The Rationing

70.

THE PRESIDENT WOULD SPEAK FROM AIR FORCE ONE immediately after the Acting HHS Secretary gave his briefing to Congress. The Communications Director was adamant that there be as little time as possible between the congressional briefing and the beginning of the President’s speech. “I don’t want them to have time to make a single tweet—not even two hundred and eighty characters,” he told the Acting HHS Secretary. “And keep it simple: here’s what’s happening, here’s what we’re doing, and here is our plan in the unlikely event that we encounter a temporary shortage of Dormigen.”

“Is that still an unlikely event?” the Acting Secretary asked. “I thought the whole point of the briefing was to make people aware of the seriousness of the situation.”

“Okay, don’t say ‘unlikely.’” the Communications Director conceded. “But I want it clear that we are still pursuing multiple options to forestall a shortage.”

“How about I just say that?” the Acting Secretary asked.

“Fine,” the Communications Director said. “But whatever you do, don’t use the word ‘ration.’”

“We are going to prioritize who gets Dormigen in the event of a shortage,” the Acting Secretary suggested.

“Perfect.”

“Because that’s not rationing.”

“No one in this administration is going to use that word,” the Communications Director declared.

“And what about Cecelia Dodds?” the Acting Secretary asked.

“What about her?” the Communications Director asked impatiently.

“It’s hard to say everything is going to be okay as she drifts in and out of consciousness.” That was the latest update from the hospital. Cecelia Dodds was being treated with an experimental German antibiotic that had proven effective against respiratory infections. So far, she had not responded positively.

“We can say something about the German drug,” the Communications Director offered. “That’s the kind of thing we’ll do in the absence of Dormigen.”

“And if she dies while I’m giving my briefing—”

“I don’t know what the fuck we should say!” the Communications Director exploded. He composed himself and continued. “I think maybe we just don’t say anything.”

The administration had vowed not to use the word “ration.” The Speaker of the House was intent on using that word as frequently as possible. She had taken a beating for her position on the South China Sea Agreement and as the putative leader of a Hispanic separatist movement before that. Those news cycles were now past. One does not get to be Speaker of the House, let alone a credible presidential candidate, without taking a few punches to the gut. The Speaker had arranged a press briefing in the Capitol forty-five minutes before the Acting HHS Secretary was scheduled to brief Congress. “How is she going to react to the briefing before the briefing?” the Chief of Staff asked sarcastically upon learning of the Speaker’s plans.

“Call her,” the President directed. “Tell her we all need to be on the same page.” The Chief of Staff phoned the Speaker, who was unavailable, according to the young staffer who answered the Speaker’s cell phone. “Tell her that if she doesn’t become available, I’m going to take away her plane,” the President growled in the background, loud enough for the staffer to hear.[27] Miraculously, the Speaker became available.

“The President would like to know what you plan to say at your press briefing,” the Chief of Staff said. There were no pleasantries exchanged.

“May I speak with the President, please?” the Speaker asked. The President, who could overhear the conversation, shook his head no.

“He’s working on his remarks,” the Chief of Staff said. “We all need to be on the same page here.”

“Of course,” the Speaker agreed.

“Then why are you doing a media availability before we brief Congress?” the Chief of Staff asked.

“I have a pretty good idea what you’re going to say,” the Speaker replied. It was true that the President had done an informal briefing for the Senate Majority Leader and for many of the Conventioneers. There was no doubt that the content of these conversations had been leaked to the Speaker, if not more broadly. “Congress is a coequal branch here,” the Speaker said. “I want the public to understand that we are a partner in dealing with this crisis.”

“So you’re calling the press to the Capitol to give them a civics lesson?” the Chief of Staff asked facetiously. “I don’t believe that.” In the background, the President was shaking his head in anger and frustration. Before the Speaker could answer, the Chief of Staff continued, “Could you just support us here for five minutes?”

“If you are going to cut me out of the loop, I have no choice but to reassert congressional prerogative,” the Speaker said insolently.

“We involved you from the very beginning,” the Chief of Staff said. “You decided to freelance on the South China Sea Agreement and you got burned. That’s on you.”

The Speaker was in no mood to back down. “I’d like to know what the President plans to say,” she declared.

“That’s why we’re doing the congressional briefing before the speech,” the Chief of Staff said.

The Speaker gave a short, mirthless laugh. “The President has been calling people all over Washington. Everybody knows the situation.”

“Then you don’t need the briefing, apparently.”

“As a courtesy, I would appreciate hearing directly from the President,” the Speaker said. In the background, the President motioned for the phone; the Chief of Staff handed it to him.

“Madam Speaker,” the President said, “I am telling you not to address the press before we do our congressional briefing.”

“Cecelia Dodds has lost consciousness,” the Speaker said. “You know that, don’t you?”

“I didn’t realize the two of you were close,” the President replied. They were not, of course. Cecelia Dodds had criticized the Speaker on several occasions for her divisive tactics. The Speaker had declined to attend the ceremony at which Dodds was presented the Presidential Medal of Freedom.

“She’s a national treasure,” the Speaker said. “This will be your legacy.”

“One has to admire her selflessness,” the President said honestly.

“Let’s cut to the chase, Mr. President, you can’t tell me when to meet with the press.”

“Okay, then I’m asking. I’m asking you to be a team player here.”

“It’s always about your team. It’s your team or no team,” the Speaker said.

“What?” the President asked in genuine amazement. “I think we’re done here. You do what you have to do.”

Eager to have the last word, the Speaker said, “And by the way, Mr. President, you can have the plane. American taxpayers shouldn’t have to bear that expense.”

The President hung up without reply. “She’s running for president,” he told the Chief of Staff. “Her donors are going to give her a nice big campaign plane. That’s what that means.”

Two other things of note were happening at roughly the same time. In Riyadh, Saudi Arabia, a small group of armed Sunni extremists burst into an international school, overwhelmed a night security guard, and took a hundred and twelve students and faculty hostage. There were twenty-seven American students and two teachers among the hostages. The terrorists’ grievances were nothing new. They demanded a withdrawal of U.S. forces from Saudi Arabia and the other Gulf nations; the end of U.S. support for the Saudi monarchy; and assorted other such things. What was new, however, was the method to their madness. The hostage takers identified the American students with parents who worked for either the American military or the U.S. Embassy; the others were released unharmed. The kidnappers then demanded that the parents—the military and embassy officials—exchange themselves for their children. They had twelve hours to present themselves. When a parent walked into the school gymnasium, their child would be released; if that did not happen in twelve hours, the child would be shot. The terrorists had found and exploited the underbelly of the heavily fortified American presence in Saudi Arabia. Our military facilities and the embassy were impregnable; the international school, less so. The rest of this story is familiar to anyone who lived through it. I mention it merely to draw attention to the timing. The President received word of the terrorist assault just before his address to the nation.

Meanwhile, the Secretary of State and the Strategist were on their way to Bahrain. They had not boarded Air Force One for the flight back to the U.S., as staffers had realized. The President had instructed them to reexamine the possibility of India as a Dormigen donor, but the delicate nature of that situation was such that they could not fly to India unless and until the Indian Prime Minister invited them to do so. The Secretary of State chose Bahrain as a logical intermediate destination: a place where they might plausibly have diplomatic business that was close enough to India to allow them to get there quickly should the Prime Minister summon them. Just as the two of them were touching down at Naval Support Activity Bahrain, several prominent Indian newspapers were reporting on a “new poll” from the Indian Institute for Future Security showing that 68 percent of Indian voters believed that India had an obligation to help the U.S. during the Outbreak; 73 percent agreed that “India would benefit from closer ties to the United States.” The details surrounding the poll—and the origins and funding of the Indian Institute for Future Security—remain shrouded in mystery. In a later moment of indiscretion, the Strategist did tell an audience at the Council of Foreign Relations in New York: “The Soviets taught us that no one ever wins an election with ninety-nine percent. To be credible, your fake results need to be in the sixty to seventy percent range. Even eighty percent strains credulity.”

The Secretary of State and the Strategist stepped off the small Air Force jet in Bahrain and were immediately belted with a blast of hot, dry desert air, like opening a hot oven. An officious two-star general met them on the tarmac, eager to be of assistance and excited to be involved in whatever was happening. One did not need to be a rocket scientist—though, coincidentally, the general in question was an aeronautical engineer—to recognize that the Secretary of State does not show up on short notice with the President’s chief strategist unless something interesting is afoot. The Secretary of State was traveling without a staff, which was also highly unusual. “We’re honored to have you here, Madam Secretary,” the General said earnestly. He ushered her and the Strategist toward a terminal where a handful of other officers were waiting awkwardly with cold drinks.

“Now what do we do?” the Secretary of State asked the Strategist under her breath.

“We know the Prime Minister is going to read the papers. We just wait for the phone to ring,” the Strategist answered.

The General said, “I know you have meetings with Bahraini officials, but might I be able to offer you a tour of the base?”

“That would be excellent,” the Strategist replied.

71.

THE SPEAKER OF THE HOUSE STEPPED TO A PODIUM BENEATH the rotunda of the Capitol, the very same place where she had advocated strenuously for “the China option.” The Washington press corps recognized that the Speaker was violating protocol by making a statement before the President’s address. The bad chemistry between the President and the Speaker always made for good copy, especially now that the Outbreak had raised the stakes in their pissing match. “I will be brief,” the Speaker began. “Today I will introduce legislation guaranteeing every American access to Dormigen, irrespective of gender, religion, race, sexual orientation, or, most important, age. We do not live in a society where lifesaving drugs should be rationed. We should not have to pass legislation to guarantee such a basic right, and yet here we are. In less than an hour, the President, having failed to provide the nation with sufficient Dormigen, will announce a plan to deny that lifesaving drug to some of the most vulnerable members of society: the old and the infirm—the very people who need the nurturing hand of government most.”

The President and Chief of Staff were watching the statement in the conference room on Air Force One. “For fuck sake,” the President muttered. “Please tell me this is not happening.”

“It doesn’t make any sense,” the Chief of Staff said, genuinely perplexed. “We don’t have enough Dormigen. She’s not an idiot. What does she think we’re going to do? You can’t promise what you don’t have—”

“She thinks we’re going to avert the crisis,” the President said with a sardonic laugh. “It’s a backhanded compliment, actually.”

“I don’t follow,” the Chief of Staff said.

“You have to give her credit for creativity, if nothing else,” the President answered. “She thinks we’re going to come up with the Dormigen, or figure out the virus, or something. She doesn’t think we’re going to have to ration anything. So she introduces her grandiose bill—protecting the old, the infirm, the left-handed, and everyone else—right before we lay out our rationing plan. Then, when the crisis is averted, she’s the one who promised Dormigen to everyone and we’re the ones who planned to let old people die.”

“And if things don’t turn out all hunky-dory?”

“Then it doesn’t matter anyway,” the President explained. “We can’t give out Dormigen we don’t have. She’s taking a gamble here.”

“Unbelievable.”

“You don’t win the presidency without taking some risks,” the President said with what his Chief of Staff would later describe as “an admixture of respect and disgust.”

The Speaker finished her statement: “The President will soon tell the nation who will be excluded, who is too sick or too old to be saved. Congress cannot allow that to happen. I will not live in a country that turns its back on the most vulnerable. In my America, there is Dormigen for every one of us.”

She did not take questions. There was no way she could. The statement made no sense given the reality of what was going on; some members of the media were openly snickering. We had crowded around my laptop to watch the talk in the NIH conference room, which had grown warm and stuffy. “Is that woman crazy?” Giscard asked without a hint of sarcasm or irony. “I mean, really, does she understand what is happening?”

“She’s a politician,” one of the CDC scientists said.

“Yes, okay, I understand, but still: How can one promise Dormigen for all when there is no Dormigen?” Giscard asked, genuinely flummoxed. Several of us shrugged by way of reply. The Speaker clearly had better political antennae than the rest of us, because almost immediately social media exploded with what would become the #norationing campaign. Progressives organized rallies in D.C. and other big cities. One influential lefty blogger compared the President to a concentration camp guard who met the trains and sent prisoners “left or right.”

The President called the Acting Secretary of HHS just before he was scheduled to do the congressional briefing. “Thank you for doing this,” the President said.

“I’m too old for this shit,” the Acting Secretary said. “What was she thinking?”

“About the 2032 race,” the President said.

“Apparently. How should I respond?”

“Don’t. Just lay out our plan. Stick to the briefing materials. The important thing is that people realize how serious the situation might become. That’s our responsibility here. Everything else is just noise.”

“What about Q and A?” the Acting Secretary asked.

“You have to answer questions. It’s Congress. But you know the drill: act professional and say as little as possible, no matter what they throw at you. It’s like a congressional hearing; you’ve done it a hundred times,” the President assured him.

“Except this time it’s all of Congress and we’ve just been compared to concentration camp guards.”

“Right. Good luck with that,” the President replied. And then, after a pause, “Seriously, thank you for carrying the water on this one.”

“It’s an honor to do what I can, Mr. President.”

“Okay, then, good luck. I’m on right after you.”

In New Delhi, the phone rang—the phone call the U.S. Ambassador had been hoping for, or at least a step in that direction. A functionary in the Indian Ministry of Health called the U.S. Embassy, asking if perhaps the U.S. Ambassador would have time for a short chat with someone in the Prime Minister’s office regarding the American Dormigen shortage. As soon as possible.

72.

THE U.S. AMBASSADOR IMMEDIATELY RELAYED THE NEWS TO the Secretary of State and the Strategist, who cut their tour of the Bahraini base short and ensconced themselves in a small secure conference room. “I assume I call him back?” the U.S. Ambassador asked.

“Give it at least a half an hour,” the Strategist advised. “The Indian PM is a rug merchant—”

“Can we show some respect, please?” the Secretary of State interrupted, casting an exasperated look across the table.

The Strategist, not one to back down when he believed himself to be right, said, “Isn’t that literally true? His family traded carpets. Wasn’t his family in the carpet business?” the Strategist asked the U.S. Ambassador.

The Ambassador replied uncomfortably, “I do believe his mother’s family exported carpets from Kashmir.”

“He wrote about it in his autobiography,” the Strategist explained.

“Fine, but for my benefit, can we please not call him a rug merchant?” the Secretary of State said. (In her memoir, she would describe herself as “horrified” by the Strategist’s manners but “simultaneously impressed” by his depth of knowledge on myriad topics.)

The Strategist, taking no offense, replied, “I don’t care what we call him. The point is that he sees the world as a zero-sum game—everything. If we win, he loses, and vice versa.”

“I would agree,” the Ambassador offered. “He’s hard to deal with that way.”

“We need to make him think he’s getting a huge win and that we’re somehow losing,” the Strategist said.

“That seems difficult, given the circumstances,” the Ambassador said earnestly. “How does the U.S. lose by getting Dormigen that’s going to save thousands of lives?”

“We suggest that we can’t give him what he most wants,” the Strategist said.

“Publicity,” the Secretary of State offered.

“Exactly,” the Strategist said, impressed his pupils were keeping up with him. “The PM wants a political win, domestically and on the international stage. We tell him that won’t be possible. We appreciate his Dormigen offer, but the President is not comfortable appearing dependent on a developing country to protect—”

“Do not refer to India as a developing country,” the Ambassador said firmly. “He will be very sensitive to that.”

“Of course he will!” the Strategist blurted out, now exasperated that one of his pupils was falling behind. “Not that people tend to confuse India with Switzerland, but still, you’re correct, so we need to exploit that sensitivity. What better way for India to signal its economic progress than to bail out the richest country on the planet?”

“I agree,” the Secretary of State said.

“Okay, so what next?” the U.S. Ambassador asked.

