-Dan
Prologue
September 22, 1918, Vilosplad, Russia
The gray air filled with the moans
of those still alive. The barely surviving were carrying the dead, as they were
coughing and wheezing through the rain. The old and the young already gone.
Those lucky enough to pass in the early days were buried with respect. Now,
large unmarked holes marred the landscape. Filled with the dead in the tattered
clothes they ended their lives in. No one left to clean them and dress them. No
one left to attend to their final religious rites. The town priest, old and
weak before the plague, died soon after the second wave of disease. The third
wave though, was the worst. Now they we’re losing the healthy ones. The ones
who were supposed to rebuild the community, write about their lives and to
remake their future. Just one more blow after a decade mostly filled with war
and hate.
Anatoly gazes upon his fellow
villagers, or rather, what was left of them and thought “Will there even be one
to remember who we were?” The pain felt too great. In the past weeks he had
buried his wife, his children, even his grand children. And now he could feel
the disease coursing through his own body. And now, even he shakes with fevers,
a racking cough, and fatigue. Oh the fatigue. He used to be able to carry two
sacks of flour on each shoulder and walk miles. Now, even the weight of his
wasted self he can barely carry. No, it can’t be long before it’s his turn for
that big hole of hell in the ground. Maybe, if there is something resembling a
god, he will be with his lovely Ana once again.
From a hilltop little Ivan watches.
No, he won’t go near them. His mother sent him away when she heard about the
disease from the next town. She sent him away with bags of barley, dried meat
and fruit. She told him not to come down to the village. No matter how loud the
people screamed, no matter how much he missed his family and friends. He was to
stay away, hide, and she implored him don’t come back until the winter comes.
After the ground has frozen it might be safe. “But not a moment sooner.”
Ivan can see an old man shuffle to
the graves. He stands over them for a long minute. Swaying to and fro. The rain
picks up and its hard to see and then the old man is gone. Ivan turns around
and hikes back into the hills, to his makeshift home, to wait for winter to
come.
Spring 2008
Chapter
1
Siberia
Two men step out of a black
Mercedes sedan. One, very Russian looking. He is heavy, short, thick necked and
thick waisted. He scans the horizon with his small dark eyes and permanent
scowl. The other man is tall and very
thin. Olive skin and large brown eyes set him apart from the usual visitors
here. He is very Middle Eastern looking and very out of place. He walks around
to the trunk and removes a heavy sack. He turns to the Russian and with a tilt
of his head gestures toward an old man, stoop shouldered in tattered brown
clothing. The Russian walks over to the old man and they begin to talk in
Russian. They seem to be negotiating. There is some finger pointing. The
Russian looks at the old man, angry now. He looks as if he might break him in
two. Finally, with a grunt the Russian pulls out a fold of bills. The old man
stares at the crisp American dollars as Russian peals off a few and hands them
to the old man. The old man seems wary but gestures them forward.
All three depart the road and hike
along a meadow path. The grass is bright green, the meadow erupting in wild
flowers. They travel over a hill. Down below is a collection of crumbling
buildings. The old man stops. He will not go any further. He points to what is
left of the old village. His rheumy eyes look up at the two men. He waits. The
Russian reaches into his pocket. He begins to remove his wallet when a loud
crack erupts. The old man falls backward with a hole between his eyes but
instead of surprise he has a look of total acceptance. The Middle Eastern man
puts his gun away, puts the strap of the sack on his shoulder and begins to
hike down the hill toward the abandoned village.
The two men enter the remains of a
very old village. The buildings have been abandoned long ago, the roofs caved
in and the fences collapsed. They continue down what must have been at one time
the main road. The road makes a turn to the right and behind a crumbled fence
is a barely visible marker. They begin hiking through brush and bramble over
ancient and toppled headstones. Toward the back is a large mound. There is no
marker. The Russian turns to the Middle Easterner and nods. The slender man
sets down the sack, unzips it and begins pulling out items. He puts on a
plastic suit, gloves, mask and goggles. Next he removes a shovel and begins to
dig. The earth is soft now that the
frost has melted and the ground is still moist. He digs rapidly through the
soft earth and then the ground becomes hard again. He has reached the layer
where the frost never melts. He pulls out a pick and swings at the ground to
loosen the earth. Hard clumps come up and after toiling for a little while he
starts to see shreds of gray and brown cloth. He slows his pace and begins to
pick at the earth with finer tools. Soon he has uncovered two bodies one lying
across the other. He gets very serious now. He carefully removes the clothing
from the torso of a man. He gently cleans the soil away.
For Ahmed knows that great respect
must be paid to the dead. Even the infidels are to be treated with respect,
even those abandoned and mistreated by their own. He turns to the East and
makes a nearly silent prayer before resuming his task. He removes a scalpel and
makes an incision on the dead man’s right side. He cuts through the rib cage
and inserts a device to spread the ribs. Next he reaches into his sack and
removes a thermos looking container. He opens the container by releasing two
latches and inside is a second container with a screw top.
Next he changes his gloves and dons
two layers. He reaches into the chest and feels the hard frozen lung tissue.
Perfect, he thinks to himself. He removes a new knife with a long serrated edge
and cuts into the tissue. He is able to remove a piece the size of a tennis
ball. He looks at it in the light and can see that the dark brown tissue is
filled with a thick frozen yellow liquid. He carefully quarters the flesh and
places it in the container. He screws the cap on and applies an adhesive tape
around the lid. Next he washes the receptacle down with pure alcohol. Again he
changes his gloves. He then places the container into its parent and seals the
latches. He reaches into his bag and removes an object that looks like a squat
cylinder with a thread top. He screws this into the thermos and twists a valve.
