian intellectuals had begun to bandy about. The Prime Minister was never confused with the intellectuals. He did, however, have a brilliant sense of which way the intellectual winds were blowing. The U.S. Ambassador to India, a former senator from New Hampshire, was a keen enough observer of Indian politics to spot an opportunity in all this. We should be thankful that the Ambassador was not one of those political hacks who make huge contributions to a presidential campaign and then find themselves ambassador to a country that they cannot find on a map. Rather, the Ambassador had started his career in the Foreign Service and had been a member of the Foreign Affairs Committee in the Senate. The President had offered him the post as a consolation after he was beaten unexpectedly in a Democratic primary. He knew politics. He knew diplomacy. And he understood the needs and wants of the Indian Prime Minister. As the South China Sea Agreement drama was unfolding, the Ambassador passed an urgent message along to the Secretary of State: If we play our cards right, India might be the solution here.

When the Secretary of State and the U.S. Ambassador were finally able to speak, shortly after Air Force One had touched down in Australia, the Ambassador laid out his thinking: “If we can create a political win for the Indian Prime Minister, he’ll give us whatever Dormigen we need.”

“He turned down our earlier inquiries without a second thought,” the Secretary of State said skeptically.

“That was then. This is now,” the Ambassador explained. “There are murmurings in the press and elsewhere that this could be India’s shining moment on the world stage, the perfect opportunity to poke a finger in China’s eye.”

“Do they have enough Dormigen?” the Secretary of State asked.

“Yes,” the Ambassador answered confidently. The Secretary of State did not ask how the Ambassador would know something like this. She assumed that the resident spooks in New Delhi had done their homework.

“Okay, then, I think we should pursue a conversation,” the Secretary of State said.

“Yes, well, there’s one caveat,” the Ambassador said.

“Of course there is. What?” the Secretary of State asked.

“The Prime Minister is going to have to think this is his idea. If we ask again for the Dormigen, we’re not going to get it. He needs to offer it to us. It has to be his shining idea, and Indian voters need to know that.”

“Really?” the Secretary of State asked. She was intolerant of the exigencies of politics in the best of times. Now, having slept little and facing a deadly deadline, the Secretary of State was even less patient with such silliness. “Really? We’re facing down a hundred thousand deaths, and he needs to feel this is his idea? Are we dealing with a teenager?”

The Ambassador laughed. “That would not be a bad guide for the negotiations. But if I’m being more charitable, I’d say that one does not become prime minister in a country of a billion people, many of them illiterate, without some rather coarse political calculations.”

“Okay, fine. How do we make this his idea?” the Secretary asked.

“I was hoping you would have a suggestion,” the Ambassador answered.

The Secretary of State relayed the conversation to the President, who seized on the possibility eagerly. “It can’t be too hard to feed this idea to the Prime Minister,” the President said. “I don’t care who gets the credit.”

“Washington is full of people who think they’ve come up with other people’s brilliant ideas,” the Strategist offered.

“Exactly,” the President agreed. “Can’t we do a poll, something that shows that Indian voters want to come to the rescue here?”

“There’s not enough time,” the Strategist said. “We need three or four days to do a decent poll. And that’s in the U.S.; India is even more complicated.”

“Give me something here,” the President said in exasperation. “I’m tired of people telling me what I can’t do.”

“Poll results, on the other hand—I could do that in about five minutes,” the Strategist said.

“What’s that supposed to mean?” the Secretary of State asked suspiciously.

“It means we create the results we want and leak them to an influential Indian news source,” the Strategist explained.

“Oh, for God’s sake, that’s exactly the kind of thing that will make people around the world even more paranoid about American meddling,” the Secretary of State said.

“Let’s worry about that next week, when people aren’t dying of Capellaviridae,” the President said.

“With all due respect, sir, we should think very carefully—”

“I just did,” the President said sharply. “Make it happen. The two of you. I want the Indian Prime Minister to wake up tomorrow and think that his entire political future depends on shipping huge quantities of Dormigen to the United States. How you make that happen—that’s your job.”

69.

LIONEL GISCARD ARRIVED AT THE NIH OFFICES WITH GREAT fanfare. He had long gray hair and a carefully manicured goatee. He wore a blue suit with a florid purple shirt and a paisley silk scarf around his neck that he wrapped and unwrapped frequently, almost like a nervous tic. Giscard was stylish for a fifty-year-old man; by NIH standards he looked like a fashion model (with a great accent). Giscard’s arrival caused a frisson of excitement. Those who knew him greeted him effusively. Others waited to be introduced. I was surprised by how all the charges of bad behavior melted away in his presence—scientific celebrity. I also recognized that celebrity can be relative. As soon as Giscard stepped out of our scientific den onto the street, he became just another old guy with a goofy-looking scarf.

The NIH Director ushered Giscard into a conference room, where the Capellaviridae team was assembling. I was seated at the table; the Director introduced me as the resident Capellaviridae expert. “Okay, yes,” Giscard said. “But I am not familiar with your work. You publish on Capellaviridae, yes?”