“You need to set up a meeting with someone in the Prime Minister’s office,” the Strategist instructed the Ambassador. “Tell them it needs to be confidential. Request to meet in a shopping mall, or a restaurant, or someplace like that. Tell them the President is very sensitive to appearing as a supplicant—yes, use that word, ‘supplicant.’”

The Secretary of State added, “Especially after the polling data showing what a huge political win this would be for the PM.”

“Yes, exactly! Good,” the Strategist said. “And then when they hint at a Dormigen offer, which they will, you must make clear that the President would be willing to accept the Dormigen, but the deal would have to be confidential, or at least very low-key.”

“And how does the President really feel?” the Ambassador asked.

“What do you think?” the Strategist answered impatiently. “The President just wants the Dormigen. The Indian PM can ride it down Fifth Avenue on a white horse, if that’s what he wants.”

“This feels like a long shot,” the U.S. Ambassador said. “We’re treating a head of state like Br’er Rabbit.”

“First of all,” the Strategist said, “Br’er Rabbit was the one who got thrown in the briar patch, so technically we’re treating the PM like the fox. Second, we’ve got no other fucking options. And third, I’ll bet you my left testicle it works.”[28]

73.

THE CONGRESSIONAL BRIEFING BY THE ACTING HHS SECRETARY was somewhat anticlimactic after the Speaker’s press conference. The President had already spoken at length with the Senate Majority Leader and many of the Conventioneers. The Communications Director had released the key points of the briefing five minutes before the Acting Director began speaking, creating an odd situation in which members of Congress were getting texts from their staffs giving them the key points of the briefing they were waiting to receive. The Speaker tweeted that this was “beyond insulting,” prompting the Communications Director to tweet back (publicly, of course), “Key 4 America should be content of briefing, not who gets it when,” at which point the Chief of Staff ordered him to disengage.

For those of us working on the Outbreak from the beginning, the congressional briefing was old news. The Acting Secretary walked through the details of how we got to this point (including the arrest and indictment of the Centera Pharmaceutical executives); the efforts the administration was making to gather Dormigen from other countries; the scientific advances that had been made with regard to the virus. The chamber was loud and unruly, as staffers scurried about and members studied their devices for details of what the Acting Secretary was about to tell them. After a few minutes of what felt like prefatory remarks, the Acting Secretary turned to the essence of the briefing, the “what now” part, and although nearly everyone in the chamber knew what was coming, the noise dissipated and most eyes turned to the Acting Secretary as he stood in the well of the House. “As you are well aware,” he intoned, “even with all of the efforts I have just described, it is increasingly likely that we will find ourselves with an insufficient supply of Dormigen to meet our basic needs.”

There were hisses and catcalls in the chamber. “Not in America!” someone yelled from the Acting Secretary’s left. “No rationing!” came another cry. The outbursts felt choreographed, as they probably were. Someone who heard only the audio, as opposed to sitting in the august House chamber, might assume they were listening to a high school principal lecturing unruly students. Of course, if I am being honest, the briefing itself was mostly theater, too. The President had instructed the Communications Director, “Just tell them enough to keep them busy.” Still, it was the public’s first official glance at what lay ahead as the Dormigen stocks were depleted.

The Acting HHS Secretary continued: “Despite our best efforts to conserve Dormigen in recent days, we are now projecting a shortfall for several days before plentiful new supplies of Dormigen can be produced. This is a short window, not quite four days according to our most recent calculations, but during that period we anticipate that not every patient who would normally benefit from Dormigen will have access the drug.” There was more hissing and jeering, but the Acting Secretary’s calm, avuncular tone took some of the negative energy out of the chamber. He continued: “In consultation with physicians and medical ethicists, we have developed a contingency plan—a plan, by the way, that we still hope will not be necessary—to allocate the available Dormigen supplies in a way that will offer the greatest possible health benefits. The available Dormigen will be prescribed where it can do the most good, and doctors will be discouraged from using the drug when the benefits are likely to have the least impact.” This last bit had been run past focus groups repeatedly, despite the confidential nature of the plan. The Strategist had been able to get groups to respond to a “hypothetical situation” in which the captain of a cruise ship adrift at sea had to explain how the dwindling food supplies would be allocated among the passengers. “The exact details of our plan are explained in the briefing packet that we have distributed,” the Acting Secretary said.

“Old people to the right!” someone yelled from the floor.

“Rich people to the left!” a different voice responded.

The Acting Secretary seized on a momentary pause to interject, “I will now answer any questions you may have.” The exact details of the Dormigen rationing were laid out in small print in the documents distributed in the congressional briefing packets: the age cutoff; the kinds of illnesses that would render patients ineligible for Dormigen; the penalties for physicians who did not comply with the protocol; and, of course, “a range of estimated incremental preventable fatalities”—right there, two-thirds of the way down page eleven. Many of the members of Congress scurried out of chamber, eager to get on camera or to push their inspired thoughts out on social media. Predictably, these missives were long on vitriolic criticism of the “White House rationing scheme”[29] and short on alternative suggestions. The Acting Secretary patiently answered questions from the members of Congress and staff who remained behind, but it soon became apparent that most of the questions were not really questions (“Isn’t it true that…”). Nor were most of the Acting Secretary’s answers really answers. He showed remarkable discipline, repeatedly referring questioners to “the briefing document you have received” and answering even the most asinine suggestions with, “We will take that under advisement.”

The Communications Director had forbidden most of us from speaking to the media: “I don’t even want you to say, ‘No comment.’ That’s too much talking. Just shake your head no. Your lips should not be moving!” For those who would be speaking in public, beginning obviously with the Acting Secretary, he was equally emphatic: “Do not, under any circumstances, say anything specific about who gets Dormigen and who does not. It’s in the briefing document. Refer to the briefing document. If someone asks, ‘My grandfather is a hundred and nine and has emphysema. If he were hit by a bus, would he be eligible for Dormigen?’ you say, ‘The specifics of the plan are in the briefing document.’ Is that clear? I don’t want to see anyone on camera saying anything remotely newsworthy about who gets Dormigen and who does not. They’re going to have to get their sound bites about Grandpa from somewhere else.”

The Communications Director distributed a press release in which he tried to find a kinder, gentler way to point out that most of the people who would be denied Dormigen were going to die soon anyway. He quoted an NIH epidemiologist: “The temporary shortage of Dormigen will have only a modest impact on the two-year mortality rate.” (More accurately, the Communications Director wrote that sentence and then called the NIH epidemiologist to tell him how he would be quoted in the press release.) The release offered several other euphemisms for “they were going to die anyway.” Only NPR figured this out at first, with a story that included the following exchange:

PUBLIC HEALTH EXPERT: “I don’t mean to be insensitive, but most of these people are very old or very ill, so their life expectancy is limited, even if they were to receive Dormigen.”

MORNING EDITION HOST: “So you’re saying they were going to die soon anyway.”

PUBLIC HEALTH EXPERT: “Obviously each one of these cases is difficult—we are denying a lifesaving drug, after all—but yes, that is the essence of what would happen if we were forced to ration the Dormigen as the administration has described.”

MORNING EDITION HOST: “And do you agree with that plan?”

PUBLIC HEALTH EXPERT: “Obviously as a physician I am very uncomfortable denying lifesaving drugs to anyone—”

MORNING EDITION HOST: “Yes, of course, but do you see a better option here?”

PUBLIC HEALTH EXPERT (after an uncomfortably long pause for radio): “Given the horrible circumstances, I would be hard-pressed to come up with a better option. Obviously, I hope we don’t get to that point.”

Our efforts to calm the public kept running smack into the reality of what was happening in the Seattle intensive care unit. Cecelia Dodds was taken off the experimental German medicine because it was harming her kidneys. Doctors put her in an induced coma in a last-ditch effort to help her body fight off the infection. As the Acting Secretary was answering questions in the Capitol, Cecelia Dodds’s daughter gave a short briefing in front of the hospital. “I spoke to my mother this morning,” she began. “There was about half an hour when she was lucid and comfortable and we were able to talk.” Her twin daughters—Cecelia Dodds’s granddaughters—were clinging to her legs, one on each side. “My mother is a strong woman and I have every hope she will pull through. She asked me to thank all of you for your love and support. And she asked me to convey to you…” The daughter paused to compose herself. Her children gripped her legs more tightly. They no longer had the care-free jauntiness of little girls; they either intuited the seriousness of the situation, or someone had explained it to them.

Cecelia Dodds’s daughter continued, “My mother asked me to convey to you, to the nation, that whatever lies ahead in the coming days… that each of us should aspire to be as brave and magnanimous and selfless as we can—as she has been. Let’s aspire to be the best of America…” Her voice choked up and she paused. After a moment: “Love, share, include, and improve. Thank you so much.” This was not exactly the nightmare scenario that the Acting Secretary had feared—that Cecelia Dodds would die while he was explaining to Congress that things would not be so bad, but it was close. As the President began to speak from Air Force One, many media outlets ran a split screen: the President on one side and the large crowd gathered in front of the Seattle hospital on the other.

The Communications Director had drafted a speech for the President that was long on language putting the Outbreak in historical perspective and short on Dormigen rationing details. The President urged the nation to face the challenge with the same vigor and bravery with which Americans had faced other adversities—and so on, and so forth. He reminded the country that his administration was still working around the clock to “beat this virus” (true) and, if that were not successful, to procure additional Dormigen stocks (also true). The President looked tired and drawn, almost grim, as he delivered the eight-minute talk. Anyone watching his speech would assume the Outbreak had taken a heavy toll on him. While this was undoubtedly true, the more immediate explanation (we now know) was that he had just spent two hours speaking to his national security staff, most of whom were sequestered in the situation room back at the White House, to devise a response to the hostage situation in Saudi Arabia. Any kidnapping situation is difficult, but this one—in which parents were being told by the terrorists to swap places with their children—was particularly fraught with ethical and strategic challenges.[30]

Near the end of the President’s talk, the Strategist and the Secretary of State had inserted a paragraph (drafted as they stalled before returning the call from the Indian Prime Minister’s office): “The people of the United States are deeply thankful for the contributions of Dormigen that have poured in from around the world. But for that generosity, this crisis would be far more devastating. We have been taught, yet once again, the role the world’s great democracies must play in fighting our collective global challenges.” This was more bait for the Indian Prime Minister—a big, bloody decapitated tuna being towed slowly behind the boat.

India, of course, is the world’s largest democracy. That paragraph had been drafted explicitly to suggest that by shirking its Dormigen duty now, India was putting its claim to global leadership at risk in the future. “Too subtle?” the Strategist had asked as the two of them polished the prose.

“Just right,” the Secretary of State assured him. “Even a hint that India is not one of the ‘world’s great democracies’ will send him into hysterics.” We have no account of what was happening on the India end of this. We do know there was a second phone call from the Prime Minister’s office to the U.S. Embassy (where the U.S. Ambassador was still waiting to return the first call, like a teenage girl playing hard to get). A senior American diplomat fielded this call, and a meeting was fixed at a California Pizza Kitchen in a large mall on the outskirts of Delhi. “This better be important,” the American diplomat warned his Indian counterpart. “Because we’ve got a lot going on right now.”

74.

I WATCHED THE PRESIDENT’S SPEECH ON MY LAPTOP AT THE NIH headquarters, along with Giscard and the rest of our impromptu team. After a flurry of activity, our work was temporarily stalled while the biochemists at the CDC examined the protein structure of the dormant and virulent forms of Capellaviridae. As we waited for those results, we confronted yet another theoretical conundrum: Suppose the dust mite did somehow deliver an antibody for Capellaviridae to its human host—then why was this effect not permanent? Antibodies typically last a long time, if not a lifetime, which is why a childhood immunization (or bout of the disease) is usually sufficient to provide immunity well into adulthood. This is where our dust mite theory collided with biological reality. We hypothesized that Capellaviridae—all lurking viruses, for that matter—bestowed some evolutionary advantage on the vectors that spread them, the North American dust mite in this case. Humans do not like having dust mites around; their bites are itchy and annoying. But Capellaviridae turns the North American dust mite into a lifesaver, literally. The dust mite somehow renders Capellaviridae impotent, making it nice to have around, all things considered.

Yes, we had some crucial details to figure out, but the theory was at least consistent with evolution—elegantly so. The three species were poised in a symbiotic relationship. Humans are more apt to thrive when the North American dust mite is present. The dust mite is more successful as a species because of the existence of Capellaviridae. And Capellaviridae thrives (in its benign form) when humans and dust mites live in proximity to one another. This is how nature is supposed to work.

So far, so good. But we were still missing the last twenty points on that Huke final exam. The only protection against viruses we were aware of consisted of antibodies, and antibodies are long-lasting—rendering the dust mite no longer relevant. “At that point, our theory consumes itself,” Giscard said dramatically as he tried to explain our theoretical conundrum to the NIH Director.

“I have no idea what you are talking about,” she said impatiently.

One of the biochemists followed up with less dramatic flair. “We’ve reached a contradiction,” he said. “Our hypothesis is that the North American dust mite makes itself valuable to humans by providing protection against Capellaviridae.”

“The dust mite spreads Capellaviridae,” the NIH Director interrupted.

“Exactly,” I said. “And the dust mite also protects against Capellaviridae turning virulent. That’s what makes this situation so biologically interesting.” We had developed more and more analogies to explain this “hostage” relationship. I offered up one of them: “A guy walks into a shopping mall with a bomb. He says, ‘I have a code that will prevent the bomb from detonating as long as I enter it every fifteen minutes. I will be perfectly happy to do that as long as you bring me food.’ Obviously if anything happens to the guy—”

“Really, it would be many, many guys with many bombs,” Giscard said.

“Yes, okay,” I agreed. “But the point is that everybody needs this guy—all of these guys—to stay alive. If anything happens to them, the whole place goes boom.”

“I already understand this,” the Director said.

“Of course you do,” Giscard said with what felt like excessive deference. Once again I was feeling the urge to harm him.

“Here’s the problem,” the biochemist explained. “That’s not how antibodies work—”

“They defuse the bomb,” Giscard interrupted. “The antibody team comes to the shopping place, they defuse the bomb, and then there is no need—”

“Enough with the bomb analogy,” the Director snapped. Various officials in the White House had been phoning her repeatedly for updates on the virus front. At one point she had angrily told the Chief of Staff, “Nothing since you called fifteen minutes ago.” I suspect the President was leaning on all the staff for some glimmer of hope that science might ward off the impending crisis.

I continued with our explanation to the Director: “Our whole theory revolves around the idea that the dust mite has somehow created a strategy to make itself valuable to humans—presumably by preventing Capellaviridae from turning virulent.”

“That’s what the data show,” Tie Guy said. “When the dust mite gets wiped out—”

“Yes, I know what the data show,” the Director said sharply. And then, more calmly, she summarized our dilemma more succinctly than we had ourselves: “The easiest way for the dust mite to protect against Capellaviridae turning virulent would be to introduce an antibody into the human host. But if that were the case, then there is no ongoing advantage to the humans from protecting the dust mite.”

“Exactly,” Giscard said, with what I felt to be a hint of surprise that the Director had so easily grasped the situation.

There was a brief silence as the Director reflected on what we had told her. “Well, I trust you’ll figure it out,” she said brusquely. With that, she turned and left the conference room. Giscard made a rude comment about female scientists and then retreated to his computer at the far end of the conference table. It never dawned on us that he was sharing our conversations with some of his French colleagues, in violation of our explicit orders. The pathetic irony is that he received credit for many of the ideas that emanated from our working group, not because he provided the intellectual spark for those breakthroughs (though that was occasionally the case) but because he disregarded our most important security protocols and wrote about them first.

75.