A hiss is emitted and the exterior of the thermos quickly frosts over. He puts
on a pair of insulated gloves and places this into a collapsible insulated bag
that he removed from the sack. Next he gently places a white sheet over the
body and says a prayer for Allah to accept the soul of this infidel for the
sacrifice he has made for the nation of G-d.
He then covers the bodies with the
dirt. When he is done he removes his protective gear. He asks the Russian to
turn away and he then removes his clothing. He puts all of this in a pile and
soaks it with lighter fluid and ignites it. When the fires is out and he has
put on fresh clothes he lays down a prayer mat and facing East prays thanks to
Allah for this great day.
The men hike back to the Mercedes
and depart.
Chapter
2
Lahore, Pakistan Farmer’s Market
Ten year old Ahmed runs through the
market with his younger brother Mastouf close behind. Ahmed is laughing as he
rounds the corner nearly sliding on the banana peels on the ground. He skids to
a halt and Mastouf runs into him right in front of the bird cages. In front of
the boys a cacophony of chirps and shouts break out among the chickens. The
boys carefully look through the cages, like diamond merchants scrutinizing a collection
of rare gems. The chickens are of various color combinations, some deep red,
others white. Most of the birds look malnourished and weak. One is barely
moving. Mastouf puts his small hand between the wires of the cage and gives the
bird a poke. The bird barely moves and he pokes again. This time the bird
breaks out in a riot of chirps and hisses and Ahmed yells at his younger
brother, “Get your hand out of there! Are you crazy, that one looks sick.”
Mastouf pulls his hand back out quickly and looks down at his feet. He is
embarrassed that he disappointed his big brother. Ahmed can see it in his eyes
and feels sorry. “Hey, don’t worry, I got a nice one here.” Ahmed shows his
brother the big bird with bright eyes and a plume of red and yellow feathers. He
gestures to the shop keeper who nods his ok and the boys take the bird out of
the cage. “This one looks healthy, I think she can make us some good eggs.
We’ll take her.” Ahmed reaches into his pants and pulls out a crumpled pile of
colorful bills. He quickly concludes the negotiations with the shopkeeper and
they bring the bird home in a burlap sack, squawking the whole way.
As soon as the boys get home they
run in the door yelling “Mama we got a perfect chicken, she’s gonna make
perfect eggs, come look!” Their mother pokes her head out the door of their
small one room home and reaches over and takes a look in the sack. “Perfect, my
children, you have found us the perfect chicken. Now go get her into her cage
and we can hope for an egg in the morning.” The boys, who ran in the front of
the single room house now race straight out the back into an alley. Against the
house was a stack of rusty and empty cages. Just as they were getting ready to
put the bird in, one of the neighbor boys strolls over. “So, what have you got
there Ahmed? Going to give it another try? Birds can’t live here, it’s too
dirty and cold back here.” Ahmed looks up at the older boy and just as he does
he sees the boy’s younger brothers and sisters form into a large circle around
him and Mastouf. “Well why don’t you at least let us see her?” Hesitantly,
Ahmed complies and passes the sack around for all of the children to see. After
the bird was given a complete tour of all six brothers and sisters Ahmed placed
her into her cage with a small cup of corn and a tin filled with water. Just
then his mother steps out into the alley, “Ok, the show is over, time to go
home!” And with a flurry of arm movememt
she shooed the other children away.
Chapter
3
Ann Arbor, MI
Alex sits down at the counter of
Angelo’s Café with her cup of coffee, in the background just audible over the
noise of the small and bustling restaurant she can hear National Public Radio.
She bites into her French toast as the news begins to unfold. “Today is the
1835th day since the President declared victory in Iraq. Three more service men
killed by IED’s in Basra and scores of Iraqis die in a suicide bomb attack in
central Baghdad. The President says the
surge is working…” Alex rolls her eyes. Fortunately, Angelo’s locally famous cinnamon
raisin French toast makes the news more palatable. Angelo wanders over to the
counter and smiles at Alex. He’s a large man, round with thinning gray hair. He
smiles at Alex “More of the same, eh?” Alex looks up at Angelo, his white apron
with the patches of grease stains, the warm brown eyes, and his thin gentle
smile. “The candidates in this upcoming election don’t have a clue either,
Angelo. This war is more ancient than our leaders will ever know and is more
complex than they can ever comprehend. Until they get touched close by the
insanity they will never know..." Alex has that faraway look in her eyes
than Angelo has seen before. Before Alex can drift into the darkness he booms
out with his deep baritone voice, "Anyway, too much misery for such a
beautiful day, Alex, I say we save the world with your smile." Alex starts
to smile again, her blue green eyes begin to soften and she pulls back in to
the moment. "Take care Angelo.” Alex takes a look at the check, pulls some
bills out of her wallet and lays the money on the counter. As she walks out she
can overhear the newscasters, “President Ahmadinejad refuses to back down to
nuclear inspections, President Bush irate and threatens action.”
