CHAPTER 15

Smiling Buddha

Sometimes the light’s all shinin’ on me,

Other times I can barely see.

—Grateful Dead, “Truckin”

May Day in Socialist India was usually a time for workers to celebrate their achievements. It wasn’t true on May Day 1974 when the country was simmering with labor protests against Prime Minister Indira Gandhi and her Indian National Congress government. One of the most powerful union leaders, Georges Fernandes, president of the All India Railwaymen’s Federation, split with the prime minister and declared a nationwide strike, initially taking nearly 1.7 million railway workers and almost all the trains in India out of commission for a month. More unions threatened to join the work stoppages. India could grind to a halt.

If the trains weren’t moving, vaccine, vaccinators, and equipment might not get where they needed to go. If health workers joined the strike, it might kill the smallpox campaign in India. Prime Minister Gandhi jailed Fernandes; in retaliation Jayaprakash Narayan, one of Mahatma Gandhi’s most beloved disciples and “the Prophet of people’s power,” organized marches to replace her government with a “people’s government” in Bihar.

The chaos was terrible for the smallpox campaign.

The longer the campaign took, the more everything cost. WHO was running out of money. Our leadership team at SEARO in Delhi was also shorthanded: Bill Foege had returned to CDC in Atlanta to try to convince the U.S. government to increase its support; Zdeno was in South India fighting off importations from Tatanagar; Nicole, alone in Delhi and struggling with kidney stone attacks, was strongly advised to be medically evacuated to Switzerland for surgery. Fortunately, the Tatanagar quarantine had stopped the reinfections. This was the first good news after setbacks with the Government of India, the railway strike, and WHO’s cash shortfall.

J. R. D. Tata agreed to meet Nicole and me in New Delhi in spite of the fact that Mrs. Gandhi hadn’t yet approved the partnership. He was seriously contemplating our request to expand Tata funding from the containment of Tatanagar peninsula to the campaign for most of Bihar, the most troubled state. Nicole and I worked with our Indian colleagues to draft a plan, creating a new and separate entity, the Chotanagpur Smallpox Eradication Program, named for the six districts in the region where the epidemic raged. It would be the first joint venture of its kind, with WHO, the Government of India, the Bihar state government, and the Tata Companies in a partnership to eradicate smallpox.

With thousands of search workers and vaccinators, dozens of junior doctors and highly skilled mid-level Tata managers transferred from their related companies, we felt we could clear smallpox from the southern half of the state in six months. But our counterparts in the Indian government remained skittish; they didn’t believe J. R. D. Tata would agree to the huge amount of money needed, or that Prime Minister Gandhi, no friend to private industry, would permit it. No one from the Government of India had come to the Tata meeting because Mrs. Gandhi had yet to give a nod to the arrangement.

We arrived at the Tata House, located on Prithvi Raj road, an area usually reserved for embassies, in a WHO jeep with Nicole’s suitcase in the backseat. Having already delayed her surgery beyond reason, she was in a lot of pain, though she tried to hide it. If all went well she would leave directly from J. R. D. Tata’s home, pick up what she needed from WHO, and continue on to the airport for a night flight to Geneva for surgery. Sujit brought a two-page plan accompanied by appendices of charts, graphs, and budget projections that we had prepared together.

My cousin Myron Belkind from the Associated Press helped us prepare for the meeting with J. R. D. Tata. He supplied us with articles from the French press reporting that not only had J.R.D. been born in Paris to a Parsi Indian father and a French mother, he had attended French schools and boasted of his “French-ness” when away from India. Nicole could not have been more French, and she never looked more French or more elegant than she did for that meeting. She sauntered toward the entrance to the house like she was strolling along the streets of Paris.

J. R. D. Tata was full of élan and a burning curiosity, the picture of old-world elegance. He had been educated in France, Japan, India, and England, and we learned that day that he had also been a soldier in the French Army. This Persian-Indian-French legend helped develop some of India’s largest industries—airlines, railways, steel, tin, and other commodities. He was lean and straight, charismatic and direct. As chai was poured from intricately designed silver teapots into fancy English china, J.R.D. fired off staccato commands in Hindustani to his household staff, spoke in businesslike English with Sujit and me about what he wanted to accomplish in this meeting, and spoke warmly in French with Nicole, from whom he evoked what looked almost like a coquettish smile.