SHORTLY BEFORE NOON IN DELHI, JUST ABOUT THE TIME AIR Force One entered American airspace, the U.S. Ambassador walked discreetly out the back of the Embassy compound and hailed a taxi. He normally traveled in an armored Cadillac with a security detail, but that entourage was inimical to what he was trying to do: somehow persuade the Indian Prime Minister that he would be fortunate to have the United States accept his offer of lifesaving Dormigen. “That just doesn’t make any sense,” the Ambassador complained as the Strategist gave him his final marching orders. “We have no leverage here. The Indian PM is perfectly aware of what’s happening in the United States. People are going to die. And you expect me to somehow persuade him that we are doing him a favor by letting him give us Dormigen?”

“No,” the Strategist said patiently. “Forget about the Dormigen. That’s not relevant here.”

“Of course it’s not,” the Ambassador said facetiously.

“Really, it’s not. What’s important is the publicity around the donation. We have to make him want that recognition more than he thinks we want the Dormigen.”

“That’s a tall order,” the Ambassador said.

“He’s got an election coming up. There are corruption investigations coming at him from every direction. Now he’s got an opportunity to transform India’s place in the world, to join the elite club of the world’s most important democracies—”

“Yes, I like that language,” the Ambassador offered.

“Who was that douchebag from New Mexico when you were in the Senate?” the Strategist asked.

“Pardon?” the Ambassador asked.

“The senator from New Mexico. Remember, ‘Never get between a television camera and’—what was his name?”

“Luvardnik,” the Ambassador answered.

“Yes. Remember how easy that guy was to deal with? He had no ideological convictions whatsoever. As long as you could assure him some political benefit, he was with you.”

“I remember. I’m not sure the Indian PM is as bad as that,” the Ambassador said.

“No, but he certainly doesn’t care whether eighty-five-year-olds in the U.S. die because they can’t get Dormigen,” the Strategist pointed out. “This is all about him, so make him a hero in India.”

“Luvardnik really was an asshole, wasn’t he?” the Ambassador reflected.

“You know the drill,” the Strategist said.

“Twelve years in the Senate did teach me a few things.”

“Then go get us some Dormigen.” And then the strategist added, “And don’t pay the bill.”

“We’re meeting at a pizza parlor,” the Ambassador pointed out.

“I don’t care if it’s three dollars. You’re doing him a favor, so he pays the bill. That’s really important.”

“Okay, maybe I’ll order dessert,” the Ambassador said jokingly.

“Even better,” the Strategist answered, not joking at all.

The California Pizza Kitchen was deep in the New India Mall, past every manner of Western shop and up an escalator that passed over a garish fountain in which an elephant was shooting water from its trunk. The mall was busy with shoppers—an occasional tourist but mostly locals seeking out a clean, orderly place to shop for the same reason Americans do. The Ambassador had never been to the mall before, though the head of the embassy’s Economic Section often used it as an example of India’s growing middle class. The Ambassador made his way to the food court before recognizing that the restaurants were scattered elsewhere. By the time he reached the California Pizza Kitchen, he was several minutes late. The Ambassador recognized Sumer Patel, one of the Prime Minister’s trusted lieutenants (albeit with an ambiguous official portfolio), sitting at a table near the door looking somewhat impatient. The Strategist would be proud of him for keeping Patel waiting, the Ambassador thought, even if it was an accident. The Ambassador and Patel had met several times before; they reintroduced themselves and exchanged pleasantries. Eventually Patel broached the substance of the meeting: “I watched the President’s speech.”

“We’ve got ourselves in a bit of a pickle,” the Ambassador said. Patel had attended university in the U.S. and was familiar with the idioms and slang.

“The Prime Minister feels this may be an opportunity to take the U.S.-India relationship to a new level,” Patel said.

“How so?” the Ambassador asked solicitously.

“The Prime Minister is now confident we will have excess Dormigen over the next week.”

The Ambassador raised an eyebrow, suggesting surprise and interest. “On what scale?”

“Perhaps enough to close your gap.”

“There are a lot of lives at stake,” the Ambassador said. At that moment, a male waiter approached the table to take drink orders. Patel waved him away angrily, telling him in Hindi to come back later.

“The Prime Minister recognizes the gravity of what is happening,” Patel said.

The Ambassador replied, “As you may or may not know, we made an overture earlier and it was not well received. If I recall correctly—”

Patel waved his hand dismissively. “The circumstances have changed.”

“They have,” the Ambassador agreed. “With China, in particular.”

“That was a terrible embarrassment,” Patel said, shaking his head.

“An embarrassment?” the Ambassador asked with concern. “An embarrassment for…”

“China,” Patel said emphatically. The waiter returned, once again drawing an angry look from Patel.

“Maybe we should just order,” the Ambassador said.

“I’ll have a Coke Zero and a pizza,” Patel said sharply.

“Sir, we have many kinds of pizza,” the waiter replied.

“Veggie.”

“Yes, sir, one veggie pizza,” the waiter said.

“I’ll have the same,” the Ambassador said.

“With Coke Zero?” the waiter asked.

“Yes,” the Ambassador said. The waiter acknowledged the order with a slight nod of his head. As he walked away, the Ambassador continued to Patel, “Please tell the Prime Minister that we are prepared to make some serious gestures to express our gratitude—to take our bilateral relationship to a new level, as you say.” The Ambassador listed several diplomatic issues the Americans and Indians had been wrangling over in recent years: cooperation on India’s civil nuclear program; more aggressive intelligence-sharing regarding Pakistan; raising the U.S. cap on H-1B visas for skilled workers. Patel nodded in approval as the Ambassador ticked off the list, all of which happened to be initiatives he had been pushing the State Department and the White House to act on anyway. “We can create a political win here for the Prime Minister,” the Ambassador assured Patel.

“Yes, these are significant gestures,” Patel agreed. “The White House has signed off on all of this?”

“Of course,” the Ambassador assured him. There was a brief silence as Patel absorbed the offer on the table. The Ambassador continued, “One thing to appreciate here is that China is trying to exploit our crisis in the U.S. The things they are asking for would make us weaker. It’s predatory. The things you and I are discussing here, on the other hand, are measures that would strengthen the U.S.-India relationship. The world’s two most important democracies, working together.”

“Yes, of course,” Patel agreed. Silence settled over the table as Patel contemplated the situation. The Ambassador had a strong sense of what direction the conversation would likely turn. They were approaching the money moment. The next minute or so would likely determine whether the Strategist would lose a testicle or not. The waiter appeared with drinks, giving Patel more time to cogitate on the situation. As the waiter walked out of earshot, Patel said, “The world’s two most important democracies, but India is very much the junior partner.”

“India has three times the population of the United States,” the Ambassador replied.

“Exactly, and yet…” Patel let the dissatisfaction with the relationship just kind of hang there.

“The President would be very happy to publicly thank the Prime Minister and the country for their generosity,” the Ambassador said.

“Yes?” Patel replied, his face brightening.

The Ambassador continued: “We will have to work on the scheduling, but the PM could do a state visit, perhaps at the beginning of next year. We could use the visit as an opportunity to announce all these agreements.”

Patel’s excitement dissipated immediately. The pizzas arrived. “May I get you anything else?” the waiter asked in English with a pleasant, lilting accent. Patel told him brusquely in Hindi to go away and the two men ate in silence.

Eventually Patel asked, “May I speak candidly?”

“Of course.”

“The Prime Minister has an election coming up.”

“His party is in a spot of political trouble,” the Ambassador said, “if I may speak candidly.”

“The Prime Minister is hoping for something…”

“With more immediate political payoff,” the Ambassador said, making explicit what Patel could not bring himself to say. Patel grimaced at the coarseness of the statement but did not disagree. The Ambassador continued with just a hint of mock outrage, “A lot of people are going to die in the United States.”

“And we would like to prevent that,” Patel assured him. “That is why I am here. The Prime Minister is just hoping we can create a win for everyone.”

“The polls I’ve seen suggest that public opinion in your country is strongly in favor of offering Dormigen to the United States,” the Ambassador pointed out.

“Yes!” Patel agreed. “That’s exactly what we would like to leverage. Can we make everyone a winner here?”

“What does the Prime Minister have in mind?” the Ambassador asked skeptically. He felt a warm glow of inner satisfaction. He had done it. He had taken the conversation in the direction it needed to go. He had arrived at the California Pizza Kitchen to ask for a donation of a lifesaving drug. And now, with the pizzas barely having arrived, Patel was beginning to look like the supplicant.

“We’re being entirely candid here?” Patel asked earnestly.

“Of course,” the Ambassador assured him.

“Something that puts him on equal footing with the President,” Patel said. “Something that makes India look like an equal partner.”

“We can make that happen,” the Ambassador replied, though there was a coolness in his tone that suggested the opposite. “Obviously the President has some political sensitivities of his own.”

“He does not want a poor country coming to the rescue,” Patel offered.

“No, no,” the Ambassador assured Patel in a tone that suggested, “Yes, yes.” The Ambassador explained, “The President is very sensitive to charges that he left the country vulnerable—that he’s responsible for this situation. He’s trying to steer a delicate political path here.”

“I can understand that,” Patel said.

“Yes, well, if there is a very public display in which India delivers the Dormigen that the U.S. somehow could not produce…”

Patel finished the thought, his voice laced with indignation: “The President must be horribly incompetent if India is coming to the rescue.”

The Ambassador said, “I’m just the messenger here. I think it’s pathetic that thousands of people could die because of his political vanity.”

“I understand,” Patel said, his tone warming noticeably. “Of course, the President’s not the only one with political vanity!” They exchanged a knowing laugh at the expense of their political overlords. The waiter approached the table once again. Neither man had eaten more than a few bites.

“The food is okay?” the waiter asked with concern.

“Fine, fine,” the Ambassador said. “Can I take mine in a box?”

“I would like a box as well,” Patel said.

“I would like something sweet, however,” the Ambassador said. “Do you have ice cream?” he asked the waiter.

“Of course, sir. Chocolate, vanilla, and mango.”

“I’ll have mango!” the Ambassador exclaimed. “I love mango ice cream. Are the mangos in season?”

“I believe so,” Patel answered. “I’ll have the same.”

As the waiter walked away, the Ambassador continued, “Why don’t you consult with the Prime Minister. Ask him what he feels he needs: a phone call with the President, maybe a public ceremony in which the Indian Ambassador comes to the White House for formal recognition… I’m just thinking out loud here. I will advocate strenuously for whatever the Prime Minister proposes because there is absolutely no reason politics should get in the way of saving lives. But, please, make the PM aware that the White House is going to push back against anything the President feels makes him or the country look like a supplicant.”

“Well put. I understand completely,” Patel replied.

The waiter returned with the ice cream. “Will there be anything else?” he asked.

“Just the check,” the Ambassador answered.

As the waiter searched for the check in his small notepad, Patel produced a credit card. “Please, allow me,” he said.

“Thank you,” the Ambassador said. He leaned closer to Patel: “I think we can make this happen.”

“I hope so,” Patel replied. “I hope so.”

76.

THE PRESSURE HAD BEEN BRIEFLY REDIRECTED FROM OUR team at the NIH to the biochemists, as we awaited their findings on the chemical structures of the virulent and indolent forms of the Capellaviridae virus. I awoke early and shared an awkward breakfast with Ellen. We watched television and said little to one another. I switched from channel to channel, eager to see how the Dormigen story was being covered. The Saudi Arabia hostage situation was the top story across channels. I imagined a crisis team like ours working in different rooms at the White House with the President yelling at them to make sure that no hostages were killed. The media seemed to have the bandwidth for one crisis at a time, so the Dormigen story had been bumped off the front page, literally in some cases, figuratively elsewhere. Most of the cable news programs were still using their “Dormigen Countdown” graphics. The White House had gained some traction in shaping the story. Our local morning program in D.C. did a story on a nearby hospital that was preparing measures to provide alternative care for patients who would be ineligible to receive Dormigen. That story, and most others, used our phrase “similar to a serious case of the flu” multiple times. But then they would cut almost immediately to Seattle, where Cecelia Dodds remained in an induced coma.

On the political side, there was a lot of waiting going on. The President had arrived back in Washington during the night. The Chief of Staff briefed him and others on what they were now referring to as “the California Pizza Kitchen Summit.” The next move would have to come from the Indian Prime Minister’s office. On the science side, we were also waiting. The NIH Director canceled our morning briefing, as there was little to discuss until we received more information from the biochemists. Meanwhile, Giscard had invited Jenna for breakfast, which she had accepted, much to my horror. So I was waiting for breakfast to be over, too.

The Speaker organized “No Rationing” protests in a number of cities. Several were scheduled for that afternoon. However, the agenda had been coopted by other progressive groups; the demonstrations now included protests against income inequality, domestic violence, sexual assault, and racial profiling. (The Democrats’ progressive wing prided itself on a lack of hierarchy, which took a toll on focus and strategy.) A Palestinian rights group offered up several speakers to address Israeli land annexation in the West Bank. In the end, the disparate causes rallied under the banner of “A Protest Against Unfairness and Oppression.” Predictably, no one without a nose ring showed up.

I was in no mood to see humor in any of this, but I now find it amusing that the Tea Party was blasting our Dormigen rationing plan at the same time. “This is exactly what happens when you put the government in charge of anything: rationing,” populist radio host Chuckford Pickens told his loyal listeners. These anti-rationing diatribes bounced around the right-wing echo chamber for a while, though the sentiment wilted quickly when exposed to anything approximating logic. As the President pointed out in a moment of exasperation, the whole point of the free market is to ration goods, albeit using price rather than some other mechanism. (I vaguely recall my microeconomics professor saying the same thing.) Eleven thousand economists signed a petition affirming the importance of government patent protection to promote innovation, and government funding to promote the kind of basic research that often lays the groundwork for major pharmacological breakthroughs (like Dormigen). Chuckford Pickens disparaged the petition on his program, describing it as “more sad evidence that our universities have been totally hijacked by the left.” Several callers shared stories of lefty academic exploits; one concerned an Oberlin professor teaching a course called Gender and Sexual Identity in The Wire.

“The Wire—like the TV show?” Pickens asked the caller incredulously.

“Yep,” the caller affirmed.

“My God, it’s not bad enough that you can watch television for college credit, now it also has to be about gender and sexual identity. You can’t even get credit for watching straight people on TV anymore! Can you believe that?” Pickens exclaimed, clearly pleased with his own analysis of the situation. “You know what we should do, we should get a copy of the Oberlin course catalog. Can we do that?” he asked his listeners, though the question was presumably directed to a producer in the studio. The answer must have been yes, because Pickens continued, “We’re going to do that.” The supposed logic of this meandering conversation, as best as I could infer, was that a handful of silly courses at Oberlin College somehow obviated the collective wisdom of eleven thousand economists, including twenty-one from the University of Chicago (a bastion of free-market thinking).

For all that, the President’s response to the Outbreak enjoyed reasonable support. He had never been personally popular. (Even before the Outbreak, fewer than half of those asked said he would be a fun person to have a beer with.) The “adults” in Congress had done a good job of explaining and defending the White House response to the crisis. The most idiotic ideas floated by other members of Congress, usually in front of a television camera, tended to sink on their own (e.g., using military force to procure Dormigen from countries unwilling to share). Policy types offered up numerous sensible reforms to ensure there would not be another Dormigen-type shortage in the future. Most of these recommendations had been filling binders and glossy reports for years. (The Brookings Institution had hosted three conferences over the previous decade on issues related to the development, affordability, and distribution of “uniquely valuable” prescription drugs; only eighty-three people attended the largest of them, including Brookings staff.) Of course, now that the milk was spilled, the nation was giving more time to those who had warned that the glass had been perched precariously on the counter. Still, the milk was spilled. Most reasonable people agreed with the President’s effort to clean it up. One could argue the President’s approach was sensible because it protected so much of the population. He was taking heaps of abuse for his proposed rationing, but, more quietly, he was also getting credit for the implicit triage. Most Americans were protected. The President had been elected by a coalition of voters exhausted by political nonsense; for the most part, they were sticking with him.