Alex stands, looks out through the
old wooden café door and steps out into the sunshine. Well at least today is a
glorious spring day. The green leaves on the trees have that intense
fluorescent green, the cherry trees visible across East Ann Street have
blossoms and all the birds are shouting to their potential mates. Alex smiles
to herself, the thoughts of her past fading as she begins to think of her own
potentials when a yell from behind stops her in her tracks. She turns to see
her close friend Paula all laughs and giggles. “So, any plans for tonight? I
thought we might check out the comedy show down at the union.” Paula has long
brown hair, big almond eyes, and an infectious smile. She’s a little heavier
than she would like but she this is offset by her generous figure which is on
display in her tight low cut brown shirt. “Sure Paula, and are you going to
finally stand up and try out your
routine, or do we have to wait for some talent scout to catch you trying your
lines out in your bathroom?”
Paula has been a wannabe comedienne
since the two became best friends in grade school. She has always been the
funny one and for the last several years now Alex the serious one. Paula gives
Alex balance and without her Alex would have easily lost herself after going
through “the tragedy”. Fortunately, this best friend has always been by her
side to cheer her up and keep her social. And Alex has done her part for Paula
as well. Back in high school when partying was all the rage there were some
close calls. If Alex hadn’t yanked her out of those parties and hadn’t pushed her
Paula probably never would have finished high school, let alone been accepted
to Michigan.
“Ok, I’ll come by around 7:30 and
we can grab some food upstairs at Charlie’s before the show”. Paula smiles and
with a twinkle in her eyes she takes off in the opposite direction, “Awesome
Alex, see you then!”
Alex heads around the corner and
into the Med Sciences building. The building was probably modern and clean
looking when her dad was in school twenty-something years ago, but now the
white-yellow exterior looks a bit sad and shabby under the watchful eye of the
new gleaming University Hospital addition. She swipes her ID card and heads in.
Medical students are scurrying around looking for labs and lecture halls. The
smell of formaldehyde wafts out of the Gross Anatomy lab around the corner.
Alex turns into the stairwell and begins her three story climb up to the
microbiology floor. The stairwell railings are black painted iron and probably
have their own microflora that could represent it’s own publication. She always
avoids those railings, who knew what nasty critters had been innocuously
carried out of a lab by a careless and sloppy assistant. At the third floor
door she swipes her card again and enters the stained linoleum hallway to her
lab. A finger print reader and she’s in. The whole thing seamed ridiculous.
Ever since 9/11 they added security to all of the labs. This was before Alex’s
time but apparently back then they did background checks on everyone, issued
secure ID’s and fingerprinted everyone. Alex wasn’t quite sure what of value
could have been taken from the Gross Anatomy lab that would bring terrorism to
the hills of Ann Arbor but the laid back atmosphere in the labs was quickly
replaced by apprehension and paranoia and more than one post doc left to go
into a different line of work. Apparently the stress level had relaxed a bit
and now the only labs requiring intensive scrutiny and security were those
either working with infectious disease or those using radioactive substances.
Both were present in Dr. Zack’s lab and so they gave him a secure floor. Funny
thing was that any first year engineering student could probably outsmart the
security anyways. Most of this stuff was off the shelf at Best Buy.
As Alex walked in she could hear
the news again coming from Dr. Zack’s office. The news now was about Iran and
nuclear weapons. The Americans were angry that the Europeans couldn’t get Iran
to guarantee to stop enrichment and a lot of posturing was going on. The Vice
President, “The Dick” as he was affectionately referred to by Dr. Zack, was
pushing for a military strike. The Presidential candidates were split, and the
lame duck president was equivocating. As Alex turned the corner she could hear
Dr. Zack shouting at the radio. She stepped into his office and he smiled. Dr.
Zack was true Ann Arbor. Raised by two Ph.D. parents he had been here all of
his life. He was a certified genius and perpetually stuck in the 1960’s despite
the fact he was about ten years old when they ended. He always has on a tie
dyed shirt, a collection that would be the envy of Jerry Garcia. His wiry gray
hair is tied back in a pony tail and he wears gold wire rimmed glasses. He had
taken Alex under his wing a few years ago when her world collapsed around her
and between Paula and him her ship has been slowly righted.
His blue eyes look Alex up and down
and he smiles widely. “I think our boy here may have finally pulled things
off”, Dr. Zack was eyeing a poster on his door of a slender black man with
short cut hair smiling in front of the American flag. “I think my buddy Barry
may just bag this nomination today, did you vote?” Alex had been harassed
regarding the upcoming vote for the candidates for President for weeks now. She
had developed a firm policy of voting for absolutely nobody in any election.
She was certain that no President would ever truly understand her needs and
losses and she couldn’t muster the drive to vote for them. Despite this she
knew that Dr. Zack wouldn’t rest until he heard the answer he was looking for.
So through a falsely wide smile she nodded her head, “Sure, taken care of.”
“Excellent then, so I imagine your
ready for another day in the zoo. We have another sample of lung tissue from
that most recent avian flu outbreak in Pakistan. We need new cultures set up
and we need to do another trial for lethality and transmission.” Alex lets out
a groan. This was going to be another marathon and there was a very good chance
she would not make the show tonight.