“I did my doctoral work on it,” I said.

“And since?”

“I work on the staff here.”

“Ah, yes, I see.” His tone could not have been more dismissive. He immediately turned and looked around the room. His gaze settled on Jenna, who was seated in the back of the room in one of the chairs reserved for junior staff.

“Good to meet you,” I said sarcastically as Giscard made a beeline for Jenna, like a wolf that has spotted a baby rabbit limping in the grass. From across the room I watched as Giscard shook Jenna’s hand, placing his other hand lightly on her arm. She laughed at something he said. Some of the senior scientists waited patiently to meet Giscard while he finished his flirtation.

The NIH Director called the room to order. She introduced Giscard to the senior staff and gave a brief overview of our progress to date, including a summary of my “hostage hypothesis.” “But of course,” Giscard said. “This makes perfect sense. I have been working on a paper to this effect. In French, we say ‘preneur d’otages,’ the taker of hostages.” Like so much else with Giscard, it is hard to know if this was the truth, an exaggeration, or a complete falsehood. He claimed he was working on a paper with a theory of lurking viruses similar to what I had proposed. “You were invited to the conference in Toronto, yes?” he asked me.

“I wasn’t able to attend,” I said. That was technically true. If one is not invited, it is difficult to attend. Also, I had no idea what Toronto conference he was referring to.

When the Director finished her briefing, the room fell silent. All eyes turned to Giscard for some pearl of wisdom. He swept the paisley scarf around his neck with even more care than usual. “Mais oui,” he said, drawing the attention of the few people in the room who had not been looking at him. He struck a pensive tone, deliberately unfurling the scarf. At last: “I think that if a vector can spread a virus, then it can also spread an antibody, yes?” He had a prodigious ability to appear profound while repeating what he had just been told.

“That is the hypothesis we are now exploring,” the Director said.

“By this thinking, the small bug—how does one say it?”

“The North American dust mite,” the Director offered.

“Yes, the dust mite. The dust mite becomes valuable to its host, the human, because it somehow introduces the antidote for Capellaviridae. Yes?”

A scientist at the conference table interjected, “We’ve not found any sign of an antibody. That was one of the first things we checked for. We cannot find any antibodies in those who are not affected—”

“Yes, yes, okay,” Giscard said, cutting him off and, at least from my perspective, dismissing him with what looked like a wave of the scarf. “I assume as much, or I would not be here. This is not your typical potato, right?” Remarkably, people throughout the room, including most of the senior scientists, laughed at this bizarre potato comment. Giscard continued, “But somehow the ongoing presence of this small bug—”

“The dust mite,” a scientist sitting opposite Giscard offered.

“Yes, okay, the presence of the dust mite is somehow affecting Capellaviridae so it does not turn dangerous.”

Tie Guy, who was sitting in a chair against the wall, interjected confidently, “We have nothing to show causality here—no biological evidence whatsoever—just a robust inverse correlation. When people are exposed constantly to the dust mite, they do not get sick. When that exposure is interrupted, either because the dust mite is successfully exterminated, or because a person moves to an area where there are no dust mites, Capellaviridae is prone to turn virulent.”

“Yes, yes, like the Director said,” Giscard agreed. “And when you expose people who are sick with Capellaviridae to the dust bug, they get better?”

“It’s been very hard to test,” I offered. “Most people get better on their own, so we’d need a huge trial to prove effectiveness. We don’t have the time and we don’t have the volunteers.”

Giscard gave the scarf one final furl around his neck. He leaned back in his chair and put his fingertips together, making sure that the whole room recognized that he was now engaged in deep contemplation. “And so here we are,” he said.

“This is where we’ve been since I proposed the hypothesis,” I said with more than a little irritation.

“Can we break for a coffee?” Giscard asked. “I think this situation is very manageable.”

“It’s not feeling manageable,” the Director said. “We have very little time.”

“Let’s have a coffee,” Giscard insisted. “I have some ideas.” The Director was nonplussed at having the meeting interrupted for a coffee break. (There were urns of coffee in the conference room.) Giscard was disrupting the protocol: reports to be presented, assignments to be made, and so on. The guy had no official role, and now here he was proposing a coffee break eighteen minutes into our official daily briefing.

“We have a lot of business to get through,” the NIH Director said.

Giscard waved dismissively at the crowded conference table. “But this is not how science happens, with bureaucratic meetings. We need to think—how do you say it, brainstorm. We do not need the accountants in the room.” Obviously there were no accountants in the room, and Giscard had now managed to annoy much of the staff, but he was not entirely wrong. The NIH meetings had become increasingly mechanistic and process-oriented. The time spent in meetings like this drowned out some of the casual conversations among researchers that could often lead to breakthroughs.

