Chapter 8

BETHESDA, MARYLAND

Infection Date 14, 1200 GMT (8:00 a.m. Local)

Isabel arrived early at the NIH and went straight to the observation room. Emma still slept like a baby despite being wired up to electrodes. Poor Beth looked exhausted.

“Dr. Rosenbaum left orders not to disturb her.” Beth’s voice was hoarse. “And Dr. Street came by handing these out.” She gave Isabel the single sheet of paper.

It was headed, “Hymenoepimecis argyraphaga.” Beth shrugged. Isabel read it aloud. “Females glue eggs onto spiders, whose larvae poke through the spiders’ abdomens to feed on their blood. The spiders tear down their old webs and spin new ones in a radically different shape that serves as scaffolding for the larvae’s cocoons.”

Beth saw Isabel’s arched brow and made a face of her own. Isabel settled in to study Emma’s ongoing brain-wave graph. “Whatta you think’s gonna happen?” Beth asked, not returning Isabel’s glance. Even though Isabel was probably only a decade older than Beth, the nurse sought comfort from the plugged-in PhD. But Isabel could think of precious little to ease Beth’s worries. “I don’t have anyone,” Beth said, eyes darting, smile gone. “My dad’s an alcoholic. My mom died of breast cancer. It’s just me.” Isabel put a hand on her shoulder. Beth surprised Isabel by wrapping both arms around her. “It’s not much of a life, but I’m not ready for it to be . . . over.”

Isabel patted and stroked her back until the tremors died down. Beth apologized repeatedly, turning away until the tears had been wiped from her pretty face and she could again muster a smile. Isabel had said nothing, and so her heart broke when Beth thanked her.

Hank arrived just before sunrise with a notepad and papers. In the guise of small talk, he said to Isabel, “I gather you and your sister grew up fairly well off?”

Isabel felt drained. Her chin rested on her upturned palm, mushing her words. “Our dad did well, yeah. Private equity.”

He made a tick mark on his pad. “Would you describe yourselves as outgoing?”

Isabel looked down at Hank’s papers. “What are those?”

“These? Oh, just . . . cultural background questionnaires. I thought maybe we could get a social context in which to frame your sister’s current world view.”

Isabel rubbed her eyes and sighed heavily. “Okay. We grew up in Greenwich. Family ski, beach, and foreign trips. Summers at a country club or at a neighborhood sailing club where we’d take Sunfish out. That’s a boat. I played tennis. Emma played volleyball. She had more girlfriends than me because she had teammates. And she had more boyfriends because I, you know, valued my free time.”

“You’re both heterosexual?” Hank asked in a failed attempt to sound casual.

“Uhm, yeah,” Isabel replied.

“Did you discuss intimate matters with each other growing up?”

“Is this some kind of psychosexual history?” Isabel asked.

“It’s part of the picture. You know, premorbid versus . . . now.”

“Okay. We both menstruated at eleven. Periods synced right up. Emma lost her virginity during our junior year of high school. Me, the sophomore year of college.”

“How many partners did each of you have?” Hank asked. “One-to-five? Six-to-ten? Eleven-to-twenty? Twenty-one-to-thirty? More? You can estimate.”

“Estimate?” Isabel was growing angry. “One-to-five should suffice, for both.”

“Would you describe Emma’s libido as low or high relative to yours?”

“I wouldn’t fucking describe it at all, Hank. Ask her.”

“I did,” he replied. “She said it’s high. She’s had twenty-seven sexual partners, plus or minus; most recently, an older, married colleague at Johns Hopkins.”

“Oh.” Twenty-seven! “She told you that?”

Hank nodded. “And about her first sexual experimentation.”

“She told you about that? Great. We’ve discovered that they lose all their filters.”

“Would you say Emma was more inhibited before infection?”

“Oh, God yes! She wouldn’t even watch R-rated movies with our parents.” Or any other movies, for that matter, Isabel thought.

Hank asked, “Do you want to revise your own partner estimate?”

That did it. “First of all, again, it’s not an estimate. I haven’t lost count. And secondly, I had a boyfriend almost all the way through my college years.”

Beth asked, “What happened?”

“Well, turned out he was an insecure, self-centered, narcissistic egomaniac.” Beth screwed her mouth into a sympathetic snarl of faux anger. Girl power!

“How long since your last sexual activity?” Hank asked. “With a partner?”

“Okay, that’s enough.” Isabel stood and paced. “It’s almost dawn. What’s today’s plan?” Reluctantly, Hank switched to a review of Emma’s testing schedule. “So,” Isabel said, “how long had it been since Emma, you know, and this married guy . . . ?”

“Right before she left for Siberia, apparently. In his car.” Emma hadn’t said a word about him. “To your knowledge, does your sister have a preference as to type of sexual partner? Age? Height? Weight? Build? Academic accomplishment? Religion? Race?”