Whenever the tissue came in from
these Asian countries the shipping was usually very sloppy. Last time the
specimen was fully rotted because the cooling packs leaked. Dr. Zack’s lab was
one of only three in the U.S. entrusted with these cultures. There was a lot of
pressure to identify what mutation would make the virus more contagious. The
first lab to figure this out would get a lot of PR not to mention that they
would be on the front line of the vaccine program. Even though Dr. Zack seemed
like a mellow guy, he was an academician and he relied on grants. No product,
no money. His last big success was over five years ago when he helped define
the strain of virus that was causing Mad Cow in the US and was able to help the
CDC trace the source to cattle from Canada. That little discovery put him in
the driver seat for a while, but the departments of infectious disease and
immunology were giving him a lot of heat lately for no recent breakthrough on
the “avian flu”.
Alex started to recall the lecture
she gave to Dr. Zack’s medical students last term. She was in charge of power
point slides in the lab along with just about all the other grunt work. After
putting the presentation together Dr. Zack asked her to just go ahead and do
the presentation. The whole idea was a bit unorthodox but everything about Dr.
Zack is.
The first slide went up on the
screen and Alex began the show. “Avian flu, so named because it is influenza
virus that is endemic in the bird population but people have been dying from it
for a few years now. The virus is scary because the mortality rate can be 80%.
We have seen it mostly in Asia because the populations they live in close contact
with birds." Next slide shows a dirty market in China, you can see sewage
running down the center of the street and a shopkeeper has dead chickens
hanging from hooks and just behind a stack of cages with obvious irate birds.
"Every now and then a person or group is exposed to an infected bird, they
themselves become infected and more often than not die. There isn’t any
treatment except supportive care and no vaccine has been developed yet."
Alex pops up a slide diagramming
animal to human transmission. "Historically, every twenty years or so, one
of the viruses endemic to a different species mutates and enters the human
population. Usually the sick, elderly and very young are quite susceptible and
die. This is why a cure for the flu is so difficult. New virus types keep on
entering the population. Even more scary is that about every eighty years a
super flu comes out and kills huge numbers of people. That’s what happened in
1918 and therefore Dr. Zack, the CDC and military have been focusing our research
on this bug because we think it is the best candidate for the next bad
event."
After the forty minute lecture the
students filed out. A couple raised hands with questions but most just quietly
moved on. Alex remembers leaving the room, wondering if she was on the correct
side of the podium. Her life would have been very different except for one very
bad day.
Chapter
4
September 9, 2001 NYC
Text: Alex, meet me at luggage,
can’t w8 2 c u. Dad
Reply: Ok me 2
“Hey hon, I feel like it’s been
forever!” Alex runs up to her dad, long blond hair swinging back and forth, a
sparkle in her blue eyes.
“I know what you mean, Dad. Hey, Hi
Kimberly.” “Hi Alex!” Kimberly and Alex embrace with a hug. They all turn, grab
their bags and head for the taxi line.
“Well you two, I think it’s about
time to share a little fun in the Big Apple. Last time I was here was about
fifteen years ago. I hear the town has changed a lot. Still a bit grumpy but
cleaner with a lot less crime. So you ladies want to chance the subway a little
this trip?”
“Sure Dad, just, you know, don’t be
cheap the whole time.”
“Hey you, I may resemble that
remark but I am very sensitive to teasing.” Alan shows an exaggerated pout.
“Ok, here’s the itinerary. I got us a place right near the Trade Center and
financial area. Today we can take one of those double decker tour buses.” Alex
let’s out a groan. “Come on Alex, it’ll be just a couple of hours and gives us
the lay of the land. Tonight we’re on our own. Tomorrow I have tickets to
“Phantom” for the matinee and we can walk around Time Square after. Monday my
meetings start and you guys are on your own.”
Alex, anxiously asks “So when do I
go shopping. I promised everyone in Tampa that I would check out the styles and
bring a bunch of things back.”
Alex had moved with her mom to
Tampa Bay a year ago and she still felt like she was caught in some bizarre
time warp. Every time she saw her dad she sensed an opportunity to enhance her
wardrobe. Being a complete daddy’s girl had worked well to her advantage and
Alan’s medical practice had been doing well lately anyways. Kimberly usually
went along but sometimes the manipulation would make her cringe. Just now the
look in her green eyes suggested that Alex was just about to cross the line.
Alan caught the look and to smooth things out decided a little diversion was in
order.
“Ok, I’m sure we’ll all have plenty
of time to spend your father’s hard earned cash. How about we check out the
town first?”
They all headed into the awaiting
taxi and started toward downtown Manhattan. About thirty seconds into the ride
Alex pulled out her cell phone and began dialing.
“Hey Tony, so we’re here. What are
you up to this weekend? Uh huh, sounds cool. No, my dad has planned out the
first two days to do a bunch of touring and shows.” Leaning into the phone and
whispering, “I’m gonna try and get hold of my cousin and see if she can save
me.”
“Hey Alex, is your mom ok with you
using the phone here?”
“Yeah dad, Tony’s on the same
carrier, the whole things covered”
Alan and Kimberly rolled their eyes
toward each other and Kimberly leaned in to Alan’s shoulder. As usual he was
sitting in the middle, between his two girls. The weekends always started out
this way. He would try to keep both girls feeling like they were equally
important. Eventually, they would push him to the outside and the two girls
would start sharing secrets and giggles. That was perfect to Alan, but he still
relished the attention and jealousy he triggered during those first hours.
They arrived at the hotel, unloaded
and rode the elevator to their room on the 44th floor overlooking
the Brooklyn Bridge. They all unpacked, the girls traded time in the bathroom
and changed for the days travels. Once all were ready, Alan grabbed the travel
books, they went to the subway and began to navigate the underground maze.