“Dr. Grasset,” he started, “I recognize my company’s obligation to clean up the mess we caused by our own inattention to the situation in Tatanagar. I am deeply sorry that unemployed youth—unemployed I might add because of the prime minister’s policy of nationalization of industry—were caught in the smallpox epidemic in Bihar and spread it through our towns and beyond. I have deployed our employees to help the district magistrates and the police enforce the quarantine, and I want to thank you and WHO and this young Brilliant here for helping us. I am willing to support cleaning up our mess and will fund the containment of smallpox in our towns.

“As far as the rest of the state is concerned, as far as the Chotanagpur area, why should Tata do the work of the Government of India? All the government does is try to stifle us. Besides our industrial grievances with the government, why stop with just this one disease? Your proposal is for Tata to provide jeeps and manpower and forty-two lakh rupees just for a single disease. I don’t mean to be unkind, but as long as people are poor, they will keep having more children. Until India has massive economic reform, you will never eradicate smallpox. Even if you do, the population will continue to explode and it will be the end of India. Tell me you will work on family planning, and I will give you lots of money.”

Nicole replied, trying to persuade J.R.D. that he and his company could have the chance to play a historic role in the eradication of the first disease in human history. “We four people drinking tea, sitting at this beautiful marble table, you and Sujit Gupta and Larry and I, we are part of the warp and woof of history.” She then offered him a chance to step into a key role on the stage of history, joining the Russians and Americans, the Indians and Africans, the doctors and United Nations visionaries.

The French government and French people would love him and regale him, she added, if he, as much a Frenchman as an Indian, helped conquer a disease that Napoleon himself had created sanitary rules against and that Louis Pasteur had battled; the disease that had killed the French monarch Louis XV, Louis the Beloved. She placed J.R.D. into history as an Indian patriot helping to liberate a country from an ancient scourge. Nicole reasoned that only an Indian businessman, not the government alone, could accomplish this. “In the end,” she said, “it is not about socialism versus capitalism, government versus industry; it is about what kind of a man you are. You can help to eradicate smallpox forever. You can be part of the greatest public health success in history.”

Then she brought her high-minded overview down to concrete examples. She spoke about what D.A. had done organizing a worldwide program, and what Bill had done in Africa. She offered Madhya Pradesh as proof of how an entire Indian state had been cleared of smallpox in six months. When J.R.D. countered with the bad press over sky-high levels of smallpox, Nicole brushed it off, reminding him that these new reports of smallpox were the result of a well-organized house-to-house search that broke open decades of case suppression. It was good news, not bad.

“I appeal to your brain and your sense of duty,” Nicole finished in French, “but I also shall appeal to your heart on behalf of your French mother to do this.”

Sujit Gupta stared at me with horror. Nobody talked to The Chairman that way!

J. R. D. Tata started to laugh. It was as if the Frenchness of Nicole’s request had hit his funny bone. It lowered his defenses and settled the question. “Well,” he chuckled, “I have been in many negotiations, but never one like this. I can see I can’t stop you or change your mind. And I accept your analysis of the need to eradicate smallpox, although I do not rationally see how you can do it.” He looked at me and said, “Let me see the plan.” I handed him the two-page document. He read every word, but it was obvious that he had already made his decision.

“Madame, I’ll do it if Mrs. Gandhi will write a letter saying that her government will accept Tata help. She must sign it personally, and it must be public. If she doesn’t, our participation will not be taken seriously, and we will have no authority over the process. Sujit must be able to attend meetings, and he tells me that he and your young fellow with the Brilliant name—how can you live up to a name like Brilliant?—can run the thing if the government either joins us or gets out of the way. The prime minister is in a lot of political trouble these days. I certainly do not want to rescue her, but I am willing to help with smallpox if she is also willing to meet us halfway.” Tata promised to put up forty-two “lakh of rupees”—the equivalent of $500,000 then, millions of dollars in today’s valuation.

On the drive to the WHO office, Nicole could hardly catch her breath or contain her pain. I thought I could see some fear in her face. If Tata did not follow through or Prime Minister Gandhi did not agree, we couldn’t contain the five hundred outbreaks in Bihar on our own. If Prime Minister Gandhi would not permit Tata vaccinators to stop travelers and detain them at train and bus stations until they were vaccinated, we might not be able to even keep a lid on exportations from Tatanagar.