Around ten-thirty in the morning, I received a text from the NIH Director summoning me to a noon meeting. Tie Guy called me separately. “They found a difference,” he said when I answered.

“Who?” I asked.

“The biochemists. The virulent form of Capellaviridae is missing a protein,” Tie Guy explained. He was speaking faster than I had ever heard him speak, and my cell phone reception was choppy, so I could not absorb all the details that he was spewing. “This is what we’ve been looking for,” he continued.

“A missing protein,” I repeated.

“Yes,” Tie Guy said excitedly.

“Which means the harmless form of the virus has an extra protein,” I said, thinking as I spoke. “As if it had been neutralized by an antibody.” That is how antibodies work: they attach proteins to viruses, rendering them impotent, like the key in a lock.

“That’s what it looks like, more or less,” Tie Guy said, growing calmer.

“It’s consistent with our theory,” I said.

“Yes, good work,” he offered.

Our noon meeting was delayed, as the NIH Director finished a call with the Chief of Staff to apprise the White House of our latest findings on the virus. She and the Chief of Staff agreed that we were not ready to make a public announcement of the breakthrough. There were too many outstanding questions: What caused the difference in the two viruses? What role did the dust mite play, if any? And most important, how could this discovery help those who became sick with the virulent form of the virus? The President overruled their decision, ordering the Communications Director to put out a release immediately. “You don’t think it will raise false hope?” the Chief of Staff asked.

“That’s the point,” the President answered, turning his attention to the Communications Director. “Say that scientists have—no, make it ‘NIH scientists’—we might as well get some credit for government work. Say that NIH scientists have made a major discovery… something about why the virus turns deadly.”

“The NIH scientists have identified the protein responsible for the difference between the indolent and virulent forms of Capellaviridae,” the Communications Director offered.

“Fine, but don’t say ‘indolent’ or ‘virulent.’ Use words that people watching The Bevin Crowley Show can understand.”

“Okay.”

“Then say that scientists are optimistic this will lead to a non-Dormigen treatment for the virulent form of Capellaviridae—but don’t say virulent.”

“Dangerous,” the Communications Director suggested.

The Chief of Staff warned, “That’s a very strong statement. The NIH Director just told me they have no idea what accounts for the difference in the two viruses and they don’t think they can develop a vaccine in three days.”

“Do we want to create false hope?” the Communications Director asked.

“Yes, I just told you that,” the President answered impatiently. Once again, he was playing political chess while others in the room were playing checkers. The press release went out shortly after noon in Washington. In New Delhi, where it was nearly ten at night, an aide to the Indian Prime Minister delivered the news to him: the Americans had cracked the code on the Capellaviridae virus. The Prime Minister was planning to phone the U.S. Secretary of State in the morning to offer a Dormigen shipment sufficient to solve the shortage (subject to certain conditions, of course).

“What if they solve this thing before we can offer them the Dormigen?” he asked his assembled aides. He really said that out loud.

77.

OUR EARLY DISCUSSIONS ABOUT DORMIGEN RATIONING HAD been theoretical, almost like an exercise in a college ethics class. It was no longer feeling theoretical. Those of us working closely with the President could see him carrying the pressure. He physically looked different, weighed down somehow. Even the sardonic humor was gone. The President reminded staff members that thousands of lives were at stake. Cecelia Dodds reminded us that each one of those cases would be a tragedy somewhere, regardless of how sick or old that person happened to be. People are going to die who do not have to die, he would intone to anyone whom he felt had become too insouciant with the situation. The staffer would apologize, surprised by the emotion in the voice of the President, a guy who normally guarded his emotions closely, especially around junior staff.

There were several White House interns whose job it was to sort through the mail (after the security screening). The President had a standing request to see a sample of the physical mail and e-mail flowing into the White House. The interns would select a handful of positive notes, a handful of critical ones, and then several selected at random. Under normal circumstances, the interns would also bring him a few from the “crazies”; the President found temporary amusement in letters from people who blamed him for the poor performance of the U.S. men’s soccer team or warned him of an imminent Canadian invasion. One famous letter from San Diego—three pages, typed—complained that a neighbor’s dog was “shitting all over a six block radius” and asked accusingly what the President planned to do about it. There were five pages of accompanying maps and several photos that appeared to have been taken by a drone. If the President was in a particularly good mood, he might dictate an ironic response. For example, he wrote a letter to the San Diego complainant informing him that the “defecating dog” was really a matter for Congress to handle. “Make sure you copy the Speaker,” he told the staffer to whom he had dictated his reply.

Even during the Outbreak, the President was diligent in spending some time every day with his mail. While he was on Air Force One, he had letters scanned and e-mailed to him, as he wanted to maintain a feel for what ordinary people were thinking and feeling. Polls could give him a snapshot of national sentiment, but they were “shallow,” as he liked to describe them. People around the country—those who bothered to answer the phone—were disturbed as they cooked dinner or watched television or surfed the Web. They answered the requisite questions, eager to get off the phone as quickly as possible. But the folks who took the time to write to the White House were different—whether it was an old-fashioned handwritten letter with an envelope and stamp (the President’s favorite, even when they were critical) or by e-mail. They tended to express a thoughtfulness and depth of emotion that the polls could not capture.

Shortly after the President arrived back from Australia, one of the interns in the mailroom phoned the Chief of Staff. “I think you should see this,” she said.

“Have you alerted security?” the Chief of Staff asked distractedly.

“It’s not that. I just think you should see this, maybe the President, too.”

“Can you just bring it up?”

“It’s pretty heavy.”

“What do you mean?”

“I mean it’s too heavy for me to carry.”

“Okay,” the Chief of Staff agreed. In the midst of everything else that was going on, she could not have been happy to trudge down to the basement office where the screened mail was sorted, but that is what she did.

When the Chief of Staff arrived in the cramped office, a glorified closet with exposed pipes running across the ceiling, the intern pointed at a brown box about the size of a laser printer. It appeared to be full of paper clips of all colors and sizes. “Paper clips?” the Chief of Staff asked.

“Uh-huh.”

The Chief of Staff ran her hand through the paper clips, letting them slip through her fingers. “Are you sure security cleared this?”

“It’s from an elementary school outside of Chicago.”

“I think we’re fine on office supplies.”

“It’s based on a documentary,” the intern explained. “I looked it up online. There’s this film about a group of elementary school kids who collected six million paper clips, one for each Jew killed in the Holocaust.”

“And this?” the Chief of Staff said, pointing at the box.

“I’d bet it’s about forty thousand, one for each person who will not get Dormigen—”

“Of course.” They both stared at the box for a while. “That’s a lot of paper clips,” the Chief of Staff said softly.

“Do you think the President will want to see it?” the intern asked.

“I do,” she said. And then, “He should, in any event.”

Later, when the President returned to the Oval Office from a meeting in the situation room, the Chief of Staff was waiting for him, along with the open box of paper clips that had been wheeled on a cart up from the basement. The President noticed the box immediately. “What’s that?” he asked.

“It came from an elementary school near Chicago,” the Chief of Staff answered. There was a brief silence as the President waited for the balance of the explanation and the Chief of Staff decided how to couch it. “There’s one paper clip in the box for each person who would be denied Dormigen—”

“Like the documentary,” the President said.

“Yes, exactly,” the Chief of Staff replied. He still surprised her on occasion, despite their many years working together. The typical day in the White House was a blur of fifteen-minute meetings; the President survived by exercising good judgment and knowing just enough about a lot of things. It was the opposite of her experience in academe, where her colleagues could spend hours drilling down on the most obscure of topics. She would sometimes forget that the President was a reader and a film enthusiast; it was his escape. After his divorce, he spent a long stretch alone in Washington. There had been a lot of media buzz in those years about his antics as one of the nation’s most attractive bachelors, but the reality was that he retired most nights to his tiny apartment with a book or a film. Even in the White House, with the First Lady traveling frequently, he would do the same, after the Chief of Staff had gone home to her husband and teenagers. On occasion, the President would invite authors or directors to dinner—not the famous ones, as he had no particular affinity for celebrities, but a historian or an accomplished filmmaker. The Chief of Staff should not have been surprised that he had seen an obscure documentary about schoolchildren who collected six million paper clips, even though she was.

“Leave them here,” the President instructed.

“In the middle of the office?” she asked.

“Somewhere everyone can see them,” he said. The paper clips were different sizes and colors: big, little, metallic, green, blue, bright pink. There was one paper clip resting on top with a sticky note attached to it. The President was not wearing his glasses when he picked it up, so he could not read the tiny elementary-school handwriting. But he knew what it said: Cecelia Dodds. In subsequent days, when staff members would ask about the box, or make jokes about buying paper clips in bulk, he would explain their significance.

Not long ago, when the President was in the final months of his term, he visited the students who had done the Dormigen paper-clip project at their elementary school in a Chicago suburb. The President spent nearly an hour and a half talking to the student body and answering questions, an unheard-of amount of time for a presidential visit. “Your project was a crucial reminder for me during the Outbreak of how our decisions would affect real people,” the President told the assembled students, most of whom were too young to appreciate the significance of what they were hearing. “That didn’t make it easier—harder, probably. But we needed that. We needed a constant reminder that the decisions we were making would affect real people and families—thousands and thousands of them,” the President explained.

The event garnered a great deal of national and international attention. To that point, the President had said relatively little about his decisions during the Outbreak. There was speculation that his elementary school visit would prompt some newsworthy reflection. By then, however, the President was thoroughly fed up with the media. He ordered the student assembly closed to the press, except for two reporters from the school newspaper, the Springhill Chronicle.[31] The balance of the media—over a hundred photographers, videographers, pundits, writers, and bloggers—were relegated to the school parking lot while the President spoke inside. Then, in a moment of delicious irony orchestrated by the President, one of the student writers for the Springhill Chronicle was deputized to give a pool report for the global media assembled outside.

“It’s going to be a pool event,” the Communications Director told the traveling White House press corps, smirking visibly. (When events were space-constrained, or when a large group of reporters might disturb an event, such as a visit to the bedside of a wounded soldier, the Communications Office would choose a single reporter and cameraperson to cover the event and share information and photos with the rest of the “press pool.” However, the reporter designated for such responsibility was not usually an eleven-year-old writer for the Springhill Chronicle.) After the event, the President stood on a patch of grass outside the school, smiling and silent, as eleven-year-old Dan “Bucky” Riegsecker reported dutifully on what had been said inside. Correspondents from the New York Times, the Washington Post–USA Today, Home Depot Media, and all the major cable news stations—notebooks out, cameras rolling—lapped up the tidbits Bucky tossed their way.

78.

THE PHONE RANG AT THE U.S. AMBASSADOR’S RESIDENCE IN New Delhi around midnight. It was Sumer Patel requesting a meeting as soon as possible between the Indian Prime Minister and the U.S. Secretary of State. “The Secretary of State is in Bahrain,” the Ambassador told Patel.

“It’s just three hours away,” Patel pointed out.

“Yes, that is fortunate,” the Ambassador agreed. “I can’t say for certain, but given the urgency of the situation, the Secretary of State might be able to get here in the morning.”

“Yes, that would be perfect, if you can arrange it,” Patel said.

“This is her top priority,” the Ambassador assured him. The details for the meeting were fixed. The Ambassador immediately phoned the Secretary of State, who was attending a banquet hosted by the Royal Family. The paperwork for the flight to Delhi had already been prepared for this contingency; a pilot and flight crew were standing ready. The Secretary excused herself from the banquet, which had gone from tedious to excruciating over the course of the evening. And so, less than two hours after the Communications Director had issued the press release announcing a “scientific breakthrough” with regard to Capellaviridae, the Secretary of State and the Strategist were on an Air Force jet bound for India.

Upon landing in India, the Secretary of State found herself with a curious problem: she had no entourage. The American Secretary of State does not travel alone; no one on the Indian side would believe that she had been in Bahrain for meetings without a large complement of aides. The fact that she was traveling with the President’s top strategist and pollster would raise even more questions. The Indian Prime Minister was vain and self-interested, but he was no fool; if word leaked that the Secretary of State had been loitering in Bahrain without all the usual hangers-on, he would suspect a scheme. (Political schemers are, of course, most adept at detecting scheming by others.) The Ambassador solved this problem by “loaning” the Secretary of State eight embassy staff members, all with the requisite security clearance. “Follow her around, look obsequious, and don’t say anything to anyone,” he instructed them. Those eight “staffers” can now claim to be a footnote to one of the most famous negotiations in modern diplomatic history—as fake lackeys.

The Secretary of State was scheduled to meet with the Prime Minister at ten in the morning Delhi time. The Strategist would not attend the meeting; even his presence in India was secret for the reasons I alluded to above. Over breakfast, he coached the Secretary on strategy for dealing with the Prime Minister. “I’ve dealt with him on many occasions,” the Secretary said, peeved by the suggestion that the Strategist’s dark arts somehow trumped her deep knowledge of foreign affairs and diplomacy.

“You need to downplay this breakthrough on the virus,” he continued, ignoring—or, more likely, oblivious to—the Secretary’s vague hostility to his briefing.

“That’s the only leverage we have,” she said.

“No, no, no,” the Strategist insisted. “No.” He paused, like a professor who realized his student had not done the reading. “Look, the PM is a guy who’s always worried he’s getting played, because that’s what he’s always doing to other people. He’s always got an angle, so he assumes everyone else does, too.”

“I’m aware of that.”

“If you walk into the room and declare that American scientists have figured out Capellaviridae, he’s not going to believe you. If you tell him that we probably won’t need extra Dormigen, he’s going to ask why the hell you are sitting in New Delhi asking for it, right?”

The Strategist had captured the Secretary’s attention, if only by the convoluted nature of what he was arguing. And he had been right so far. The California Pizza Kitchen Summit was brilliantly choreographed, she had to admit. (Upon hearing the recap, the Strategist had yelled, “Mango fucking ice cream! I love it!”) The Secretary asked, “Our only leverage here is that we may develop some kind of vaccine in the eleventh hour—and I’m supposed to downplay that possibility?”

“Play possum,” the Strategist instructed her. “Tell him you really don’t think there’s time to develop a vaccine. Scientists are working on it around the clock, but they’re pessimistic… blah, blah, blah. That kind of thing.”

“Okay,” the Secretary said, still not sure where the strategy was headed.

“This is a guy who’s always wondering if he’s paranoid enough. If you tell him we’re on the brink of developing a vaccine, he’ll know you’re bluffing. But if you downplay that possibility, then he’s going to worry about the opposite: ‘Oh, shit, what if they pull off the vaccine right as I’m about to ride my white horse down Fifth Avenue?’”

“You really think he’s that callow?” the Secretary asked.

“What’s so callow about that? We all want to be the hero. We’ve set him up to think there’s a huge political payoff—which, by the way, there may well be. Just because we made up the poll numbers—”

“Stop,” the Secretary said sharply. “I don’t want to hear anything about that.”

“Anyway, I think he’s like anyone else. He doesn’t want a lot of people to die unnecessarily in the U.S., but if someone is going to prevent that, he wants it to be him.”

“You think this is going to work?” the Secretary of State asked.

“I have no idea, but I do know that if you’re holding a pair of twos, you don’t try and persuade people around the table that you’ve got four aces. You try to make them think that you’re trying to make them think that you have a pair of twos.”

“I don’t play poker.”

“Yes, that’s apparent.”

