'Good morning, I'm Dr. Alexandre,' he said to the patient. The man's eyes were listless, but it was the marks on his cheeks that made Alexandre's breath stop. It was George Westphal's face, come back from more than a decade in Alex's past.
'How did he get here?'
'His personal physician told his wife to drive him in. He has privileges at Hopkins.'
'What's he do? News photographer? Diplomat? Something to do with traveling?'
The resident shook her head. 'He sells Winnebagos, RVs and like that, dealership over on Pulaski Highway.'
Alexandre looked around the area. There were a medical student and two nurses, in addition to the resident who was running the case. All gloved, all masked. Good. She was smart, and now Alex knew why she was scared.
'Blood?'
'Already taken, Doctor. Doing the cross-match now, and specimens for analysis in your lab.'
The professor nodded. 'Good. Admit him right now. My unit. I need a container for the tubes. Be careful with all the sharps.' A nurse went off to get the things.
'Professor, this looks like—I mean, it can't be, but—'
'It can't be,' he agreed. 'But it does look that way. Those are petechiae, right out of the book. So we'll treat it like it is for the moment, okay?' The nurse returned with the proper containers. Alexandre took the extra blood specimens. 'As soon as you send him upstairs, everybody strip, everybody scrub. There's not that much danger involved, as long as you take the proper precautions. Is his wife around?'
'Yes, Doctor, out in the waiting room.'
'Have somebody bring her up to my office. I have to ask her some things. Questions?' There were none. 'Then let's get moving.'
Dr. Alexandre visually checked the plastic container for the blood and tucked it into the left-side pocket of his lab coat, after determining that it was properly sealed. The calm Doctor's Look was gone, as he walked to the elevator. Looking at the burnished steel of the automatic doors, he told himself that, no, this wasn't possible., Maybe something else. But what? Leukemia had some of the same symptoms, and as dreaded as that diagnosis was, it was preferable to what it looked like to him. The doors opened, and he headed off to his lab.
'Morning, Janet,' he said, walking into the hot lab.
'Alex,' replied Janet Clemenger, a Ph.D. molecular biologist. He took the plastic box from his pocket.
'I need this done in a hurry. Like, immediately.'
'What is it?' She wasn't often told to stop everything she was doing, especially at the start of a working day.
'Looks like hemorrhagic fever. Treat it as level… four.' Her eyes went a little wide.
'Here?' People were asking the same question all over America, but none of them knew it yet.
'They should be bringing the patient up now. I have to talk to his wife.'
She took the container and set it gently on the work-table. 'The usual antibody tests?'
'Yes, and please be careful with it, Janet.'
'Always,' she assured him. Like Alexandre, she worked a lot of AIDS experiments.
Alexandre next went to his office to call Dave James.
'How certain are you?' the dean asked two minutes later.
'Dave, it's just a heads-up for now, but—I've seen it before. Just like it was with George Westphal. I have Jan Clemenger working on it right now. Until further notice, I think we have to take this one seriously. If the lab results are what I expect, I get on the phone to Gus and we declare a for-real alert.'
'Well, Ralph gets back from London day after tomorrow. It's your department for the moment, Alex. Keep me posted.'
'Roger,' the former soldier said. Then it was time to speak to the patient's wife.
In the emergency room, orderlies were scrubbing the floor where the bed had been, overseen by the ER charge nurse. Overhead they could hear the distinctively powerful sound of a Sikorsky helicopter. The First Lady was coming to work.
THE COURIER ARRIVED at CDC, carrying his 'hatbox,' and handed it over to one of Lorenz's lab technicians. From there everything was fast-tracked. The antibody tests were already set up on the lab benches, and under exquisitely precise handling precautions, a drop of blood was dipped into a small glass tube. The liquid in the tube changed color almost instantly.
'It's Ebola, Doctor,' the technician reported. In another room a sample was being set up for the scanning electron microscope. Lorenz walked there, his legs feeling tired for so early in the morning. The instrument was already switched on. It was just a matter of getting things aimed properly before the images appeared on the TV display.
'Take your pick, Gus.' This was a senior physician, not a lab tech. As the magnification was adjusted, the picture was instantly clear. This blood sample was alive with the tiny strands. And soon it would be alive with nothing else. 'Where's this one from?'
'Chicago,' Lorenz answered.
'Welcome to the New World,' he told the screen as he worked the fine control to isolate one particular strand for full magnification. 'You little son of a bitch.'
Next came a closer examination to see if they could subtype it. That would take a while.
'AND SO HE has not traveled out of the country?' Alex was running down his list of stock questions.
'No, no he hasn't,' she assured him. 'Just to the big RV show. He goes to that every year.'
'Ma'am, I have to ask a number of questions, and some of them may seem offensive. Please understand that I have to do this in order to help your husband.' She nodded. Alexandre had a quiet way of getting past that problem. 'Do you have any reason to suspect that your husband has been seeing other women?'
'No.'
'Sorry, I had to ask that. Do you have any exotic pets?'
'Just two Chesapeake Bay retrievers,' she replied, surprised at the question.
'Monkeys? Anything from out of the country?'
'No, nothing like that.' This isn't going anywhere. Alex couldn't think of another relevant question. They were supposed to say yes to the travel one.
'Do you know anybody, family member, friend, whatever, who does a lot of traveling?'
'No—can I see him?'
'Yes, you can, but first we have to get him settled into his room and get some treatment going.'
'Is he going to—I mean, he's never been sick at all, he runs and doesn't smoke and doesn't drink much and we've always been careful.' And then she started losing control.
'I won't lie to you. Your husband appears to be a very sick man, but your family doctor sent you to the best hospital in the world. I just started here. I spent more than twenty years in the Army, all of that in the area of infectious diseases. So you are in the right place, and I am the right doc.' You had to say things like that, empty words though they might be. The one thing you could never, ever, do was take hope away. The phone rang.
'Dr. Alexandre.'
'Alex, it's Janet. Antibody test is positive for Ebola. I ran it twice,' she told him. 'I have the spare tube packaged to go to CDC, and the microscopy will be ready to go in about fifteen minutes.'
'Very well. I'll be over for that.' He hung up. 'Here,' he told the patient's wife. 'Let me get you out to the waiting room and introduce you to the nurses. We have some very good ones on my unit.' This was not the fun part, even though infectious diseases was not a particularly fun field. In trying to give her hope, he'd probably given her too much. Now she'd listen to him, thinking that he spoke with God's voice, but right now God didn't have any answers, and next he had to explain to her that the nurses would be taking some of her blood for examination, too.
'WHAT GIVES, SCOTT?' Ryan asked across thirteen time zones.
'Well, they sure as hell tossed a wrench into it. Jack?'
'Yes?'
'This guy Zhang, I've met him twice now. He doesn't talk a hell of a lot, but he's a bigger fish than we thought. I think he's the one keeping an eye on the Foreign Minister. He's a player, Mr. President. Tell the Foleys to