“Larry, to get this started, D.A. will need to get the director-general to personally intervene with Mrs. Gandhi.” That meant Dr. Halfdan Mahler, the director general of WHO. He was a Danish doctor who had worked on tuberculosis in India and was very well regarded by a generation of Indian doctors and politicians. “I will try to see D.A. in Geneva after my surgery. You need to keep the planning going with Sujit Gupta and see what you can learn from M.I.D. or Basu about the politics.”

We got to WHO and went up to the smallpox unit. Nicole packed papers and went over last-minute details. She rattled off a dozen ideas and instructions. “Larry, you’re on your own here in SEARO for a while. We need Zdeno to make sure none of the importations catches fire in the south. When Bill gets back from CDC, he is going to go right into meetings in Patna in Bihar. He will have to beat back the skeptics in WHO and the Government of India. I know I can count on you to represent us all in Delhi for the next few weeks.”

Then, as she rushed out of the office for her ride to the airport, she said, “You did a great job with Tatanagar and the Tatas. I will work with D.A. to figure out how we are going to get Mrs. Gandhi to write that letter. J.R.D. is quite a man, isn’t he? Very smart. J-R-D—find out what those letters stand for and let me know. But vain, I think it is vain, to demand she sign something. But I think she will have to do it, won’t she?

“Let’s be optimistic. You and Sujit go figure out how we are going to best spend the rest of J. R. D. Tata’s money when we get it. We will need more. I still plan to stop in Iran before I come back and try to get the shah to give us money for petrol. Don’t tell Gunaratne that I am planning to go to Tehran and meet the shah. And do not tell a soul that I’m rushing to Geneva for kidney stone surgery.

“I know I can count on you to keep things going while I am gone,” she repeated.

A few days after Nicole left, May 6, 1974, was a full moon—the “Buddha moon” or “Buddha Purnima,” dedicated to Buddha. By tradition, it was during the full moon in May close to twenty-six hundred years ago that Buddha was born. Years later, also during a full moon in May, he reached enlightenment, and again, years later, on the full moon in May he passed into parinirvana on his death. The full moon in May is an important time for Buddhists all over the world, and Kainchi, though nominally a Hindu temple, celebrated Buddha as an emanation of Vishnu.

The day before the full moon was my thirtieth birthday, and Girija and I celebrated with a quick trip to the ashram. Quite a few Indian families and Western devotees were staying there: Ravi Das, one of our closest friends, Mike Jeffery, a Yale-educated U.S. lawyer who would later become a judge in Alaska, was there. Kainchi was beautiful in the light of the bright moon. There was no better place to celebrate my birthday, almost a year into working for smallpox eradication, no better thing to do than to sit in front of the tucket Maharaji had sat on when he told me, time and time again, “You will get this job with WHO and smallpox will be eradicated.”

During the next two weeks I was the only international WHO medical officer in SEARO, so technically I was the acting program head. I did my best not to break things. All the reports from the countries in the region, from Sri Lanka to Mongolia, Indonesia to Burma, had to be read and answered. A large number of expense accounts had to be approved.

Most of all I oversaw the analysis of the April smallpox reports from Nepal, Bangladesh, and India. We processed the search results from all the endemic Indian states up to the end of April, and while the numbers of new cases from the searches had increased, the early reports in the first two weeks of May began to show a decrease, as we had hoped. The incidence of smallpox was decreasing across India. Exportations from Tatanagar had stopped completely.

The whole office was engaged in helping our Indian counterparts with planning for the next search in May and June. Bill Foege had been successful in getting CDC to send more young, energetic epidemic intelligence service officers. Both D.A. and M.I.D. sent word that it looked like Prime Minister Gandhi was probably going to sign the agreement. I confirmed with Sujit Gupta, and we made tentative plans to open a new office in southern Bihar for the joint venture. The Tatas rented a large complex in Ranchi, a small town located a couple of hours’ drive northwest of Tatanagar. Sujit went there to open it up, and I readied myself to join him after Nicole returned. Sujit purchased a dedicated telex terminal so we could stay in touch from this remote area. I asked him to buy the telex address “Zeropox.”

Two weeks later, on May 18, 1974, amidst the monthlong celebrations for Buddha, the teacher of peace, India exploded its first nuclear device, thus becoming the first country outside the five members of the UN Security Council to do so. The newspapers said, “India has become the world’s sixth nuclear power.” The name given to the underground test was “Smiling Buddha.”