“Ok Alex, I want to show you this
stuff so if you decide to take off on your own you’ll know what you’re doing.”
Alan went over the subway map and showed Alex how the trains were color coded
and numbered and lettered. He explained the uptown downtown directions and what
to do if you get disoriented. Kimberly leaned in to hear the explanation as
this was her first time to New York City as well and she had plans to check
things out without Alan. She also had overheard Alex’s reference to her cousin
and figured she might be on her own on Monday and Tuesday.
Next, they were off on the Metro.
Exiting 49th Street they quickly found the tour buses. They found an
available open double decker and headed to the top just as Alex let out a groan
of embarrassment. Kimberly turned and gave Alex “the eye” and they move on to
find some seats. Alan breathed in the warm late summer air as the tour bus
headed down the street. Landmarks were progressively identified and the history
of each area was explained. Kimberly was jotting notes into the guidebook for
later revisits. Alex leaned over the bus and pointed out the various shopping
areas that enticed her. After a while she looked at her father and asked, “So
how much longer dad? I thought you said we could get out and walk around.”
“Yeah Alex, but the rides only two
hours and you have all weekend to walk around.”
“I know, but there are some places
here I really want to check out. Like how are we going to find these places
again. Can’t we just get off the bus and walk around? You know dad I didn’t
meet you here just to get stuck on tour buses all day long.”
Alan knew exactly what the issue
was. He could see Alex’s look, she was beginning to pout and her voice was
starting to whine. Obviously, there was something Alex wanted and she couldn’t
relax. She had been like this since she was little. In fact, Alan knew this was
really a trait she inherited from him. Once an idea was in his head he couldn’t
relax until it was dealt with, purchased, resolved, whatever. Now Alex was
starting to act the exact same way.
“Hey Alex, here’s the deal. Stick
with me on this bus for forty five minutes more. I know exactly the place to go
to. I promise you’ll love it. If I’m wrong you can control all of the plans for
tomorrow, no questions asked. Deal?”
“Fine.”
The bus continued the tour through
the village, into Soho and Chinatown and began to work its way uptown again.
Once they crossed Fifth Avenue Alan called to the girls “Time to go,” and the
three departed. They took a turn uptown and Alan marched them right into Saks,
then Tiffany’s and then Burberry. Alex’s eyes were the size of billiard balls.
She went through the racks at Saks, tried on jewelry at Tiffany’s and compared
the purses at Burberry. After two hours of intensive comparison shopping
interrupted by brief calls to her supervising girlfriends in Florida she began
to smile again. Alan made sure to keep Alex from spending all of her money,
reminding her that there was a long weekend ahead and every store she went into
would be a new opportunity.
“Remember Alex, you have the high
end traditional things around here, but tomorrow were going to walk around the
Village and Soho and those areas are trendy and edgy. Just keep control, check things out and most
of all have fun. Heck, hon, we’re in New York. Now I just have one thing we
have to do today. I’ve been wanting to do this since I booked this weekend.
Follow me.”
The three headed out and Alan
walked them toward Central Park. As they got there Kimberly new exactly what
was on Alan’s mind. Alan checked out the horses and chose a horse and carriage
dressed in beautiful floral bouquets for a ride around the park. They settled
into the carriage, Alan in the center, and they rode through the park on this
stellar fall day. Halfway into the ride the driver took a photo of the three of
them on Alan’s digital camera framing the horse and carriage and its three
passengers. The two girls with their heads on Alan’s shoulders and in the
background the sun breaking through the leaves on the trees.
Chapter
5
Lahore, Pakistan
“Oh Mastouf, what is wrong?” His
mother cried. She looked up to heaven with heavy eyes. “What is wrong with my
son” she thought to herself. For two days Mastouf had been acting irritable,
then he began coughing with a runny nose. This wasn’t alarming but then this
morning he barely woke up. His skin looked dull and he was hardly breathing.
She could hear the raspiness in his chest and every now and then he would have
a violent coughing fit and shaking chills. She had sent Ahmed to get the doctor
an hour ago but he hadn’t returned. All she could do was hold her small boy to
her chest and sing to him. Suddenly she heard noises at the door.
Finally, in walked Dr. Abed and her
older son. She grabbed Dr. Abed’s hand and led him over to Mastouf. Dr. Abed
took a look at the small child and the one room house he was living in. He
could hear chickens chirping in the coup in the alley. These weren’t the best
conditions in Lahore but they could hardly be described as the worst. The room,
although dark and aged was clean. He leaned into the child and listened with
his stethoscope. He could hardly hear the air move with each breath. Mostly
what he heard sounded like rales of fluid. He shined his light in the boy’s mouth
and could see that his gums were a dusky blue.
The only chance of survival for
this child would be at the main hospital, and that was if they could get him
there quickly and if there was room in the wards for the child. He looked over
to the mother, “He is very ill, his lungs are hardly working, he has caught a
very bad bug. We must take him to the hospital immediately.” The mother broke
out in sobs as the doctor picked up the child and carried him out the door.
Chapter
6
Ann Arbor, MI
“Alright Dr. Zack, I’ve got the
paperwork for this one and this time the CDC sent it with the history. Do you
want to take a look while I begin processing the specimens?” “No, that’s ok,
just take a look at the timeline and names and let me know what you come up with.”