They were holding their discussion in a small, secure conference room at the U.S. Embassy (a curious building with offices arrayed around a large indoor fountain and pool that had allegedly inspired Jackie Kennedy to hire the same architect to design the Kennedy Center in Washington). The U.S. Ambassador knocked and then entered. “Your meeting has been pushed back to eleven,” he told the Secretary. “There was some shooting across the border in Kashmir and the PM is dealing with that.”

“Anything serious?” the Secretary asked.

“No, just the usual,” the Ambassador assured her.

The Secretary of State used the time to check in with the Chief of Staff, who pointed out a logistical reality that had not been top-of-mind. The U.S. was now, by our most recent estimate, three days from the point at which the existing Dormigen supply would have to be rationed. “Maybe a little sooner,” the Chief of Staff warned. “Doctors haven’t been as strict with Dormigen prescriptions as we had hoped.” She walked through the realities of the globe: Delhi was an eighteen-hour flight from New York. It would take additional time to distribute Dormigen across the U.S., particularly to rural areas. The Chief of Staff connected the dots for them: “If the Indian Prime Minister is going to save the day, that Dormigen is going to have to be on a plane sooner rather than later.”

79.

IN WASHINGTON, THE NIH SCIENTISTS WERE HOPING TO REPLICATE the success of the Manhattan Project in a fraction of the time, albeit with the benefit of the Internet. The technical details of the most recent Capellaviridae breakthrough—the difference in the protein structure between the virulent and indolent viruses—were posted publicly with an invitation for teams of scientists anywhere in the world to explore the crucial questions: What caused the difference in the two forms of the virus? And how might the virulent form of the virus be rendered indolent? The hope was that “parallel science” might replicate the success of parallel computing, in which millions of personal computers linked together by the Internet had proved more powerful than even the largest supercomputer. The Scopes Foundation, a previously obscure philanthropy, offered a $1 million prize for a definitive answer to either Capellaviridae question, though the prize was quickly canceled at the behest of the Acting HHS Secretary, who feared that it would promote secrecy at a time when “massive openness” offered the only hope of a breakthrough in the little time available.

One bottleneck to this massive scientific effort was bizarrely low-tech: access to dust mites. The North American dust mite was not endemic to most of Europe, Asia, or South America (as the name would suggest). Even in the U.S., there was no ready supplier of dust mites for laboratory work as there was for mice or rats. A cottage industry grew up almost immediately, with the people who had been previously afflicted by the small, itchy bites suddenly able to cash in on the nuisance. (Despite the very clear description of the North American dust mite on the NIH website, eager entrepreneurs showed up at regional laboratories bearing everything from red ants to cockroaches.) The Midwest turned out to be the place where dust mites could be gathered most easily for research purposes. As a result, we leaned heavily on teams at Northwestern, the University of Chicago, and several of the other Midwest universities.

We set up a “war room” in the NIH headquarters to be the central repository for the myriad decentralized research efforts. Almost immediately we realized that we were lacking even the most basic tools for sharing the information that was being generated. The normal scientific process involves peer review, publication in journals, and presentations at scientific conferences—all things that take months or years. Now we had hours. “We need a place where everyone working on pieces of this challenge can post their progress,” I explained to the Director. The NIH had internal sites where we posted this kind of information, but there was no way to grant security clearance to outsiders in a short amount of time (nor did we necessarily want teams of foreign scientists to have access to these sites).

“How much security do we need?” she asked.

“Not much,” I figured. “We don’t want anyone without access posting a lot of nonsense. Other than that, we just need a place to gather a lot of information.” Even as I spoke, I was thinking of an easy solution, but it seemed too silly to mention.

“I’m sure somebody from the NSA can set something up for us,” the Director suggested. “Or maybe we should call one of the big software companies.”

“It will take three hours just to get the right person on the phone,” I said. “Look, I think all we need here is a big Google Doc. We can invite people to join.”

The Director was scrolling through messages on her phone, trying to manage other problems as she dealt with mine. My suggestion caused her to stop and look at me. “A Google Doc?” she asked incredulously. “That’s what my daughter uses for eighth-grade projects.”

At that moment, like so many other moments during the Outbreak, I was tempted to blurt out the obvious: “If you’ve got a better idea…” In fact, there may still be a commercial market for some product in this spirit—maybe an iPhone app with an elegant-sounding British voice that says, “If you’ve got a better idea…” at the push of a button—because if I learned anything during this ordeal, it is that the world is full of people who are very good at criticizing any proposed course of action and far less skilled at offering practical alternatives. To her credit, the NIH Director was not normally a naysayer, and she came around quickly to my suggestion once she focused exclusively on our conversation. “Really?” she asked. “Do you think that would work?”

“Why not?” I said. The Director gave a small shrug of approval. With that, the world’s most intensive scientific effort since the Manhattan Project was launched on the same platform that the NIH Director’s daughter was using to collaborate with three classmates on their U.S. Constitution project. We posted our plan on the NIH website and invited researchers to request access to the document. The timing was not good, as it was now nearly midnight on the East Coast. I worried that we would lose precious time since few scientists would pick up the news until morning. Still, we granted access to the document to thirty-one researchers in the first half hour; by one-thirty a.m., there were one hundred and twelve: biologists, physicians, biochemists, epidemiologists, virologists, evolutionary biologists. Giscard became the self-appointed master of the document, like a disc jockey managing the flow of information. I must admit that he was really, really good at it. The flow of data, questions, and theories was overwhelming. Giscard stood in the middle of this surging river of information, constantly directing the effort back to the questions that mattered: Why did the indolent form of the virus have a different protein structure than the virulent form? How did it get that way? And, of course, the holy grail of this whole endeavor: How could we render the virulent form of the virus harmless in the absence of Dormigen?

Almost immediately, we had our first breakthrough. A team from Rockefeller University in New York explained how the benign form of the virus could lose a protein, rendering it virulent. The long, scientific explanation for that process (which they would subsequently publish) involves changes that take place in a cell as it replicates (divides); namely, that parts of the cell break down after repeated replication. (This is the reason living creatures grow old and die; their cells degrade as they divide over time.) The shorter, more accessible answer to how the benign form of the virus could lose a protein is comically simple: it eventually falls off, “like a button on some pants that go through the washing machine over and over,” as Giscard would explain to his social media followers.

There was euphoria in our war room as we celebrated this discovery—and the speed with which it happened. We were painfully aware of how little time we had left. The Army had provided us with a small logistical team that was offering guidance on everything from how long it would take to mass-produce a new vaccine (long) to what would be the best way to distribute such a vaccine around the country (UPS and FedEx). At every turn, the Army logistics experts told us things would take longer than we expected. Still, it was the middle of the night and we had just unlocked one of the key mysteries of Capellaviridae, which would in turn fuel insights by the other teams.

“Beautiful work, everyone,” Giscard exclaimed to the room. I admired his confidence and extroversion. We are going to figure this thing out, I thought.

It was right about then that the French film crew arrived. I heard the NIH Director’s voice before I knew what was happening. “You have got to be fucking kidding me,” she yelled from somewhere outside the war room. The film crew was waiting down in the lobby: two camera operators, a producer, and a technician, all from a famous French news program.

Giscard, alerted to their arrival, stood up in the war room and said loudly, “We are in history!” A film crew was the last thing we needed in our cramped, hot, frenetic war room. Giscard had invited them, of course, with no approval from anyone. As obnoxious as that was, it was becoming increasingly apparent that we were participating in something historic. The next major discovery came around three in the morning, just after the start of business in Europe. A team from the Munich Institute for Tropical Diseases confirmed that Capellaviridae had indeed evolved from the influenza virus. Using DNA analysis, they discerned that Capellaviridae was a near-exact match for a flu virus that had infected Native Americans roughly nine thousand years ago. The German team found one other interesting thing: the benign form of Capellaviridae resembled a flu virus that had been neutralized by human antibodies. Less than an hour later, a team of evolutionary biologists offered an elegant explanation: The North American dust mite transmitted the flu virus to its ancient human hosts along with antibodies to neutralize it. “The North American dust mite evolved into the earliest known flu shot, thus bestowing an evolutionary advantage on the human populations where it was endemic,” the lead Stanford scientist wrote on our Google Doc.

We were getting very close to the answer for one of Professor Huke’s final exams, and we could feel the time slipping away. As we were celebrating our wiki science project, the Chief of Staff requested a moment alone with the President. “The doctors are going to bring Cecelia Dodds out of a coma,” she informed him.

“That’s great—”

“No,” she said gently. “They don’t think she will make it, and this will give her some time with her family.”

“Thank you for letting me know.”

80.

THE MEETING BETWEEN THE SECRETARY OF STATE AND THE Indian Prime Minister kept getting pushed back, first to eleven-fifteen a.m. Delhi time and then eleven-thirty. Just as the Secretary of State and her entourage were preparing to leave the American Embassy for the Parliament building, the Secretary of State was summoned to a secure conference room to take a call. It was the Secretary of Defense, who had been consumed with the Saudi hostage situation, but was now insistent on speaking to the Secretary of State before her meeting with the Indian Prime Minister. The two cabinet members had a prickly relationship in the best of circumstances. The Secretary of State was still angry at having been left out of the China Dormigen discussions, something for which she blamed the Secretary of Defense (unfairly, I would argue). In any event, she did not welcome his reappearance in what was clearly a diplomatic process. “We think the Indians are going to ask for the F-80,” the Secretary of Defense said without any prefatory small talk.

“And why do we think that?” the Secretary of State asked coldly.

“That’s what sources are telling us,” he replied vaguely. The F-80 was America’s most strategically advanced fighter jet. The U.S. government had not offered to sell the jet to any other countries save for the Israelis, and even then some of the most important technology had been removed. “It can’t happen,” the Secretary of Defense said emphatically.

“The Indians are an important ally,” the Secretary of State answered. “Maybe we offer to share some of the technology down the road.”

“No,” the Secretary of Defense said. “It will destabilize the entire region. The Pakistanis will go nuts.” His voice was rising. “There can be no mention of the F-80—none.”

The Secretary of State knew he was right but resented the lecture anyway. “How good is your intelligence?” she asked.

“The intelligence is good,” the Secretary of Defense answered. “We know the Indian generals want the F-80. What we don’t know is how the PM feels about it. We don’t know if he cares enough to make it a negotiating point.”

“He’s ex–Air Force,” the Secretary of State offered.

“I think that works in our favor,” the Secretary of Defense said. The Indian Prime Minister had been a decorated fighter pilot and later a general in the Air Force. Conventional wisdom, at both State and Defense, was that politicians with a military background were less enamored of fancy, expensive hardware than politicians with no military experience. They also had more credibility when facing down the generals who were clamoring for such toys.

“I suspect he’ll probe a bit,” the Secretary of State said.

“You have to be very clear that it’s not even a possibility,” the Secretary of Defense declared.

“Obviously.”

“You’ll have to be prepared to walk away—”

“Yes, I understand that. I know how negotiations work. Is there anything else?”

“No, that’s it. Sorry to have to drop this on you,” the Secretary of Defense said earnestly.

“This is going to be China all over again, isn’t it?” the Secretary of State said. “The price will be too high.”

“I don’t think so,” the Secretary of Defense said. “The PM may be a self-interested bastard, but he still gets up every morning and reads the newspapers to see how he’s doing. If rushing Dormigen to America plays well in the villages, that’s what he’ll want to do.”

“That’s what would happen in a Hindi film,” the Secretary of State mused.

“With all the singing and dancing? I don’t watch Hindi films,” the Secretary of Defense replied. “But I am idealistic enough, or maybe just naïve enough, to think that democracy might work to our advantage here.”

“That would be nice, wouldn’t it?” the Secretary of State said.

“Good luck.”

81.

THE SECRETARY OF STATE, THE U.S. AMBASSADOR, AND assorted aides were finally ushered in to see the Indian Prime Minister at around noon Delhi time. They met in the Prime Minister’s capacious personal office, decorated with tapestries depicting various historical scenes, from the Moghul era to Independence. The Prime Minister showed the American entourage to a small sitting area with two stuffed chairs, one for him and one for the Secretary of State. Their aides, including Sumer Patel on the Indian side, arrayed themselves awkwardly behind the two principals. There were not enough seats at first; an Indian functionary rushed to bring more. “Mr. Prime Minister, we have brought you a small gift,” the Secretary of State offered, at which point an aide behind her produced an elegant wooden box about the size of a brick. The Prime Minister carefully opened a latch on the side of the box, revealing a small bottle of rare bourbon. “Ah,” the Prime Minister exclaimed with genuine enthusiasm, “the British have their scotch, but the Americans do bourbon! Shall we try it?”

“How about if we celebrate with a drink after we consummate a deal?” the Secretary of State suggested.

“Yes,” the Prime Minister agreed. “We are prepared to offer you the assistance you need. At first, we did not appreciate the seriousness of your situation. This is why…” He gave a wave of his hand to dismiss the Indian government’s charades when they were first approached about offering up Dormigen. On this point, he was almost certainly telling the truth. U.S. intelligence reports—and plain common sense—suggested that many governments, including the Indian government, did not believe the American Dormigen shortfall was as serious as it had been made out to be.

“I appreciate your willingness to help,” the Secretary of State said. “I think it could be an important step toward cementing our bilateral relationship. The President feels the same.”

“As do I,” the Prime Minister said.

“I have to be honest here,” the Secretary of State said. “We have few other options and we are running out of time.” In terms of playing possum, the Secretary of State was now lying on her back, legs in the air.

The Prime Minister looked skeptical. He proceeded to sniff: “There is an impressive scientific effort happening,” he said, making it sound more like a question than a statement. “A new Manhattan Project.”

“What we’ve learned about the virus is very impressive,” the Secretary of State replied. “But it’s hard for me to conceive of a situation in which the scientists can produce actionable results in the time that we have. Even if they were to come up with a treatment right now—this very minute—it would take days, if not weeks, to produce and distribute a new drug.” Rarely had she felt so manipulative while speaking the absolute truth.

“Dormigen is a more elegant solution,” the Prime Minister said.

“Of course. Absolutely,” the Secretary of State agreed.

“This could bring our two nations closer together,” the Prime Minister said.

The Secretary of State finished the thought: “This can be an opportunity to revitalize some of the bilateral initiatives that have been languishing for too long: our civil nuclear cooperation, the intelligence-sharing, the H-1B visas.”

“Exactly,” the Prime Minister said, looking over at Patel, presumably to acknowledge his work at the California Pizza Kitchen Summit. There were subtle nods of agreement among the aides in both delegations. Yet the Secretary of State was developing a bad feeling. The conversation had gone on too long—too many dates without a kiss, as one of her mentors at State would describe this kind of situation. The Prime Minister should have closed the deal by now; they had seemingly reached agreement. “We could do reciprocal state visits,” the Prime Minister offered. The longer the conversation went on, the worse the Secretary of State began to feel, regardless of what the PM was saying.

“Sooner rather than later,” the Secretary of State suggested. “The President and First Lady have a special affinity for India.” What is the holdup here? she wondered.

The door to the office opened. An aide scurried to the Prime Minister’s side and handed him a small folded note. “Excuse me,” the Prime Minister said as he read. “My goodness,” he exclaimed. “Your scientists are making great progress.” The press was eagerly reporting our wiki science breakthroughs in real time. The NIH Director reckoned there was little hope in keeping the developments secret, and no compelling reason to do so anyway. It was not a surprise that the Indian Prime Minister was keeping abreast of these scientific developments; it was surprising that an aide had interrupted him with specific news. The Ambassador and the Secretary of State exchanged a puzzled glance. “This is very exciting,” the Prime Minister said.