That same week, WHO published the official results of the April All-India Search. It was old news to me, but not for the general public. Our latest internal numbers for May showed declines in smallpox, but the data that was published for the April search hit the all-time peak—8,664 infected villages with “pending outbreaks,” a new term Bill Foege had introduced to reflect the burden of smallpox on health-care resources. Altogether, 11,000 men, women, and children were reported sick with smallpox in a single week.

WHO and the government did a terrible job explaining to the press the counterintuitive truth that finding a higher percentage of smallpox cases was a success, not a failure. It was an outbreak of better reporting, not an outbreak of new cases. Some reporters for the Times of India and the Indian Express wrote front-page stories that the smallpox epidemic was raging out of control. The truth was that even though smallpox was indeed raging, it was not out of control. But some of our internal WHO reports, including my confidential report on how bad the exportations were from Tatanagar, had been stolen from the Patna state government office and leaked to reporters who used them to add “color” to the numbers.

Smallpox Eradication in India: Number of Cases per Week

The shock: impact of active searches on reporting of smallpox cases, India, 1973. 1 = first active search; 2 = second active search; 3 = third active search.

As news broke of the Smiling Buddha nuclear explosion, reporters from all over the world streamed into India to cover the test and report on what it meant for nuclear nonproliferation and the balance of power around the world. The United States threatened sanctions. Pakistan vowed to follow suit with its own bomb. Journalists also saw the Indian headlines that the smallpox epidemic in India was history’s worst; Myron told me that several had contacted him for background material. Everyone was looking to write a variation of the following story: “As India takes one step forward into the nuclear age, the worst smallpox epidemic in history takes the country two steps back.” Having already interviewed the scientists responsible for creating India’s nuclear device, international reporters next wanted to meet the idiot who was head of what the newspapers called a failed smallpox program.

That idiot, on that day, was me.

One morning, as I walked past Mrs. Boyer’s desk in the reception area of SEARO, she stopped me. “Some people are waiting in the boardroom for you, Larry.”

That was all the warning I had.

Reporters from every major international paper jammed the boardroom, the same room where I had first heard the Mongolian health minister discuss death rates. There was barely space for me to squeeze through.

“When are the cars coming to take us to the field?” “Why did you let this happen?” “What do you think of India’s nuclear test?” “Is Mrs. Gandhi’s government corrupt?” “How did these outbreaks get past WHO?” “Why is smallpox getting worse when so many millions of dollars have been spent on eradication?” “How is it possible that WHO has failed again?”

The questions came at a staccato pace. I had been interviewed by the press only once before—the day after the baby Wovoka had been born on Alcatraz. I tried to explain that the search-and-containment strategy was working, that to epidemiologists it was good news that we were finding a higher percentage of hidden outbreaks. I wasn’t worried about the shower of reports—we expected them. I was more worried about the Indian rail strike, which would keep vaccine from getting to the field.

I was thirty years old and had no skill in untangling the conflation of the epidemic of reports and the declining numbers of suppressed cases for the press. I wished Nedd Willard, the WHO PR man, was with me, but he was out of the country. I wished D.A. or Bill or Nicole were there. I fumbled through the press ambush, leaving the journalists with one new concern: what the hell was WHO doing appointing an inexperienced kid to run the smallpox eradication program for eleven countries? Their articles reflected that: reading the papers the next week stung.

I called D.A. to warn him. He thought I was overreacting—until he read the first article: “Smallpox Outbreak Catches WHO Epidemiologists Unprepared.” Over a crackly phone line, he was very mellow and simply asked, “You need a little help, son?” With Nicole recuperating in Geneva, both D.A. and Isao Arita flew to New Delhi to my rescue. It was not just the international press we needed to mollify; it was also the Indian government, which was deciding between ramping up the smallpox program, with outside funding provided by CDC, the Swedish government, and the Tatas, or giving up on eradication altogether and resuming mass vaccination.

When Gunaratne, the same regional director who had torn me apart for leaflet bombing WHO, read the papers, he was furious. He had been alarmed by the huge increase in cases revealed by the house-to-house searches, but Nicole had convinced him that we needed to suffer the pain of uncovering a higher percentage of cases in order to avoid outbreaks smoldering undetected and erupting out of nowhere later. After the negative press coverage, Gunaratne berated me every day. “Where is Nicole! How could she leave you in charge? Where is Foege? Zdeno Jezek? This is no time for on-the-job training, Dr. Brilliant. This is not a good time for Madame Grasset to go home to Geneva for a holiday! She is being incredibly irresponsible.”