“We have some important things to get through,” the Director said. “Then perhaps we can do a smaller session a little later with no agenda. Please understand that we are keen to take advantage of your expertise, Dr. Giscard.”

“As you like,” Giscard said with a twirl of the scarf. “I am here because there is a crisis.”

The Director moved through business quickly, after which a group of us on the science side retired to a small windowless conference room with whiteboards on three walls. As we filed into the room, Giscard spotted Jenna speaking with the Director. Once again, he made a beeline for her. “Will that room be okay, Dr. Giscard?” the Director asked as he approached.

“Yes, yes,” he assured her as he turned to Jenna. “But you will join us?”

“Me?” Jenna asked, apparently oblivious to the fact that Giscard was stalking her. “I’m just an extra pair of hands around here.”

The Director, no naïf when it came to predatory scientists with huge egos, said quickly, “Jenna has some things to do for me. She’s not part of the virus working group.”

Giscard touched Jenna lightly on the shoulder: “We will talk later.”

“That would be great,” Jenna said.

With the flirtation out of the way (for the time being), a group of six or seven of us retired to our small windowless room. Tie Guy spoke first, outlining his statistical findings. A scientist from the CDC summarized what we had learned about Capellaviridae, including its similarity to the influenza virus. Giscard behaved differently in this environment—more scientist and less French showman. It may have been my imagination, but I think he even twirled his scarf less often. Moments earlier I had felt a strong urge to strangle him with the scarf, but now I could not help admiring how his mind worked. I presented my theory that the North American dust mite was somehow using Capellaviridae to gain an evolutionary advantage. “I suspect this virus has an on-off switch—somewhere, somehow,” I said. “The dust mite controls that switch and benefits as a result.”

“Yes, this is right,” Giscard said confidently.

“We can’t find any evidence of that,” a CDC scientist objected. “The virulent and dormant forms of the virus are identical.”

“That’s not right,” Giscard said dismissively. “One form of the virus makes you sick, one does not. Those are not the same. They cannot be the same.”

“They have the same DNA,” the scientist replied.

Giscard grew even more dismissive, something I did not think possible. He made a strange pffff sound, blowing air out his pursed lips. He pointed at a young CDC scientist sitting next to him. “You have DNA. I hit you with a mallet. Your DNA does not change. But now you are different because your brain is on the floor.” He paused as we digested and recoiled from his analogy, not least the scientist whose hypothetical brain was now lying on the floor. Giscard continued, “If you people start with the assumption that the virulent form of the virus is no different than the dormant virus, then of course you will miss the difference!” I watched the body language of the scientists around the table as this French interloper chided them for their sloppy work. There were a few sets of rolled eyes, but I suspect most in the room were feeling some variation of what I was feeling, namely that Giscard was a complete asshole who was probably right.

“Healthy people carrying Capellaviridae have no antibodies,” I offered. “It’s not that their bodies are fighting it off. There is nothing to fight off. It’s innocuous—until it’s not.”

“Okay, yes,” Giscard said, encouraging this line of thought. I felt like an elementary school student who has answered a math problem correctly, basking in the admiration of my teacher. I hated myself for it, but I wanted Giscard to appreciate my input.

“So what’s happening is not a difference in reaction to the virus,” I continued. “It’s not that some people fight it off and others don’t. The virus itself appears to be behaving differently. Maybe there is a difference at the molecular level.”[26]

“Exactly,” Giscard said.

“The President is going to speak in about twenty-five minutes,” Tie Guy said.

Giscard turned to him, seemingly annoyed by the interruption. “The President is not going to help us understand the virus,” he said.

“I’d like to watch,” one of the CDC scientists said with a hint of hostility.

“We have time to waste?” Giscard asked.

“I’ll stream it on my laptop,” I said. “We don’t have to interrupt what we’re doing.”

The rest of the meeting is the subject of what might generously be called “competing memories” (which have in turn generated competing news accounts, competing lawsuits, competing memoirs, and even one pathetically inaccurate French documentary, The Hero in the Room). Here is what we do know: (1) the biochemists began comparing the molecular structures of the dormant and virulent Capellaviridae viruses; (2) we proposed a hypothesis whereby Capellaviridae is rendered indolent by the disruption of a key protein; and (3) we further hypothesized that the North American dust mite transfers an enzyme to humans that renders Capellaviridae harmless. Our theory left some crucial questions unanswered (e.g., Why did this effect appear to be only temporary?). But for the first time, we had an elegant and testable hypothesis that could explain not just Capellaviridae, but potentially all lurking viruses. Most important, if we were correct, we would in theory have an antidote for the virulent form of Capellaviridae: the mystery enzyme.

The biochemists immediately reached out to their colleagues at the NIH and in academe to begin examining the protein structures of the virulent and indolent Capellaviridae viruses. I briefed the NIH Director on our progress. She in turn called the Chief of Staff to report the potential breakthrough. And Lionel Giscard, as best as I can tell, immediately set to work claiming credit for all the important work we had done.