“We are still a very long way from having any actionable findings,” the Secretary of State said, as if she were reassuring him that his magnanimity would not be supplanted at the last minute by some scientific miracle. Both the Ambassador and the Secretary of State later described this moment in the conversation at length in their respective memoirs, but somehow it got lost in the wider public discussion of the Outbreak. Our remarkable research efforts at the NIH and this bizarre diplomatic chapter in India were inextricably linked. Yes, they were two different paths we pursued for managing the Dormigen shortage, but they converged in the Prime Minister’s office in those few delicate moments. The science—the possibility that our unprecedented network of scientists would render Dormigen unnecessary—offered the Secretary of State the only leverage she had.

“I think it would be to India’s great advantage if we were able to assist during this crisis,” the Prime Minister said, which was just a restatement of what he had been saying since the meeting began. The members of both delegations nodded in agreement. More dating, still no kissing, the Secretary of State thought. The Prime Minister continued, “Perhaps we could have a private session?”

“Of course,” the Secretary of State agreed. Anything to encourage him to get to the point. The various aides began to file out of the room. And if he’s going to ask about the F-80, the Secretary thought, the fewer people in the room, the better.

“Would it be okay for Mr. Patel and the Ambassador to stay?” the Prime Minister asked.

“Yes, of course,” the Secretary of State said. Patel and the U.S. Ambassador moved their chairs closer to the principals. Neither one of them said much during the balance of the meeting, but we are fortunate that the Ambassador was there to substantiate the Secretary’s account of the extraordinary conversation that followed.

The Prime Minister leaned forward, placing his fingertips together, almost like a little prayer. “This is very exciting, yes?” he asked. The Secretary did not know quite what to make of the question. She had spent every wakeful hour in recent days pleading with world leaders, fending off Chinese aggression, dealing with petty members of Congress, and squabbling with her fellow cabinet members. The most recent NIH projection was that between thirty-seven thousand and a hundred and eleven thousand people would die prematurely in the United States due to Capellaviridae. She could think of a lot of adjectives—“frustrating,” “infuriating,” “tragic,” “exhausting”—but “exciting” was not on the list. The Prime Minister must have read her expression, because he added, “Not the Outbreak, of course, but that it can be a catalyst for better relations between the world’s two most important democracies.”

“I hope so,” the Secretary of State said cautiously.

“I have two personal requests,” the Prime Minister offered.

“Please,” the Secretary answered, inviting him to continue. She had known something was coming, but a “personal request”? Her mind was racing. The F-80 would hardly be a “personal request.” Did the PM have teenage children? How many times had she been asked by foreign leaders to get their children into Harvard, Princeton, or Yale?

“It would be very beneficial for India to assist the United States with your Dormigen situation,” the Prime Minister said.

“Yes, I think we’ve established that,” the Secretary responded. Patience is like a muscle; it grows stronger when exercised. But even the Secretary’s prodigious patience, exercised constantly by rambling Russian diatribes and verbose NATO bureaucrats and lying Iranian negotiators, was growing fatigued.

“It would be good for me, too, politically,” the Prime Minister said. The Secretary and the Ambassador nodded in understanding. He continued, “I would never put my political interests ahead of what is good for my country—never.”

“There’s no reason they can’t be aligned,” the Secretary said, urging him along.

“Yes! Exactly.” He seemed relieved that his visitors grasped this point. “In that spirit, I have two requests to help keep these interests ‘aligned,’ as you say.”

“You are in a position to save a lot of lives, Mr. Prime Minister. I will do whatever I can,” the Secretary said honestly.

“Hmm, yes.” The Prime Minister was a remarkably articulate man, but he was clearly stumbling for words. “Well, first,” he began, “I would like to make sure that India gets the appropriate credit for this generous donation.”

“Obviously,” the Secretary said emphatically. She was still entirely puzzled as to where this was going.

“The scientific discoveries around this virus are moving very quickly,” the Prime Minister explained. “That’s a good thing, obviously. Please don’t get me wrong.”

Finally, the Secretary thought. So that was it: The Prime Minister was worried about being upstaged by some last-minute discovery. Not merely upstaged, but embarrassed. Nothing would be worse for his political standing at home than making a high-profile announcement offering assistance to the United States, loading up Indian cargo planes with Dormigen, and then having the whole effort rendered unnecessary—foolish, even—by this wiki Manhattan Project. India, the perpetual junior partner in the relationship, would have its planes loaded up with nowhere to go.

The Secretary of State felt a wave of relief. This she could manage. “I understand completely,” she assured the Prime Minister. Because she did. Her job was to prevent any potential embarrassment for the PM or his nation. “I’m thinking out loud here, but tell me what you think of this,” she said, pausing to gather her thoughts. “The President obviously cannot suspend the research efforts—it would be imprudent, and he couldn’t stop the progress even if he wanted to.”

“I understand.”

“But he can certainly make a statement—an entirely truthful statement—telling the American people that those efforts have not yielded a Dormigen substitute and will not in the time we have left. They’ve failed. I don’t think he would use the word ‘failed,’ because it’s been a remarkably impressive scientific effort all things considered, but the time has passed for the science to bail us out.”

“Yes,” the Prime Minister said.

“And then he could couple that statement—”

“A live statement, not just a press release,” the Prime Minister clarified.

“Absolutely,” the Secretary of State agreed. “Perhaps a short address to the nation. In any event, I could imagine him coupling that dire news with the announcement that India will be providing the Dormigen necessary to ward off the crisis. That makes perfect sense to me.”

The U.S. Ambassador interjected, “I can’t speak for the President, but I’m sure he would be comfortable running the text of those remarks by you in advance.”

“It would be the least we could do,” the Secretary added.

“Excellent,” the Prime Minister said, visibly excited. “Then I think we have a deal!”

“You had a second request?” the Secretary of State said, while thinking, Please, God, do not make it the F-80, because then this whole thing will unravel, but what else could it possibly be?

“Oh, yes, it’s a tiny favor, I can’t imagine the President would object.”

Help me, the Secretary thought, because when anyone asks for a “tiny favor” it’s usually a complete disaster, like when the bullying Turkish President tried to persuade her that arresting some of his critics in the U.S. would be “such a small thing”—

“I’d like to fly the Dormigen there myself.”

“Pardon?” the Secretary asked. Her thoughts were racing so quickly that she had missed the essence of what the Prime Minister was asking.

“I’d like to deliver it myself—the Dormigen. I’d like to ‘fly west!’ as the President would say.”

The Secretary of State was still struggling to catch up. The Ambassador, seeing her confusion, said, “You’re saying that you would like to be on the plane that takes the Dormigen to the United States?”

“Exactly.”

The Secretary of State felt a wave of euphoria sweep over her. This was going to happen. “The President would be delighted to have you deliver the Dormigen,” she said confidently. “I’m not sure we can plan a state visit with two days’ notice, but we will do everything short of that. We will plan an event befitting what you and your country are doing for the United States.”

And you can wear a fucking superhero outfit, if you want, she thought. The Secretary of State is not a profane woman, but according to her memoirs, that was exactly what was running through her mind as she shook hands with the Prime Minister, consummating the deal.

82.

THE SECRETARY OF STATE IMMEDIATELY PHONED THE CHIEF of Staff, who was traveling with the President. “We did it,” the Secretary of State reported breathlessly. The excitement in her voice was laced with fatigue.

“You’re certain?” the Chief of Staff asked.

“Yes. We have a firm commitment: five hundred thousand doses. Technically it’s a loan. The embassy is preparing the documentation. There are some other things: the civil nuclear cooperation—”

“He’s not going to go back on his word?” the Chief of Staff asked.

“The Prime Minister? No. For all his foibles, he’s rock-solid when he makes a deal. That’s the military in him.”

“Thank you,” the Chief of Staff said softly. And then, after a pause: “I’m going to tell the President now.”

The President was standing alone on the tarmac at Dover Air Force Base. He and the Chief of Staff had traveled there to greet the remains of the two U.S. diplomats who had been killed in the Saudi school kidnapping. The plane carrying their bodies was expected to land shortly. The families would be coming, too, along with a Marine honor guard. The President had been here many times before, greeting the fallen soldiers on their return at all hours of the night. He felt it was his duty; the families were always grateful, despite the horrific circumstances. He also enjoyed the solitude and used it as a time for reflection. On this morning he had made a point of arriving early. The Chief of Staff walked over to where the President was standing. The air was pleasantly cool and the sun was just coming up over a runway on the horizon. The Chief of Staff’s heels clicked loudly on the asphalt. The President turned slightly as she approached, seemingly annoyed by the interruption.

“We got the Dormigen,” she said without undue drama. “The Prime Minister is offering up everything we need.”

The President nodded, betraying little emotion. “I need to call Cecelia—”

“Done. It was my first call.”

“And?”

The Chief of Staff shrugged. “She’s very sick. They gave her Dormigen immediately, but her daughter says it could go either way.”

The President nodded in acknowledgment. “What does he want?”

“Who?” the Chief of Staff asked.

“The Prime Minister.”

“No problems,” the Chief of Staff assured him. “Just the stuff we talked about: civil nuclear, intelligence-sharing, visas—he didn’t even ask about the F-80.”

The President exhaled audibly. Someone watching from a distance would have no idea that he had just received great news, but the Chief of Staff knew him well enough that she could see some of the tension go out of his body. “We’re not out of the woods yet,” the President said. “We still have to make sure the Dormigen gets on a plane. There’s not a lot of time, and it is India, after all. There’s a big difference between offering five hundred thousand doses and actually getting it loaded on a plane and off the ground.”

“The Ambassador is on it,” the Chief of Staff assured him. She wished the President would take more time to savor what they had accomplished. “There’s one other thing,” she said.

“There’s always one other thing. You know how I feel—”

“I think you’ll find this amusing,” the Chief of Staff said. “The Prime Minister wants to fly the Dormigen here himself. Apparently you’ve started quite a thing—this whole ‘flying west.’”

The President smiled in genuine amusement. “Whatever makes him happy,” he said. They stood in silence for some time, appreciating the peace. “There is going to be a lull, while we wait for the Indian Dormigen,” the President told his Chief of Staff. “You should get some time with the family.”

The Chief of Staff gave a short, sardonic laugh. “My daughter is failing trig. I think she’s doing it just to get back at me.”

“Does anyone really need to know trigonometry?” the President asked.

“Don’t tell her that,” the Chief of Staff replied, with a more mirthful laugh. “Dan’s been a saint.”

“Don’t take that for granted.”

“No.”

Moments later a minivan arrived on the tarmac carrying the parents of the slain consular officer. They had traveled to Dover from a suburb of Detroit. Their son had been in the diplomatic corps for thirteen years, having done tours in Belgium, Ghana, Jordan, and then Saudi Arabia. The President walked purposefully toward the van. The Chief of Staff watched as he helped the couple out of the vehicle, hugging the mother and shaking hands with the father. She could see the President pointing toward the runway, presumably explaining that the plane carrying their son’s body would arrive shortly. A few minutes later another minivan arrived carrying the second family.

83.

OUR “WAR ROOM” WAS BUZZING WITH ACTIVITY WHEN THE NIH Director walked in shortly after daybreak. The large conference room had no windows; the fluorescent lights bathed the room in bright light, disguising any sense of what time it was. Most of the scientists and staff had been there all night. The pace of discovery was intoxicating; even those who had planned to leave found it hard to do so. I was on the phone with a science blogger, walking her through all that we had learned in the past twelve hours. “This place smells like a locker room,” the NIH Director said. The French camera crew, having tired of footage of slovenly people hunched over keyboards, eagerly turned their cameras on her.

“Give her a little breathing room, please,” I told them. Giscard repeated my admonition in French (though I am certain they understood my instructions in English perfectly well).

“It’s fine,” the NIH Director said. And then, more directly to the film crew, “You’ll want to get this.” Everyone who heard that curious remark stopped working and turned to the Director. She continued, “Could I have everyone’s attention, please?”

The clicking of keyboards slowed and then stopped. The two camera operators sidled even closer. “I just received a call from the President’s Chief of Staff,” the Director said, projecting her voice across the room. “She informed me that the Indian Prime Minister has offered the United States five hundred thousand doses of Dormigen. That medicine will be on a plane bound for Washington shortly.” A loud cheer erupted in the room, but there were also a few sighs of disappointment. We were all relieved, obviously, but we were disappointed, too. We could have figured this thing out, I was thinking, as were many others. Perhaps sensing this emotion, the Director continued, “The Chief of Staff asked me to tell the people in this room one other thing.” She paused to put on her reading glasses and unfold an ordinary piece of copy paper on which she had scrawled several sentences. “This is an exact quote: ‘Our leverage in the negotiations came from the blistering pace of progress we were making on the virus. Without that, there would be no Dormigen on its way to the United States right now.’ The Chief of Staff asked me, on behalf of the President, to thank each and every one of you.” There were hearty cheers. The French film crew turned their cameras on the room to capture the reaction.

After the Director left, our room was oddly still for several minutes. A few people, exhausted from the all-nighter, left to get real food or to go home for some sleep. But most of us did not want to leave. There was a unique bond in the room, holding us there together. The crisis may have passed, but the urge to figure out Capellaviridae had not. Less than fifteen minutes after the Director addressed the room, a group of biologists, a joint Northwestern–University of Chicago team, posted the most extraordinary finding yet: when the North American dust mite transmits Capellaviridae to humans, it also passes along an enzyme that destroys the older Capellaviridae viruses already in the body. “New Capellaviridae viruses get swapped out for the old ones, effectively,” they wrote in the What does this mean in plain English? section of our Google Doc. We recognized immediately that this could easily be the piece of the puzzle we had been waiting for.

“Do they know?” Giscard asked no one in particular, his distinctive voice rising above the clatter in the room.

“What?” I asked.

“Do they know we have the Dormigen?”

“I’m not sure it matters,” I replied. That reading of the situation turned out to be broadly correct. Our site had more meaningful posts over the next twenty-four hours than we had in the first twenty-four.

84.

THE INDIAN DORMIGEN PLEDGE SET IN MOTION A FLURRY OF logistical activity. The NIH was worried about Dormigen shortages in rural areas, even with the arrival of the Indian doses. It would be roughly thirty-six hours before the new Dormigen arrived on the East Coast, and then at least another twenty-four hours before it could be distributed to all parts of the country. Deep in the bowels of Homeland Security, some nameless bureaucrat opened up the electronic equivalent of a binder: Pandemic Drug Distribution. There were other such “binders”: bioterror evacuation, and nuclear accidents, and dirty bombs. The people who prepared these binders went home at night hoping that nothing they ever did would be relevant.

But on this day, the “binder” came off the shelf. Once the Indian Prime Minister’s plane touched down in D.C., the U.S. Air Force would take the lead in moving the Dormigen to the major metropolitan areas. From there, National Guard units would ferry it to more remote areas with the assistance of private couriers, as necessary. There had been simulations of this exercise before; now the contingency plan was set in motion for real. The Air Force began flying a massive fleet of cargo planes to airports in and around Washington, D.C. National Guard units in all fifty states were called up for duty. National Guard trucks and planes, with their respective drivers and pilots, were assembling near airports in the major cities. The maps and routes had already been drawn up. It was all in the binder.

The planning on the India side was more ad hoc. The Prime Minister requisitioned an Air India 747 cargo plane to make his historic flight and requested that the aging plane be repainted for the occasion. When he was told that a 747 could not be painted in twenty-four hours, he settled for having enormous Indian and American flags painted on the tail and fuselage. The hulking 747, a beautiful plane under normal circumstances, looked appropriately majestic for the PM’s mission. The U.S. Embassy was testing samples of the Dormigen as it was loaded on the plane. This request had come from the CDC in Washington, where there was some fear that a high proportion of the Indian Dormigen might be counterfeit or expired.