My youth continued to be a huge affront to Gunaratne, and I was willing to accept that, but Nicole was my hero and I wouldn’t let him blame her for this mess.

“It’s not her fault, sir,” I tried. “She is not on holiday, she is on sick leave. Please.”

“What kind of sick leave requires her to be out of the country, back at home, at the peak of an epidemic she is in charge of?”

So I told him, “She’s in Geneva having emergency surgery for a kidney stone.”

He didn’t take my word for it until D.A. arrived. D.A. went straight from the airport to give Gunaratne his assurance—personally and professionally—that the smallpox peak was because of our effective search and was not the sign of an epidemic out of control. I will never forget that he went to bat for me. D.A. must have told Gunaratne that the same kid that he had worried “appears to have gone native” had done important work in clearing smallpox out of Madhya Pradesh and ending the nightmare of Tatanagar. He asked Gunaratne to back off and not be angry with me for the press making the obvious comparison between India becoming a nuclear power while still the world’s major source of smallpox. It was sobering, D.A. told Gunaratne, that this number of cases—or more—had persisted, hidden, in India for years, maybe even decades. Gunaratne, D.A. said, would be a hero if he held firm. He could be at the helm when we reached zero smallpox in a year. However, knowing D.A., he might have hinted to Gunaratne that he could also be a goat if the press learned that there had always been this number of cases in India year in and year out for every year that Gunaratne had been the regional director. D.A. offered Gunaratne the choice to be hero or goat. Gunaratne chose wisely.

D.A. gave me my first press relations lesson and, later, asked Nedd Willard to spend a couple of days guiding me. I worried that I had let everyone down; however, in D.A.’s mind this was all simply part of the rookie learning curve.

Bullet dodged. Another about to hit.

Larry, M.I.D. needs to see you at the Health Ministry as soon as you can get there.” All the internationals, myself included, loved the charismatic M. I. D. Sharma, but after the press ambush and Gunaratne yelling at me again, I expected the worst.

In addition to being the head of the National Institute of Communicable Diseases, M.I.D. was now becoming the commissioner of health for the Government of India. The Health Ministry was in the old, imposing British government buildings. His office was in Nirman Bhavan, or the Health Palace. I greeted his personal assistant with the usual namaste and received in return the salute of palms together. M.I.D.’s office was in a large wood-paneled room with a huge circular desk that had the capacity to seat six. M.I.D. was a head taller than most of the Indian doctors. Charismatic and well-respected, he was a big, warm teddy bear of a man. It was always good to see him, and I was happy as long as there was not another bad surprise.

“Larry,” he said, “perhaps from now on I should call you ‘Sonny’ and you should call me ‘Papa.’”

“That would be wonderful, M.I.D. Is there some special reason?”

“I was in a meeting with Mrs. Gandhi a few days ago about the quarantine of Tatanagar. Do you remember hearing anything about a politician at the train station being vaccinated by force?”

I vaguely remembered hearing about an unhappy member of parliament. “I don’t know, M.I.D. Maybe. It wouldn’t surprise me if there hadn’t been a few like this. The Tata volunteers had to be aggressive about getting proof of vaccination and not letting anyone on trains. You know we had to button up the city, vaccinate everyone, no exceptions.”

“Your volunteers were enthusiastic, to say the least. But this particular politician turned out to be a member of parliament. He was so humiliated he launched an investigation into how Tatanagar came to be quarantined, and your name came up.”

In response to the look of panic on my face, M.I.D. raised his hand to stop me from interrupting.

“Wait,” he said. “It gets worse, Larry. This MP called his cousin. Do you know who his cousin is?”

I had no idea.

“His cousin is the chief minister of Bihar. He called his cousin to complain that WHO had flouted Indian sovereignty by forcing a member of parliament to be vaccinated against his will. The chief minister wanted the entire organization to be kicked out of India.”

My mind went blank. My ears started to ring.

“The chief minister of Bihar heads the Muslim coalition that Mrs. Gandhi relies on to keep her base of power. Especially in Bihar, where Jayaprakash Narayan’s movement to create a parallel government is so strong. This MP who was forced to be vaccinated has considerable power.”

Oh shit.

The airplanes, the leaflets, the reward, Gunaratne yelling at me over the press, my leaked report on Tatanagar—I could see a long list piling up. Maybe I was too conspicuous, too loud—too American. Maybe it was my ego again, exactly what Maharaji had warned me against.