Alex grabbed the box and went over
to the containment area. She slit open the card board box with a cutter and
lifted off the plastic folder with the manifest. Next, she lifted out the
Styrofoam case enclosed in the airtight plastic bag. This she took over to a
large plastic case with a drop down door. She opened the door and slid the
Styrofoam case inside and closed the door. Next she activated a button that
initiated a vacuum in the containment cell. She pressed another button and the
Styrofoam case was carried down a short conveyor belt to a work station. Alex
slid her hands into a pair of gloves through the wall of the plastic
containment cell. Next she grabbed a scalpel and slit the plastic case. She
gently opened the Styrofoam case and vapors escaped briefly coating the inside
of the containment cell and obscuring her view of the contents. Inside were two
containers filled with biologic material and marked with biohazard warnings on
the outside. She placed the packaging back on the conveyor where it was carried
to a mechanized door. Once the packaging entered the door it would be
incinerated at 2000 degrees Celsius.
She took the vials placed them on
another belt where they were carried into a controlled temperature cooling
room. Alex thought to herself that the vials would be safe for a while and she
turned her attention to the manifest.
She carried the paperwork over to her work station. She placed her right
hand over the finger print reader and her computer came to life. She entered
her password and logged into the labs data site. She read off the manifest and
reviewed the identifying information. The CDC organized the tissue sent to her
with a series of words and numbers. Each vial was sequentially
numbered in the series. They always started with the virus identification. In
this case H5N1-Pakistan-Lahore-051208-MS the second vial was nearly the same
H5N1-Pakistan-Lahore-051408-AS. Next she entered the summary findings from the
CDC. For some reason technology had not gotten to the point where they could
receive the manifest information electronically into their system. Probably a
fear of someone hacking the transmission. Either way, Alex was stuck once again
reentering the historical information.
MS admitted to Children’s Hospital
and Institute for Child Health Lahore (CHICHL) 05/10/08. This six year old
child had purchased a chicken with his older brother 3 days before admission
from the local farmer’s market. He developed cold and cough symptoms over the
next 24 hours. This progressed to congestion, fever, cough and chills. He was
admitted to the hospital on 05/10/08. Initial Influenza A screen positive. He
was immediately isolated and his symptoms rapidly deteriorated. He was
intubated and placed on respiratory support. Intravenous fluids and antivirals
were instituted. He rapidly progressed to kidney failure. Over his final 24
hours he had fulminant organ failure developed petechial hemorrhages over his
skin. He finally succumbed to the disease at 4:08 p.m. 05/12/08. Due to the
rapid progress of his death and the history of bird exposure a suspicion of
bird flu was entertained. The CDC in Atlanta, Georgia was notified. H5N1 was
confirmed on 05/12/08 and appropriate specimen containment was performed. Once
confirmation was achieved the Lahore Department of Health was notified for
appropriate quarantine procedures.
Alex proceeded to enter the
sequential laboratory values from the hospitalization. Once this was complete
she went on to the second vial’s manifest.
AS admitted to CHICHL 05/11/08 with
initial symptoms of fever and cough. Due to suspicion of H5N1 this ten year old
child, who is the older brother of MS, was immediately placed in isolation.
Alex continued to read essentially
the same story of progressive symptoms in the older brother. What a shame, Alex
thought. Some mother lost both of her children in just a few hours of each
other. Alex pondered the situation, she couldn’t comprehend losing a child but
she definitely understood losing two of your most important family members in
just a blink of time. Yes, she definitely understood. Alex pulled her mind away
from her past and focused on the task at hand. She now had hours of work to go
and she would have to work hard to even catch a glimpse of Paula tonight.
After completing the entry of data
Alex focused on her main task of the day. She walked over to the
bio-containment lab. The lab was very high security and required both
fingerprint and voice recognition. Once she entered the lab she donned her
“moon suit”. Alex usually enjoyed the complete peace and quiet of the lab
although she was always a bit annoyed with putting on the protective suit. Alex
had long, and currently blonde, hair and she was slender. Her hair tended to
get wrapped into everything in the protective suit and she always felt like she
was swimming inside the thing. But, once she was geared up and entered the
pressure lock she would practically enter a trance. Alex placed the earbuds of
her iPod in her ears and hit the play button. The mellow and melodical music of
Joe Jackson’s Night and Day album began to play. For a brief moment she
remembered listening to that album for her first time while riding with her
father and his wife, Kimberly, on one of their first trips together to the Lake
Tahoe ski resorts. As the sounds of the album filled her ears and the hypnotic
overhead fluorescent lights bathed the room in a uniform glow Alex’s mind became
super focused in the absence of visual and auditory distractions.
Alex went to the specimen cooler
and retrieved the two that she had sent into the cooler earlier that morning.
Next she retrieved six fresh chicken eggs each labeled with a bar code for identification.
She used a sterile needle and syringe and sequentially drew a few milliliters
of the turbid fluid in the specimen container and injected it into each of the
eggs. After each transfer she used a barcode scanner on both the egg and the
specimen. Fortunately, the eggs came pre-stamped with a unique barcode for
identification. In her first year in the lab she was tasked with stamping the
eggs, a potentially very messy process for someone new at the task and one she
did not recommend when nursing a hangover. She then placed the eggs in their
own isolated incubation chambers.
Next Alex went into the room that
housed the animals for testing. Usually several tests were done for both
virulence and transmissibility. The first was to see if a test animal could be
infected and then to see if the infection would spread from one animal to the
next. Alex took a look at the cages, twelve in all, each had it’s own ferret.