Nearly all attention in India was now focused on the Prime Minister’s “toilets and televisions” initiative. “I assume you’re joking,” the Secretary of State had said when an aide hustled into her temporary office at the embassy and described the program.

“Nope. Fifteen thousand villages in forty-eight hours,” the aide said. “That’s the plan.”

Less than an hour earlier, the Indian Prime Minister had announced a plan to furnish fifteen thousand villages with a sanitary latrine, a television with a satellite dish, and a solar panel that would generate sufficient electricity to power the television. The Prime Minister proclaimed, “In the middle of the twenty-first century, no Indian village should be without a clean, sanitary toilet. And no village should be cut off from the rest of the country.” He bypassed the legendary Indian bureaucracy and enlisted the Army to carry out his edict. A public school teacher in each of the designated villages was recalled to the nearest population center, where he or she was paired with a small contingent of soldiers who would return to the village—often hiking for hours to remote places with no road access—to dig the latrine and install the solar panel and television.

The Prime Minister called the program “Technology for India” or something like that; within a few hours, even he was referring to it as “toilets and televisions.” His political opponents went ballistic, declaring the obvious: the PM wanted to ensure that even the smallest village (where voter turnout tended to be quite high) would be able to witness his heroic journey to the U.S. At first the Prime Minister’s lackeys tried to argue that the program’s timing was coincidental. Eventually that charade became impossible to maintain, since every village participating in the program was given a single sheet of paper with a description of three things in the simplest possible language: (1) instructions for the television; (2) an explanation of how and why using the latrine could prevent the spread of disease; and (3) a description of the PM’s flight to America, including a photo of him posing in front of the 747 and its enormous Indian and American flags.

The new toilets turned out to be perfect insulation against charges of political opportunism; public health officials reckoned they would save thousands of lives in the long run. The solar panels, too, would be beneficial, as they could be used for other village functions, such as charging mobile phones and powering lights so students could study at night. In the end, the PM’s opponents argued that if the program was so beneficial, he should have done it earlier—hardly a searing indictment. The most creative claim was that Pakistan would invade India while the Army was busy digging toilets in remote parts of the country. The Prime Minister, never one to shy away from adding more frosting to his own cake, phoned the Pakistani Prime Minister and asked him to do his best to deter any border provocations that might jeopardize the assistance plan for their mutual ally, the United States. We have no record of the Pakistani PM’s response; we do know that Pakistan did not invade India while its Army was digging toilets.

It took about nineteen hours to gather the Dormigen in Delhi and load the 747 (plenty of time for the paint to dry on the large Indian and American flags on the fuselage and tail). The plane was scheduled to depart around six p.m. Delhi time. A small diplomatic contingent was invited for a departure ceremony. Takeoff was pushed back to eight p.m. and then nine; the Prime Minister’s spokesperson did not offer a reason. The President phoned the Secretary of State to ask about the delay. “It’s never too late for them to ask for the F-80,” he said. “They’ve got us over a barrel now.”

“I don’t think the Prime Minister would do that,” the Secretary of State assured him.

“We don’t have a big buffer here. Tell them we need that plane in the air,” the President insisted.

“I’ve made that abundantly clear,” the Secretary of State replied. “If I were to guess, the PM is stalling for time so more televisions can get to the villages.”

“You can’t make this shit up,” the President muttered.

The departure was postponed once again, this time until seven the following morning, putatively because of a mechanical issue with the plane. The U.S. Ambassador called Sumer Patel to implore the Indians to get the flight in the air. “Don’t worry,” Patel said. “The seven o’clock departure is firm.”

“You think the mechanical issue will be resolved by then, do you?” the Ambassador asked sarcastically.

Patel laughed. “The Prime Minister wants ten thousand televisions installed before he takes off, and another five thousand in operation before he refuels in Germany,” he explained.

The U.S. Ambassador did not know how to respond. Finally, he said, “We have absolutely no cushion. You realize what’s at stake here?”

“Of course I do,” Patel bristled. “And so does the Prime Minister. You’ll get your Dormigen. Just let him have what he wants.”

85.

THE DELAYS IN NEW DELHI NOW PUT THE DORMIGEN DISTRIBUTION plans in the U.S. in jeopardy. An Air Force logistics officer arrived at the White House to brief the President on the disruption. She was a stocky woman with close-cropped hair who stood at rigid attention after the Chief of Staff ushered her into the Oval Office. The President was finishing a call with the Mexican President, who had called to express his displeasure with an immigration bill making its way through Congress. The President motioned the Air Force officer to a seat, but she remained standing. “I can’t promise you I’m going to veto it—that would be unwise—but I can tell you that I think it’s a lousy bill and I don’t think it has enough votes in the Senate,” the American President told his Mexican counterpart. He then listened for what appeared to be an excessively long time.

“Lots of translation,” the Chief of Staff explained to the Air Force officer.

“I appreciate your thoughts on this,” the President said in a tone meant to wrap up the call. He waited for assorted pleasantries to be translated, said goodbye, and then hung up. He looked at the Chief of Staff plaintively and said, “This isn’t on the schedule.”

“We’ve run into a snafu with the logistics for the Dormigen distribution,” the Chief of Staff said.

“Why can’t we get that goddamn plane in the air?” the President snapped. The Chief of Staff nodded to the Air Force officer, inviting her to speak.

“Sir,” she began nervously, “even if that plane takes off right now, we are bumping up against the time we need to deliver the Dormigen to all the specified hospitals and clinics.”

“How long do you need?” the President asked.

“Our plan requires thirty-six hours from the moment the Prime Minister’s plane touches down in Washington.”

“I was told twenty-four hours,” he said angrily.

“That’s to reach ninety-five percent of the population, sir,” the officer explained. “That’s typically how the logistical people—”

“Thirty-six hours?” the President exclaimed. “Are you kidding me? Are you delivering this stuff on bicycles?”

“No, sir.”

“When is the Prime Minister’s plane supposed to take off?” the President asked the Chief of Staff.

“Now they’re saying seven a.m. Delhi time,” she answered.

“And that’s for real?”

“The Ambassador says it’s firm,” the Chief of Staff replied.

The President turned to the Air Force officer. “So what are our options?”

“I’ve prepared three plans,” she answered, holding a briefing book out to the President.

“I don’t have time for the bad ideas,” he said sharply. “Just tell me what you think we should do. What’s the best option?”

“Yes, sir. If we act reasonably soon, we won’t have a problem, but we have to change the sequencing of the plan.”

“What does that mean?” the President asked.

“I think she was about to explain that,” the Chief of Staff said, trying to calm the President.

The Air Force officer continued, “We can take the Dormigen we have now and begin moving it immediately to more distant areas. Then when the relief shipment comes from Delhi it can be distributed relatively quickly to the major population centers. We would just turn the plan on its head, so that the shipments to our far-flung areas can happen before—”

“I understand,” the President said.

“That’s clever,” the Chief of Staff added.

“It buys us a lot of time,” the Air Force officer suggested.

The President nodded in acknowledgment. He was calmer now that there was a feasible option on the table. He began thinking out loud. “That’s asking a lot: hospitals have to give up a dwindling supply of Dormigen for the promise of a replacement that’s still sitting on a runway in Delhi.”

“Do we even have that authority?” the Chief of Staff asked.

“Yes, ma’am,” the Air Force officer said confidently. “I’ve consulted with the legal counsel at Homeland Security. The President has the necessary authority to set the plan in motion.”

The President was still talking mostly to himself. “What if they don’t give it up? I don’t want to be in a situation where federal marshals are wrestling Dormigen away from doctors and nurses.”

“Mr. President, if we go with this option, we’ll have a cushion again,” the Air Force officer said, gaining confidence. “We can afford to wait until the plane is aloft.”

“Assuming it takes off at seven,” the President said.

“Yes, sir, that’s right.”

The Chief of Staff offered, “Everyone would be much more willing to pass along their Dormigen if they were confident the replacement was in the air and on its way to the U.S.”

“I agree,” the President said. “Let’s do that. And, for God’s sake—”

“I will call the Prime Minister’s office and tell them to get the plane in the air,” the Chief of Staff assured the President, finishing his thought.

86.

THE SEVEN A.M. DEPARTURE WAS IN FACT FIRM. A SMALL group of diplomats assembled on the tarmac. The Prime Minister, dressed in his former military flight uniform, shook hands with each of the assembled officials. As a military band played the Indian national anthem, he climbed the stairs to the hulking 747 with his wife and two children. The Prime Minister’s family disappeared into the plane. The Prime Minister paused at the top of the stairs, and as the band finished, he turned and briskly saluted the assembled guests (and, of course, the hundreds of millions of Indians watching on television). The door to the jet was closed and moments later the plane was aloft. Flying west.

It was nine-thirty p.m. on the East Coast of the United States; the major news channels all cut away from their normal programming to cover the takeoff. The President watched the dramatic departure in his study in the family quarters of the White House with the Majority Leader, the Strategist, and the Chief of Staff. They broke into spontaneous applause as the 747 left the ground. The news channels cut to the Seattle hospital where doctors reported that Cecelia Dodds was “responding to Dormigen” and had been upgraded from critical to serious condition.

“She’s the toughest person I know,” the President offered.

“She’ll pull through,” the Majority Leader said. “This calls for a drink.”

“I’ll go find some of the good stuff,” the President agreed.

“This is great news,” the Chief of Staff said. “I’m going to head home.” She handed the President his schedule for the next day. In the morning, he would be making a brutal trip to California, where wildfires were ravaging eleven counties. He would tour the area briefly and then fly back across the country in time for the Prime Minister’s arrival.

“The guy knows how to make a departure, doesn’t he?” the President said. His mood was noticeably improved, almost buoyant.

“At least he’s in the air,” the Chief of Staff said. “That’s precious cargo.”

“Get some sleep,” the President advised her. “Give my best to Dan and the girls.” The Chief of Staff walked wearily out of the study. The President went in search of a bottle of rare Irish whiskey the Prime Minister of Ireland had given him on his last visit.

Twenty minutes later the President, the Majority Leader, and the Strategist were sipping Irish whiskey and watching cable news coverage of the Air India flight when the Chief of Staff walked briskly back into the study. “I thought you went home,” the President said quizzically.

“We have a problem,” she announced.

The President set his tumbler on the coffee table, leaned back in the sofa, and exhaled audibly. “Do you know what I dream?” he said with resignation. “I dream that one day you’re going to come bursting in here and exclaim, ‘Great news: Something went much better than we expected!’”

“Not today,” the Chief of Staff said, unamused.

“What?” the President asked.

The Chief of Staff explained, “Three governors are saying they won’t allow Dormigen to be moved out of their states. They’re refusing to allow their National Guard units to participate—”

“Hold on,” the President said. “Why does any Dormigen need to cross state lines?”

“The Homeland Security plan has Dormigen moving from metro areas to rural areas,” the Chief of Staff answered.

“Okay,” the President acknowledged.

“Well, look at a map,” the Chief of Staff said impatiently. “The fastest way to get Dormigen to northern Wisconsin is from Minneapolis. If you want to get it to northern Mississippi, it comes from Memphis.”

“Of course,” the Strategist said.

“And three governors won’t play ball,” the President said, absorbing the situation.

“Correct,” the Chief of Staff said. “The federal government can’t tell them what to do, they have an obligation to protect lifesaving medicine from federal bureaucrats, and so on, all the usual claptrap.”

“Let me guess,” the President conjectured, “Hazlett, Goolsbee, and Spencer.”

“Congratulations. A couple of others are making similar noises,” the Chief of Staff said.

“Alabama, Mississippi, and Louisiana,” the Strategist added. “I sometimes find myself wondering if we should have just let the Confederacy go.”

“You’re welcome to wonder that,” the President said sharply. “I would appreciate it if you would not say it out loud.”

“I’ve asked the General Counsel’s office for our options,” the Chief of Staff said wearily.

“I can nationalize the National Guard units,” the President said. “Do we have time?”

“I’ve called some staff back in. They’re working on it,” the Chief of Staff answered.

The President sipped his whiskey and stared at the television. There was a graphic on the screen of the Prime Minister’s projected flight path from New Delhi to Washington. “They’re just trying to make a point, more partisan grandstanding,” he said bitterly.

“This is more serious than they realize,” the Chief of Staff replied. “If they mess up the plan, then the logistics go off the rails. And if that happens, we run out of time. Every hour means unnecessary deaths—”

“I understand that,” the President said, his former buoyancy long gone.

“These fuckwits think they can have their Dormigen and flip off the federal government, too,” the Strategist offered.

“They can’t,” the Chief of Staff said plaintively. “These are complex algorithms. It’s not like we can just redraw the maps so that no Dormigen crosses state lines. Even if we could, if we make some concession to these guys, then every other governor will want the same thing. Then the plan unravels and people start dying because the Dormigen isn’t going to make it to some places in time.” She paused to breathe. She was worn out, and this political play—so gratuitous—felt like one more kick. “They’re playing with a loaded gun,” she added.

“But they don’t think it’s loaded,” the President said. “That’s what makes it so dangerous.”

“That happens, you know,” the Strategist interjected. “If you take the clip out of a semiautomatic pistol, there’s still one bullet left in the chamber. Most people don’t know that.”

The President stared at him, too fatigued to tell him to stop talking. “If I have to nationalize the National Guard, so be it,” the President said.

“If they resist, or even delay—we don’t have hours to play with,” the Chief of Staff lamented. “Every minute they dick around in front of the television cameras is going to put some areas of the country at risk.” The room went silent as the four of them absorbed the potential cost of this political ploy. “And it’s totally unnecessary,” the Chief of Staff added angrily.

“With respect, Mr. President,” the Majority Leader said quietly, “I’m wondering if there isn’t a better option here.”

“I’m all ears.”

“Can you get me an office with a phone?” the Majority Leader asked. “I might be able to persuade these esteemed elected officials—”

“Fuckwits,” the Strategist declared.

“Yes, well, I might be able to get these fuckwits to think about the situation differently,” the Majority Leader continued.

“You know who you’re dealing with,” the President said. His exhaustion was evident. For the first time during the crisis, there was also a hint of sadness, as if the ongoing parade of self-interest and narrow-mindedness and partisan grandstanding had finally begun to erode his belief in basic human decency.

“I do know who I’m dealing with,” the Majority Leader said confidently.

“I’ll get you an office downstairs,” the Chief of Staff offered. The Majority Leader stood and retrieved his suit jacket from a nearby chair. He put on the jacket, buttoning it over his paunch. He picked up his empty whiskey tumbler and shook the ice cubes against the expensive crystal.

“Might I get a refill?” the Majority Leader suggested. The President fetched the bottle and poured two fingers for the Majority Leader. “Now, can someone get Governor Hazlett on the phone for me?” he asked.

“You’re going to try to talk sense to Hazlett?” the President asked skeptically.

“He’s the least decent of the bunch,” the Chief of Staff said.

“That’s exactly why I’m going to start with him. I’m going to talk his language,” the Majority Leader said.

“In that case, here,” the President said as he poured more Irish whiskey into the Majority Leader’s glass.

The Majority Leader rattled the ice cubes gingerly in the expensive glass, creating a pleasant clinking. “Thank you. I’ll be back.”

As coincidence would have it, I was working on a press release on our new discoveries regarding Capellaviridae in one of the small communications offices below the living quarters in the White House. The print media may have been dying a long, slow death, but Americans still liked to wake up to their news, even if it was no longer in a newspaper lying on the front porch. Tens of millions of Americans would start their mornings by checking their phones and tablets and computers. We were hoping to control that narrative, pushing out all of our good news through every possible channel.