My stomach tightened and I braced for the final blow. “Most of the others did not agree with kicking WHO out of India, or stopping the smallpox program, because of the international implications. But Mrs. Gandhi had to do something. So she compromised and she decided she would not evict WHO. But you do know she would have to do something, don’t you? She decided that you should be deported. She asked that a Quit India notice be made up immediately for you.”

M.I.D. paused for dramatic effect.

“Oh?” I said when I couldn’t stand the silence any longer.

“And that’s why I think you should call me Papa.”

I didn’t understand.

He smiled. A huge smile. A chuckle began to break through. And then more laughter. I was beyond confused.

It turns out that M.I.D. made a last-minute plea to the prime minister and he related the rest of the conversation: “Madame, a request.” He was already an Indian public health hero. He was a notoriously hard worker; it was widely reported that he hadn’t taken a day off in thirty years. Additionally, he had run the malaria eradication program and was one of the top doctors in modern India. People listened when he spoke.

The prime minister stopped for a moment. “What is it, Dr. Sharma?”

“Madame, will you delay the Quit India notice for Dr. Brilliant if I request it?”

“Why?”

“I need seventy-two hours.”

“Very well, Dr. Sharma, but please tell me why?”

“Because you are prime minister and may do anything you wish.”

I do not remember exactly what he said to me because I think I had stopped breathing. But since he told the story several times again to his wife, my wife, and some of our friends when he visited us later in Ann Arbor, I can summarize what this good man told Prime Minister Indira Gandhi of India on my behalf.

“If you give me seventy-two hours I will adopt Larry, and then you cannot deport him. I will make him an Indian citizen; this is already his adopted country. And, Madame Prime Minister, we need him, and we need all these young, strange, aggressive smallpox workers. We need the Russian scientists, the Czech fieldworkers, and we need these bearded, energetic, creative Americans. We need them. And we also will need the money from Tata and the Swedes. I have not worked to improve public health in India for thirty years to see us become the laughingstock of the world. Smallpox is a global priority. India may be the last place on earth with smallpox. Pakistan has already eradicated smallpox. Pakistan! Pakistan! This is embarrassing. Please do not use this as a time to malign the foreigners.

“And by the way, his guru, Neem Karoli Baba, who, you remember, when the Chinese invaded, predicted they would leave without provoking war, has predicted that we would eradicate smallpox. We have had two hundred thousand cases of smallpox in the last twelve months. India has nearly 90 percent of all the smallpox in the world, but the Baba said that we would eradicate smallpox. So I am willing to adopt Larry to keep him here.”

M.I.D. finished telling me what had happened and then chuckled as if at a private joke and said, “For both of our sakes, I hope I did the right thing, Sonny.”

From that day until the day he died, this brave, wonderful man called me “Sonny,” and I called him “Papa.”

The bad press did lead to some good things. The articles lampooning India’s attempts to enter the nuclear age amidst a huge outbreak of smallpox finally spurred Prime Minister Gandhi into action. She agreed to swallow her pride, gave support to the surveillance-containment strategy, and put her signature on the public-private partnership with Tata Companies.

The summer was full of amazing advances and heartbreaking setbacks. The Tatas continued to pour in manpower, money, and managerial skills. J.R.D. became more personally involved. Over the next year he would write Nicole and me separate letters on the first day of every month. His typewritten letters always began with a warm, flowing, handwritten salutation, “My dear Larry,” in turquoise-colored ink, asking about case counts, jeep deployments, and progress in other countries. Nicole never did show me what J.R.D. wrote to her.

Even as the actual case count declined, the cumulative effect of skepticism and innuendo, however, began turning more WHO officials in Geneva against the search-and-containment strategy. They felt the smallpox campaign was sucking up all the oxygen, diverting staff from malaria and family planning and sanitation and even other immunization programs. It was taking too long. Jankowicz, the WHO communicable disease director who said he’d eat a Land Rover tire if smallpox was eradicated in India, began throwing up roadblocks. His support for reverting to mass vaccination was tantamount to giving up on eradication and settling for a Band-Aid of routine vaccination.