All of them looked healthy. Next she checked to make sure that all of the
monitoring equipment for each cage was in good order. Each cage had sensors for
heart rate, body temperature and weight. They also had automatic delivery of
air, food, water and even nitrous oxide for anesthesia. They also each had
their own video camera and were able to be monitored from the main lab. Even
though there was a person in charge of the ferrets Alex never trusted the lab
techs. She went through each cage in detail. After all, this was her study and
if she didn’t want to be wasting her time she needed to make sure all was well.
Finally, before leaving she checked to make sure the simulated daylight timer
was set correctly. If the ferrets were given the wrong amount or timing of
daylight they tended to be pretty stiff by morning.
By the time all was done and Alex had
changed out of the bunny suit and gear and had shut down and logged off all of
the computers it was only three o’clock in the afternoon. Good, plenty of time
to make the show and maybe even lay out on the deck of her studio apartment in
the sun. Paula was on at 9 and Alex thought she should have plenty of time to
change and get ready.
As Alex stepped around the corner
of the lab Dr. Zack came running out, “ Alex, we have another urgent delivery
coming. Seven more specimens from Lahore. They should be arriving any second.
They were given top priority from the CDC and they want us to start the
cultures ASAP! This is now the largest outbreak since last year. I need the
cultures run and then when complete we need to get everything over to the
electron microscopy lab to analyze all nine specimens for mutations in the
virus structure and I need you to run gel’s on all of these and compare the RNA
sequences to last year’s outbreak.”
Alex let out a grunt and rolled her
eyes but none of this was visible to Dr. Zack since he was yelling all of this
to her from inside his lab. “Great,” she thought, if she was incredibly lucky
and everything really did arrive in the next few seconds and she got all of the
specimens into cultures she would be lucky to get out by seven o’clock. There
goes her chance at catching the first real rays of sunshine Michigan had to
offer since October. Sometimes she wondered why she moved here at all. She
could have stayed in Florida with her mom and gone to a state school or she
even could have moved back to California. She still had a few friends there.
Somehow, here she was working in this lab, no real forward progress for years,
and far off of her original path. And, that original path was probably flawed
from the start. It was probably just a way to earn daddy’s approval and maybe
pull a little attention away from his new wife, the “beautiful and perfect”
Kimberly. And then, just as things started to slide into place and Alex began
to figure out where she fit in “the tragedy” struck.
A knock was heard at the door and
Alex walked over and let in the delivery man from FedEx. After signing off on
all three forms as well as the little tablet computer she took the box over to
her containment area and started working. First step, like always, rubber
gloves, open box, remove manifest and set to side. Next step pull out the
Styrofoam case in plastic and place it into the door to the containment cell.
Just like before she placed her hands into the articulated sleeves and opened
the case. Inside there were seven slots for specimens. Oddly, there were only
six specimens though. Well, Alex hoped it would all flesh out in the end. Maybe
they miscounted somewhere along the way. “Typical foreignors!” Alex thought to
herself. Alex finished up this portion and sent the respective items in their
appropriate directions. Styrofoam case and packing material to the incinerator
and specimens to the storage cooler.
Next she pulled out the manifest
and went to her work station. At least the initial work had already been
entered. If she was lucky then everything would be in sequence and the data
wouldn’t take too long.
Alex took a brief look at all of
the included paperwork. Indeed, there were seven people. Six children and an
adult. Everyone appeared to have expired on the fifteenth. The six children all
were treated at the same children’s hospital. The only standout was the one
adult female thirty-one years old. She never even made it to the hospital. She
was found dead in her one room house. There appeared to have been some sort of
a struggle which was attributed to psychosis from the hypoxic effect of the
virus on the lungs. There was a great deal of blood. The sheets were soaked in
it. She had a knife in her hand and had stabbed herself in the chest three
times. Due to the fear of contagion no one in Lahore wanted to touch her or
anything in the room. The local coroner apparently did a cursory look over the
body and brought her to the morgue. Ironically, the local Department of Health
official was in a home across the alley talking to the parents of the other six
victims. He had heard the commotion across the alley but hadn’t paid much
attention at the time. By the time word got to him about the adult he raced
over to the morgue and placed the whole area under quarantine. He then talked
to his superiors who then arranged for the harvest of specimen to be added to
the shipment of the six children’s.
All of this was in the manifest.
The whole sequence of events appeared very strange but who knew what was
“normal” in a Third World country. The six children made considerably more
sense. Apparently, all of them had played with the same bird brought home by
the original two victims. They all started coughing and sneezing that night.
The next day the local Department of Health official was walking through the
neighborhood to inform the neighbors of the outbreak and to watch out for just
such symptoms. As soon as he talked to the mother of the six children he had
all six sent to the children’s hospital. All six were placed in isolation and
all six died. Basically, an identical death of sneezing, then cough, then fever
and chills, followed by labored breathing, hypoxia and eventual death. No
supportive measures helped, all children had received antiviral medication but
it was too little and too late. The respirators only briefly prolonged their
very short lives.