The Chief of Staff appeared at the office door with the Majority Leader standing just behind her. “Are you using the phone?” she asked. I shook my head no and moved to a small chair in the corner of the office, so the Majority Leader would be able to sit at the desk. She turned to the Majority Leader. “Do you need privacy?”

“Oh, no,” he assured her. “This will be a very public exercise. Do we have Governor Hazlett on the line?”

“He’s not taking our calls,” the Chief of Staff answered.

“Try again,” the Majority Leader said confidently. “Only this time, tell him I’d like to discuss the Sea Snake Sonar appropriation.” The Majority Leader took off his suit jacket and placed it delicately on the back of his chair. He loosened his tie and sat down at the desk, fully expecting the phone to ring. Sure enough, within minutes the Majority Leader was on the phone with Alabama Governor Sterling Hazlett. I continued to type at my laptop, but mostly I was watching the Majority Leader do what he does.

“Governor Hazlett,” the Majority Leader intoned, “I don’t have a lot of time for pleasantries. This is a courtesy call. I thought I would let you know that I’m withdrawing my support for the Sea Snake Sonar in the Defense Appropriations Bill.” He listened briefly and then continued, “It’s over budget and it doesn’t work. You know that, I know that, the Navy knows that. I spoke to the Chair of Armed Services, and he agrees. We shouldn’t be spending a billion dollars on a sonar system that can’t tell the difference between a Russian submarine and a school of tuna.”

“That’s six thousand jobs,” Governor Hazlett answered on the other end of the line, loud enough for me to hear clearly.

“I understand that, which is why I wanted you to be the first to know,” the Majority Leader said with faux-sincerity. “You’re going to want to do some damage control.”

“Is this about the Dormigen thing?” Governor Hazlett asked.

“What do you think?” the Majority Leader asked coldly.

“I can certainly reconsider,” Governor Hazlett offered.

“That ship has sailed, Governor,” the Majority Leader said, “if you’ll forgive the nautical metaphor.”

Governor Hazlett began to protest, but the Majority Leader cut him off. “We have a lot going on here with this Dormigen situation. Thank you for your time.” He hung up.

I stared at the Majority Leader quizzically. “He’s not willing to participate in our plan to move Dormigen where it needs to go,” the Majority Leader explained. Now, the good thing about crappy weapons systems is that they come in handy when you need to get rid of them. And it really will save a billion dollars.”

After a few seconds, I worked up my courage to ask, “But you just hung up… Don’t we need him to agree to the Dormigen plan?”

“Oh, no. This is about sending a message to the other governors,” the Majority Leader said. “Sometimes you have to shoot someone like Hazlett in the head to get the others to pay attention. How do I get someone around here to issue a statement?”

I hustled down the corridor and returned with the Communications Director, who had been working to push out his own good news. The Majority Leader, leaning back in his borrowed chair, issued instructions: “Put out a statement over my name saying I’m withdrawing my support for the Sea Snake Sonar. It’s over budget, it doesn’t work, budgets are tight, blah, blah. Put a quote in there from the Armed Services Chair saying this will allow us to devote more resources to our troops. Then call the Armed Services Chair at home to tell him what he said.”

“Do you want to look at it before I send it out?” the Communications Director asked.

“No, it’s not that complicated,” the Majority Leader answered jauntily. After the Communications Director disappeared, the Majority Leader sipped his whiskey with evident satisfaction. “Now we’re going to use a little sugar,” he said to me. “Can you have someone connect me with Charlotte Johnson in Texas?” He looked at his watch. “In about half an hour.”

“It’s late,” I said, almost instinctively.

“Texas is an hour behind us,” the Majority Leader answered. “I need Governor Johnson to learn about what happened to Hazlett before we get her on the phone.”

I felt like I was a student in some kind of backroom political science tutorial. The Majority Leader sat patiently at the desk, sipping from his drink. He seemed perfectly comfortable with the silence, the waiting. After five minutes or so, I asked, “Is Governor Johnson refusing to ship Dormigen out of state?”

“Oh, no,” the Majority Leader replied, eager to share his strategy. “Charlotte’s a good egg. But she could waffle, and she’ll feel pressure to follow these other assholes. Texas is big and important. That’s where we need to hold the line. It’s like Lincoln in the Civil War: he knew he couldn’t afford to lose the border states.”

We went back to our silence. After a few more minutes, a young aide stuck his head in the door. “Governor Hazlett is on the line for you. He said you and he were just talking and there was some confusion about the Sea Snake Sonar—”

“Tell him to hold,” the Majority Leader said, exchanging a knowing glance with me.

“Of course,” the aide said compliantly.

The Majority Leader and I both looked at the phone on the desk, where a small red light began blinking hypnotically. “That’s Hazlett?” I said, pointing at the light.

“I would assume so,” the Majority Leader said. He sipped his drink.

The minutes passed. I finished my press release. The small red light continued to blink. I have never watched anyone sit still so contentedly. The Majority Leader did not check his phone. He did not make notes to himself. He did not feel compelled to make small talk. He sat stiffly in the chair, sipping his drink periodically, but mostly just still, like a hunter in a blind. Eventually the aide reappeared. “We’re going to place the call to Governor Johnson in Texas. Shall we send it in here?” he asked.

“Yes, please,” the Majority Leader said pleasantly. The small red light on the phone panel was still blinking. After a minute or so, both because I was uncomfortable with the silence and because I was curious, I asked, “How long are you going to keep Governor Hazlett on hold?” But before the Majority Leader could answer, the phone rang and he picked it up.

“Charlotte,” the Majority Leader said warmly. “It’s so good to hear from you.” He listened to pleasantries on the other end and then continued. “The President is up to his eyeballs in this Dormigen thing. He needs all the help he can get.” The Texas governor, not nearly as loud or as agitated as her fellow Alabama governor, said something about the Texas National Guard. “You are absolutely correct,” the Majority Leader assured her. “But as a personal favor to me, can we have that conversation another time?” he asked. The Majority Leader laughed loudly and warmly at whatever Charlotte Johnson said in reply. “Yes, that’s right,” he continued. “News travels fast. That Sea Snake system never did work.” He looked in my direction and gave a little smile. “Why not save the taxpayers some money?” the Majority Leader told the Texas governor, laughing some more. “Look, if you could spread the word among your buddies that the President could use a favor on this one, I would appreciate it. I owe you one, and the President owes you one.” He listened, nodded, and then chuckled. “My God, you really are something, Charlotte. Yes, that’s two favors: one from me, and one from him.”

After the Majority Leader hung up, the aide stepped back into the doorway and said, “Senator, I just want to remind you that Governor Hazlett is still on hold.”

“I’m aware of that.”

“Line one.”

“Okay, thank you.”

The Majority Leader stood and carefully lifted his jacket off the back of the chair. He was clearly invigorated by the phone calls. He put on his jacket, buttoning it deliberately. He was not a thin man, as I have noted, but he must have had a good tailor, because the jacket fit neatly over his sizable girth. The aide continued to linger in the doorway, looking at the phone on the desk, where line one was still blinking red. As the Majority Leader buttoned his last button, he looked at me and said, “There are sandwiches upstairs in the kitchen. Are you hungry?”

87.

THE PRIME MINISTER’S FLIGHT—DESIGNATED AIR INDIA One—landed in Germany and refueled without incident. The camera crew on board broadcast footage of the Prime Minister and his family resting comfortably in a small compartment built especially for them at the front of the cargo plane. There were beds, a bathroom, and a makeshift shower. The Prime Minister walked the camera crew through the cargo hold, showing off the pallets of Dormigen. “Five hundred thousand doses,” he explained to the viewers. “Each with the potential to save an American life.” As Air India One left Germany, the President was landing in Orange County for his tour of the areas that had been wiped out by the wildfires. “The Dormigen flight is on schedule. No more delays,” the Chief of Staff informed him.

“Then let’s make sure we stay on schedule,” the President replied. He wanted to be back in D.C. with a comfortable cushion for the Prime Minister’s arrival. The California visit went as planned—some pro forma visits to damaged areas, a breakfast with firefighters, meetings with local elected officials, and most important, a declaration of the affected counties as a federal disaster area. On the flight back to Washington the Chief of Staff briefed the President on the process for distributing the Dormigen upon the Prime Minister’s arrival. “Governors Goolsbee and Spencer are back on board with the plan,” she said.

“They had a change of heart, did they?” the President replied. “What about Hazlett?”

“He’s been very cooperative.”

The President laughed. “He’s not getting the Sea Snake Sonar back,” he said. The Chief of Staff shrugged. That was a problem for next week. “I’d like to send the Majority Leader a bottle of that Irish whiskey,” the President continued.

“That’s a nice idea,” the Chief of Staff agreed. “I’ll do that.”

With that, for the first time since the beginning of the Outbreak, the President found himself with nothing urgent to do. He watched a romantic comedy for a while and then drifted off to sleep.

The Indian Prime Minister, however, had not played his last card.

88.

OVER THE NORTH ATLANTIC, ROUGHLY TWO HUNDRED NAUTICAL miles off the coast of Newfoundland, the Prime Minister took the controls of Air India One. The President was working in his office in the family quarters of the White House, having showered and dressed after the whirlwind California trip, when the Chief of Staff burst in. “Turn on the TV.”

CNN was showing live footage of the Prime Minister at the controls of the 747, ostensibly flying the plane. He checked several gauges, conversed with his copilot, and generally went through the motions of flying a plane. A banner along the bottom of the screen explained: “Indian PM takes the pilot seat on historic lifesaving flight.”

“He’s a pilot,” the President offered.

“Does he know how to fly a 747?” the Chief of Staff asked.

“God, I hope so.”

“It’s probably on autopilot, don’t you think?” the Chief of Staff said optimistically.

The two of them watched the live broadcast, transfixed like so many other viewers around the world. Some four hundred million people were watching in India as the Prime Minister piloted Air India One toward Washington. Even in bustling Mumbai, where business types typically dismissed political shenanigans, groups of people gathered informally in front of televisions in restaurants and cafés to watch their Prime Minister at the controls of the 747. The film crew on board broadcast the cockpit audio, so that viewers could hear communications between the flight crew and air traffic control, beginning when Air India One made radio contact with the air traffic station in Gander, Newfoundland.

“Greetings, Air India One,” a voice crackled over the radio, with a hint of a Canadian accent. “Maintain your current altitude and bearing.”

“Roger that,” the Prime Minister answered confidently.

Soon thereafter, the plane was handed off to the FAA Washington Center in Leesburg, Virginia. “Washington Center, this is Air India One,” the Prime Minister said loudly.

“Go ahead, Air India One,” a female voice responded.

“We are requesting permission to enter American airspace.”

“Roger that, permission granted,” the woman replied. And then, with over a billion people listening, she continued, “On a personal note, Captain Joshi, may I be the first to officially welcome you and your crew to the United States of America.”

“It’s an honor, ma’am,” the Prime Minister replied.

In the White House, the President said, “The guy is a fucking genius—a political genius.”

The Chief of Staff replied, “I just hope he doesn’t crash the plane. That would be a sad end to all this. Seriously, do we know if he can fly a 747?”

“I do think it’s on autopilot.”

“What about landing? You know he’s going to want to land it himself,” the Chief of Staff worried aloud.

The phone in the President’s study rang, interrupting their conversation. The President answered, listened for a moment, and then said caustically, “Of course he has.” He turned to the Chief of Staff and said, “The Prime Minister has requested a flyover of the Capitol.”

“At what altitude?” she asked.

“I don’t know. Would you know the difference?”

“No, but I have a bad feeling about this.”

The President went back to the phone call. “Look, I don’t care about the noise restrictions. We can apologize for that later. But could you please inquire discreetly whether this guy really should be flying a 747?” The President listened for a while and then hung up, turning back to the Chief of Staff. “They say he’s really good. He flew jets.”

As the President and Chief of Staff nervously watched the news coverage, the phone in the President’s study rang again. A White House operator informed him that Cecelia Dodds would like to speak with him. “I was worried we were going to lose you,” the President said when she was patched through.

“I’m not that easy to get rid of,” Cecelia Dodds replied warmly.

“How are you feeling”? the President asked.

“Like someone backed over me with a truck. They told me I’m not supposed to be on the phone, but I felt I owed you a call.”

“Are you watching this flight?” the President asked.

“The Prime Minister really knows how to make a point, doesn’t he?” she said.

The President laughed loudly. “Coming from you that’s high praise.”

“My intent was never to make things harder for you,” she said. “I hope you understand that.”

“Of course,” the President said honestly. “You didn’t make things easier, necessarily, but you know that. Sometimes I appreciate the moral clarity. Not always… Moral clarity is not usually the currency of choice in Washington.” It was not clear from the President’s tone if he was answering her question, musing aloud, or both. Cecelia Dodds listened, in any event.

Air India One did a low (1,750 feet), slow flyover of the Capitol Mall, dipping its wings as it passed over the White House. Tourists gawked at the enormous 747 flying bizarrely low over the city. Government workers hustled outside to witness the arrival of the historic flight. The Prime Minister was at the controls the whole way. Moments later the plane landed without incident at Joint Base Andrews. The landing and subsequent arrival ceremony was the most watched television event in Indian history—half a billion viewers—with many viewers in remote villages watching on their new televisions. The jumbo jet and its precious cargo taxied to a halt in an area where the President and First Lady were waiting. Seats had been set up on the tarmac for other VIPs. The entire NIH crisis group was there, as well as the White House staff who had worked on the Outbreak and the senior diplomats from the Indian Embassy. I was sitting in the second row with Jenna. The NIH Director, part of the official delegation welcoming the Prime Minister, stood slightly behind the President. Rows of Army trucks were parked near the terminal building, ready for the Dormigen to be unloaded and then reloaded onto the Air Force cargo planes that would fly it to the major population centers. One could feel the logistics folks ready to spring into action; the President had ordered them to stand down until the Prime Minister had his moment in the spotlight. (Of course, no one in the White House had anticipated how good the Prime Minister would be at shining the spotlight on himself—all down the Eastern Seaboard and over the Capitol at 1,750 feet.)

I found it all thrilling. The disappointment that we could not ward off the crisis with a scientific miracle had given way to the realization—valid, I still believe—that we had been part of a successful team effort. We were watching history, like being at Cape Canaveral when the moon shot was launched. The 747 taxied into position, the huge Indian and American flags on the fuselage gleaming brightly in the afternoon sun. Was that choreographed, or was it just luck? In any event, the perfectly illuminated flags provided an idyllic backdrop for the subsequent photos. A Marine band struck up a tune, something I could not identify but that felt vaguely familiar. The staircase was wheeled into position as the jet door popped open. The Prime Minister appeared and waved jauntily to the crowd.

The President walked to the bottom of the stairs, leaving the First Lady (wearing her wedding ring once again) and the others in the welcome party behind. The Prime Minister descended slowly, pausing about halfway to give a crisp salute in the direction of the Marine color guard standing at attention on the tarmac. The President, almost instinctively, began to climb the stairs so that the two men met on the second step. The Prime Minister extended his hand, which the President grasped, pulling the Prime Minister into an embrace, almost like two children. This was the photograph broadcast around the world: the two leaders locked in a bear hug. The Prime Minister was looking over the President’s shoulder, beaming at the adoring crowd. The President had closed his eyes in an expression that looked like profound relief.[32] Two politicians. Two statesmen, I suppose, though even now I would be hard-pressed to explain the difference. “I’m very glad to see you,” the President whispered to the Prime Minister, who laughed heartily.

“It’s good to be here,” the Prime Minister replied. “Yes, it’s good to be here,” he repeated. “And how are you doing, Mr. President?”

In a moment of candor—one elected head of state to another—the President of the United States replied, “I’m very tired.”