To keep up the house-to-house searches, we needed more health workers. We needed millions of vials of vaccine and hundreds of millions of bifurcated needles to administer the shots. After surgery, on her way back to Delhi from Geneva, Nicole stopped over in Iran. She knocked on the door of the shah’s palace and persuaded him, charmed him perhaps, as she had J. R. D. Tata, to contribute oil to keep the smallpox jeeps moving. The oil never materialized because of Indian government pride, but other support did. The British charity Oxfam managed to buy nearly one hundred jeeps for the Chotanagpur program. Nicole found the money for five more epidemiologists from the Swedish Development Agency, which would eventually donate millions of dollars. J.R.D. added to the original sum with several more grants, including one specifically intended to bring more international epidemiologists to help India along the border with Bangladesh.

I was still alone in Delhi, still nominally acting in place of Nicole, when I was called to brief the Indian secretary of health, a Mr. Karmachandran,^† on what I assumed would be about the importance of holding fast to the search-and-containment strategy. Bill was in Bihar attending a critical strategy meeting on the same subject.

Mr. Karmachandran was a tall, thin man in his sixties, dressed in a white shirt and Indian khadi vest and trousers, with an elaborate sandalwood tilaka on his forehead. Two trails of red powder began on both sides of his forehead and ran below the hairline, joining at the bridge of his nose, where it dipped into an elongated U shape. This mark symbolized the foot of Vishnu, indicating Karmachandran was a Vaishnavite and so also devoted to Ram and Krishna. Finding this connection made me feel like I was meeting a spiritual cousin.

As I told Karmachandran about our plans, he was most curious to learn we were about to order two hundred Mahindra and Mahindra jeeps for the campaign in the jungles of Chotanagpur, sourcing them for the first time in India instead of using Land Rovers and Toyotas.

“Oh, very good that WHO is buying Indian-made jeeps this time,” he replied. “But you will like my cousin’s jeeps better. They are called Indian Standard jeeps. They are much better than Mahindra’s.”

“I wish we could order them, sir, but the Standard company makes only two-wheel-drive jeeps. They won’t work in the jungle and remote villages. I’m sorry.”

“Oh, that’s too bad. Especially when things are going well and you have Indira Gandhi back on your side,” Karmachandran continued. “It would be disappointing to see things go badly for the smallpox program now when you are so close to finishing the job, Dr. Brilliant. I think you should cancel the order for Mahindra and buy the Standard brand instead. And you’ll need to place that order within forty-eight hours.”

“But the two-wheel-drive jeeps will mean that we won’t be effective in the remote villages,” I repeated, near panic. “We can’t risk not getting to every corner and making sure we have gone after every case of smallpox.”

“You have to choose, my young friend,” Karmachandran responded coolly, “between more effective jeeps or a more effective relationship with me.”

I thought the floor had dropped out from underneath me. I was being extorted by a man who advertised his spiritual beliefs on his forehead. As with my first press conference, I wasn’t equipped to deal with this.

“I am just an underling at the WHO offices,” I stalled. “I don’t know what I can manage.”

That same week, Lama Govinda’s wife, Li Gotami, contacted me. She was worried that he was having mini-strokes again. Girija and I agreed to make a weekend visit. When we arrived at their house in Almora, near the Kainchi ashram after about a ten-hour drive from Delhi, Lama Govinda was in a lighthearted spirit. He had indeed been experiencing transient ischemic attacks, but as far as I could tell, there was no long-term damage. So far. He and Li were thinking about accepting an offer from some American Buddhists to go to the United States for an extended visit and medical treatment. Meanwhile, I couldn’t do much except make sure he was limiting his salt intake to avoid dangerous spikes in blood pressure. As usual, Lama Govinda asked how he could pay me, and as usual I demurred.

“Is there anything I can help you with, Larry?”

In fact he could. This business of the jeeps was deeply troubling. I did not want to give into a bribe.

I shared my dilemma about the health secretary, who I thought had me in a bind. I conjured up an image of thousands of dead children if I angered Mr. Karmachandran. I couldn’t get that image out of my head. I presented the story like someone debating whether or not to sell their soul to the devil to keep all those children from dying.

“Are you sure you are correctly placing yourself in the story?” Lama Govinda asked me. “Don’t overly dramatize your role. Be very clear what is asked of you and the likely outcome of your behavior. Then be sure that your actions are for the benefit of the children you are trying to save. If they are, decide only on the basis of the children, not whether or not your hands are getting dirty by giving in to extortion. When compared to the lives of children, your hands getting dirty is not as significant as you are making it out to be. Do not make the problem and your role in it into grand theater nor bigger than it actually is.”