As Alex read through the manifest
and entered the data into the computer she felt a twinge of sadness for the
tragedy that affected these two families. She also wondered whether this would
be “the one” the outbreak that finally raced through world causing the chaos
and death the CDC had been so worried about. The good news so far was that all
of the victims had physical contact with the bird. There was no mention of airborne
transmission. The only other oddity about this is that there was no mention of
the bird. Usually, the entire bird came in a separate shipment frozen. But, so
far no mention of the bird and whether it was being shipped. Once again, Alex
chalked this up to the relative incompetence of foreign nations when it came to
these issues. “After all” Alex thought to herself, “if they can’t even keep
track of a disease outbreak and a bird how are they ever to be trusted for
everything else?”
Dr. Zack shouted around the corner,
“So Alex how’s it all coming?”
“Well, at least everything arrived
on time. I just finished entering the data and I’m getting ready to go into the
Cave. I’m hoping I can be done in the next couple of hours. After I get the
rest of this cooking I’m going to take off. I think by tomorrow morning we
should be able to start the analysis.”
Dr. Zack stepped around the corner,
“That was pretty quick. How’d you get that data entered so fast?”
“Well, basically the six kids had
identical stories so I did a lot of copy and paste. The only one that doesn’t
fit is the adult mother of the first two children. She had a kind of weird
death. Also, I only got six specimens, I’m not sure which is missing and won’t
know until I get in the cave and start the cultures. Also, did you know that we
haven’t got a bird?”
“Hmmm, well I can send out a couple
of emails after you tell me which one is missing. Maybe it’s just a screw up at
the health department in Lahore.”
“Yeah, that’s what I was thinking
as well. Do you remember that outbreak last year when the Chinese health
department flipped around all of the ID information for the specimens and it
took like a week to figure out which person belonged to which specimen?”
“Oh yeah, just punch away and we
can catch up tomorrow. I also have a proposition I need to talk to you about,
but it can wait. I’m outta here. See you in the morning.”
“Ok, see you then.”
Once again the underling stays late
while the boss heads out. Probably to join his buddies to a smoke a joint in
the arboretum. Thoughts began to tumble through Alex’s head again, she was
frustrated and pretty annoyed. Maybe she should reenroll in the medical school.
They offered her an open opportunity to rejoin at any time. Alex knew that
eventually they would close that door she just wasn’t sure when. They gave a
lot of breathing room to the “flexies”.
Alex was one of a select few who
was given the opportunity in high school to enroll in Michigan’s special
program of accelerated medical training. In six years they combined undergraduate
and medical school curricula. In addition, they placed you in a research lab
during the first three summers. The hope was that the ultra-bright who entered
the program would use the shortened program to add on a Ph.D.. Some did, but
the program was so intense that a lot of kids didn’t finish in six years or
sometimes ever. Alex fit into the latter group at this point. She still wasn’t
sure what her destiny really was. Ironically, Paula, who took forever to
declare a major and couldn’t decide what she wanted to do with her life was now
nearing the end of her second year of medical school and was getting ready to
start her clinical rotations. Soon, she would be well ahead of Alex.
Alex pulled on the protective suit
and put in her ear buds. This time she decided to honor the sunny day outdoors
with a little Jimmy Buffett. Another tribute to daddy, who turned her onto the
music one day on a surf safari. As “Margaritaville” filled her ears her mind
turned away from her past and she began to focus on the task at hand. Carefully
she worked with each of the specimens, injecting tissue into the chicken eggs,
scanning the data, and placing them into the incubator.
Finally, Alex finished up, double
and triple checked the incubators, cleaned up and disposed of the needles and
syringes, changed out of the protective gear and reentered the main laboratory.
She stretched long and hard and took a look at the wall clock. Seven o’clock,
plenty of time to get home and maybe even hit the tanning salon on the way. Alex
headed out of the lab, turning off the overhead lights and proceeded down the
hall. She exited the stairwell and stepped outside.
The sky was already dusk and the
air temperature had dropped about twenty degrees. She walked over to the bus
stop and took the University bus down to South University Street. She got off
the bus and went down the street. She turned into an old wooden door and
ascended a narrow wooden staircase, she then entered through an even older
wooden door and came into a paneled room. Around the room were neon signs and
images of palm trees, waves, and over a small counter a rather too large neon
sign saying “Paradise Tanning”. This place must have housed dozens of different
businesses catering to different students tastes over the decades. She even
heard that it was a pinball arcade in her father’s years. Alex looked at the
student behind the desk. A young girl with long blonde hair and an obvious
indoor tan wearing a tank top and shorts. The room was warm, as it was all year
long, and a ceiling fan rotated overhead to create a gentle breeze. The music
playing over the stereo was an old Bob Marley recording. Alex presented her the
frequent user card, and the girl, Stephanie, punched one of the marks on the
card and indicated to Alex to use room three.
Alex went into room three and began
to undress. Since Alex didn’t really trust the cleanliness of the tanning unit
she did her usual thing and sprayed her own disinfectant on the tanning bed and
wiped it down. Just before she went to lie down she remembered she was supposed
to meet Paula for food across the street at Charley’s upstairs restaurant,
fondly referred to by Alex as “Up Chucks”. Alex quickly typed out a text,
“Sorry, ran late, at work, will meet at Union at 9.” Alex lay down on the tanning
bed and once again put in the earbuds, she clicked play and pulled down the
clamshell top of the tanning bed over herself. The warm tanning lights clicked
on and the tropical music of Chris Isaaks played into her ears. Alex began to
relax and the stress of the day began to dissipate. Her mind drifted as she
fell into a deep relaxing sleep.
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