Mr. Preston:
Unless you include the feeling generated by gazing into the eyes of a waving confrontational cobra, “fascination” is not what I feel about Ebola. How about “shit scared?”
Two days after he and his colleagues isolated Ebola virus for the first time, Karl Johnson headed for Africa in the company of two other C.D.C. doctors, along with seventeen boxes of gear, to try to organize an effort to stop the virus in Zaire and Sudan (the outbreak in Sudan was still going on). They flew first to Geneva, to make contact with the World Health Organization, where they found that the WHO knew very little about the outbreaks. So the C.D.C. doctors organized their equipment and packed more boxes, getting ready to go to the Geneva airport, from where they would fly to Africa. But then, at the last possible moment, one of C.D.C. doctors panicked. It is said he was the doctor assigned to go to Sudan, and it is said he was afraid to proceed any farther. It was not an unusual situation. As Karl Johnson explained to me, “I’ve seen young physicians run from these hemorrhagic viruses, literally. They’re unable to work in the middle of an outbreak. They refuse to get off the plane.”
Johnson, one of the discoverers of Ebola virus, preferred to talk about these events while fly-fishing. (“We’ve got to keep our priorities straight,” he explained to me.) So I flew to Montana and spent a couple of days with him fishing for brown trout ont the Bighorn River. It was October, the weather had turned clear and warm, and the cottonwood trees along the banks were yellow and rattled in a south wind. Standing waist-deep in a mutable slick of the river, wearing sunglasses, with a cigarette hanging from the corner of his mouth and a fly rod in his hand, Johnson ripped his line off the water and laid a cast upstream. He was a lean, bearded man, with a soft voice that one had to listen for in the wind. He is a great figure in the history of virus hunting, having discovered and named some of the most dangerous life forms on the planet. “I’m so glad nature is not benign,” he remarked. He studied the water, took a step downstream, and placed anther cast. “But on a day like today, we can pretend nature is benign. All monsters and beasts have their benign moments.”
“What happened in Zaire?” I asked.
“When we got to Kinshasa, the place was an absolute mad house,” he said. “There was no news coming out of Bumba, no radio contact. We knew it was bad in there, and we knew we were dealing with something new. We didn’t know if the virus could be spread by droplets in the air, something like influenza. If Ebola had spread easily through the air, the world would be a very different place today.”
“How so?”
“There would be a lot fewer of us. It would have been exceedingly difficult to confirm that virus if it had any major respiratory component.
I did figure that if Ebola was the Andromeda strain—incredibly lethal and spread by droplet infection—there wasn’t going to be any safe place in the world anyway. It was better to be working at the epicenter than to get the infection at the London opera.”
“Are you worried about a species-threatening event?”
He stared at me, “What the hell do you mean by that?”
“I mean a virus that wipes us out.”
“Well, I think it could happen. Certainly it hasn’t happened yet. I’m not worried. More likely it would be a virus that reduces us by ninety percent.”
“Nine out of ten human killed? And you’re not bothered.”
A look of mysterious amusement crossed his face. “A virus can be useful to a species by thinning it out,” he said.
A scream cut the air. It sound nonhuman.
He took his eyes off the water and looked around. “Hear that pheasant? That’s what I like about the Bighorn River,” he said.
“Do you find viruses beautiful?”
“Oh, yeah,” he said softly. “Isn’t true that if you stare into the eyes of a cobra, the fear has another side to it? The fear is lessened as you begin to see the essence of the beauty. Looking at Ebola under an electron microscope is looking at a gorgeously wrought ice castle. The thing is cold. So totally pure.”
Karl Johnson became the chief of an international WHO team that gathered in Kinshasa.
The other C.D.C. doctor, Joel Breman, who had flown with Johnson to Zaire, became a member of a field exploration team that boarded an aircraft bound for the interior to see what was going on in Bumba. The airplane was a C-130 Buffalo troop-transport, an American-made military aircraft that belonged to the Zairmen Air Force. It happened to be President Mobutu’s private plane, equipped with leopard-skin seats, folding beds, and a wet bar, a sort of flying presidential palace that ordinarily took the president and his family on vacations to Switzerland, but now it carried the WHO team into the hot zone, following the Congo River north by east. They sat on the leopard- skin seats and stared out the windows at endless tracts of rain forest and brown river, a featureless blanket broken by the occasional gleam of an oxbow lake or a cluster of round huts strung like beads on a barely visible road or footpath. As he leaned against the window and watched the terrain unfold into the heart of Africa, Breman became terrified of coming to earth. It was safe in the air, high above the immeasurable forest, but down there… It began to dawn on him that he was going to Burmba to die. He had recently been assigned to Michigan as a state epidemiologist, and suddenly he had been called to Africa. He has left his wife back home in Michagan with their two children, and he began to suspect that he would never see them again. He had brought an overnight bag with a toothbrush, and he had managed to pack a few paper surgical masks and some gowns and rubber gloves into the bag. He did not have proper equipment for handling a hot agent. The Buffalo descended, and the town of Bumba appeared, a rotting tropical port spread out along the Congo River.
The Buffalo landed at an airstrip outside the town. The plane’s Zairmen crew was terrified, afraid to breathe the air, and they left the propellers idling while they showed the doctors down the gangway and heaved their bags out after them. The doctors found themselves standing in the backwash of the Buffalo as it accelerated to take off.
In the town, they met with the governor of Bumba Zone. He was a local politician, quite distraught. He had found himself in deep waters, in over his head. “We are in a bad way,” he told the doctors. “We have not been able to get salt or sugar.” His voice trembled on the edge of weeping as he added, “We have not even been able to get beer.”
A Belgian doctor on the team knew how to handle this situation. With a dramatic flourish, he placed a black airline pilot’s bag on the table. Then he turned the bag upside down, and wads of currency slapped out, making an impressive heap. “Governor, perhaps this will make things a little better.” he said.
“What are you doing?” Breman said to the Belgian.
The Belgian shrugged. “Look, this is the way things are done here.”
The governor scooped up the money and pledged his full cooperation together with all the extensive resources of government at his disposal—and he loaned them two Land Rovers.
They pushed north toward the Ebola River.
It was the rainy season, and the “road” was a string of mudholes cut by running streams. Engines howling, wheels spinning, they proceeded through the forest at the pace of a wall, in continual rain and oppressive heat. Occasionally they came to villages, and at each village they encountered a roadblock of fallen trees. Having had centuries of experience with the smallpox virus, the village elders had instituted their own methods for controlling the virus, according to their received wisdom, which was to cut their villages off from the world, to protect their people from a raging plague. It was reverse quarantine, an ancient practice in Africa, where a village bars itself from strangers during a time of disease, and drives away outside who appear.
“Who are you? What are you doing?” they shouted to the Land Rovers from behind a barrier of trees.
“We are doctors! We are coming to help!”
Eventually the people would clear away the trees, and the team would proceed deeper into the forest. In a long and desperate day of travel, they penetrated fifty miles away from the Congo River, and finally, toward evening, they came to a row of round, hatched African houses. Beyond the houses stood a white church in the middle of the forest. Around the church, there were two soccer fields, and in the middle of one field they noticed a heap of burned mattresses. Two hundred yards farther on, they came to the Yambuku Mission Hospital, a complex of low, whitewashed buildings made of concrete, with corrugated tin roofs.
The place was as silent as a tomb and appeared to be deserted. The beds were iron or wooden frames