Given the tenuous relationship between the Government of India and WHO, I did think that the smallpox program could fail, and more children would die, without a good relationship with this strange and powerful bureaucrat.

I decided. I would sign a purchase order for two hundred two-wheel-drive jeeps if it meant that the Government of India—and Karmachandran—would keep supporting the program. I rationalized the purchase by thinking we could allocate those jeeps to the big cities.

On Monday morning, back in Delhi, I walked into the Health Ministry and approached the desk of Karmachandran’s personal assistant.

“Mr. Karmachandran wants to see me,” I announced.

“That’s impossible,” he replied.

Oh, no. I didn’t act quickly enough. “But I have to see him today. He gave me a deadline. He’s waiting for this.”

“It will be impossible for you to see Secretary Karmachandran today because he was transferred out of the central government and sent back to the South India office,” the clerk replied. “Would you like to see the interim secretary who is here now?”

Relieved, I told him that that would not be necessary.

Karmachandran knew he was being transferred when he insisted I buy his cousin’s jeeps—he was hoping for one last perk from his high position and I was an easy target. In the end, WHO bought only four-wheel-drive jeeps, no one was offered or took a bribe, and Nicole was happy that I had steered the order through WHO and the Government of India, although she was surprised that it had happened so fast.

The entire jeep drama was an illusion in which my righteous indignation was revealed to be just another trick of the ego. Lama Govinda was right: act on behalf of the kids; the results take care of themselves. I also learned a very big lesson: I should have called D.A. in Geneva or Bill in Bihar, but, in my own confused mind, I thought I had to be the hero.

Nicole finally returned in July, free of kidney stones. I worried about how she would react to learning from D.A. about my being overwhelmed by the press. She not only forgave me, she even apologized for putting me in that position.

“You did a very good job while we were gone,” she told me in her office. “I was so relieved that Tatanagar was contained and J.R.D. was willing to put up more funds; I was right to hire you as a clerk.” She laughed. “Do not worry about the thing with the reporters. We didn’t equip you for the news media. But everything is working. The states are making progress. You should make a career in global health. You should stay on with WHO in India after we eradicate smallpox. I thought about some of the things you have done while I was in Europe. The reward leaflets, the elephants—we won’t discuss the leaflet drop over the WHO building, will we? Madhya Pradesh is now smallpox free. Tatanagar has stopped spreading its poison. Zdeno and Bill will be back soon and we’ll be at full strength again. You won’t have to worry about being left alone with a pack of reporters. D.A. gives me credit for sweet-talking J. R. D. Tata, but I could not have done it without you. Tata told me himself that you created quite a favorable impression with your midnight raid on the home of Russi Mody. The corporate officers like your missionary zeal. And you have a real supporter in M.I.D. It is not easy for an American to be so accepted by so many different parts of Indian society.”

We walked together through an adjoining door to Zdeno’s office. Then she turned to face me.

“By the way, Larry, how did Gunaratne find out I was having surgery for kidney stones?” she asked.

“I told him, Nicole. He thought you were taking a vacation, not a medical leave. He was screaming that you had been irresponsible leaving me in charge to go on vacation. I had to tell him you were having kidney stone surgery so he wouldn’t think you used your medical leave for something else.”

Thwap! I never saw it coming. Perfectly coiffed, in a new French outfit, red lipstick, and nail polish, the Hurricane on High Heels hauled off and smacked me across the face. My cheek burned. Her fingerprints on my skin bore witness.

“Nicole! What was that for?”

“For telling people I was sick!”

“But, Nicole, I didn’t tell anyone who didn’t already know. Gunaratne is your boss. You signed a request for sick leave. He knew you were sick but wanted to know why you left so quickly and left me in charge without his knowing. He demanded to know what you had that made you leave so abruptly. I thought he would understand if he knew you had something that required urgent surgery, and he did. He dropped the matter when he found out it was a kidney stone.”

“I told you not to tell anyone I was sick and I trusted you with my secret! You’ll see,” she continued. “One day you will be old and the last thing you will want is other people gossiping about your infirmities. But it’s done. You have done more good than bad. Now let’s get back to work.”

In retrospect, that was the first annual review I had ever received as a UN employee. I was embarrassed and my cheek stung, but I never had nicer things said about me. The French twist at the end was a little bit of a surprise. It came suddenly, like the deluge of the monsoon rains, hitting all at once, and then moving on, nothing lingering behind.