“You’re not her type, Hank.” Beth stifled a chuckle.

“Is she anti-Semitic?” he asked.

“No, I didn’t mean . . . I was kidding.”

“Do you think you’d know what Emma’s preference in sexual partners is?”

“Of course. Her age or a little older. Tall. Athletic. Any race or religion, but leans toward her own. Smart, but doesn’t have to be, you know, academically pedigreed. And six-pack abs and a tight butt are indicators of good genetic stock, right?” Beth giggled.

Hank asked, “Are you sure you’re not describing someone you’re attracted to?”

“Hank, I’m describing someone every woman is attracted to.” Beth nodded.

He turned a few pages. “Her current lover is married, forty-nine, five foot seven, not in athletic shape, mixed race black and Chinese, adopted and raised Jewish, and eminently degreed. So, are you sure your sister doesn’t keep secrets from you?”

That added to the insult. “We’ve both been busy!” She paced and tried again to change the subject. “So, Hank, what do you think about this whole secrecy craze?”

He said, “They arrested two scientists in Geneva, is what I think. One at the train station with his family. The other at the airport trying to get to hers. Both walked right out when they saw the data. So, have you and your sister ever talked about having children?”

Jesus! “Listen, Hank. I don’t know why you’re on this sex kick. But just because my sister will answer whatever you ask doesn’t mean you should ask. It’s like abusing someone who’s handicapped. I mean, we’re Presbyterians from Connecticut.”

“She’s getting up,” Beth said, swinging into action, tablet in hand.

The first light of day streamed through the outside window. Emma stretched and went to the bathroom, heedless of the wires connected to a transmitter or the armband in which it was housed. Beth logged it. She didn’t brush her hair because of the electrodes. Instead, she sat on her bed and stared into space looking like an inmate at an asylum.

Isabel hit Talk before Hank could object. “Morning, sunshine!” They had shared a room as girls, and their mom had woken them with those words every day.

“Good morning,” Emma replied, looking not at the ceiling speakers but at the frosted glass. Object permanence, Isabel thought. Good! Emma now remembered that Isabel was behind the observation window. “The latest news,” Isabel said, “is they’ve isolated the pathogen. It’s a DNA virus: Pandoravirus horribilis.”

Emma betrayed no reaction, then looked up at the high window. A bird on the sill bobbed its head, stabbing a twig into a growing mass under construction. Beth said, “That got her attention.” When the bird flew away, Emma returned seemingly to doing nothing.

“Check this out,” Isabel said, pointing at Emma’s brain wave graph on the laptop. “Here’s where she was asleep.” Flattish lines. “Here’s where she woke up.” The lines danced at a much higher signal level. “About here is where she went to the bathroom, sat on the bed, and we spoke. There’s activity throughout. She’s thinking . . . about something. Look. When she saw the bird, it distracted her, but there was no spike in activity.”

Hank rocked back in his chair and cupped his hands behind his head. “I read a WHO abstract about an infected Chinese port engineer. The field team, Lange and Groenewalt, asked if he saw the fork on his food tray, and he picked it up. When they asked if he saw anything else, he had no answer. But when asked specifically if he saw a spoon, he picked it up. He only saw things to which his attention was explicitly drawn.”

“Simultanagnosia?” Isabel asked. “But Emma’s able to see everything around her.”

“Maybe she’s just adept at rapidly processing each serial observation. Her experiences might be like driving down a long, straight highway. You see Exit 46, but note nothing again until Exit 47 glides by.”

“Her mind’s a blank?” Isabel said.

“Not exactly. There’s robust brain activity between external stimuli. You’re thinking something as you drive down the road. Obviously, there’s the act of driving. But also maybe you’re fantasizing. Singing along with the radio. Figuring out what gets your team into the playoffs. You’re just not ‘present in the moment.’”

“And you think Emma’s entire life is being lived that way?”

Hank said, “Another WHO report described an infected paramedic who got up from his cot and walked out of an open-air ward, attracted by the lights and siren on an ambulance. When it took off, he followed it down the road, out the gate, with Lange and Groenewalt trailing him. He continued in the direction he’d last seen the ambulance for about a mile. Nothing distracted him from the familiar, compelling sights and sounds from his past. That sure seems like simultanagnosia to me.”

“Or maybe he just wanted to help. Do his job. What happened to him?”

“He failed to respond to orders and Chinese soldiers shot him.”

Isabel got Hank to tell her where on the network she could read the WHO reports.

The bird returned, and Emma watched it. She’d always loved nature and had led Isabel into science by getting her to watch documentaries and read books about great discoveries, and take AP science courses in high school. As long as the bird was in the window, Emma stared at it. When it flew off, her gaze lost its focus. But her brain waves continued their uninterrupted, cognitively active dance. Isabel told Hank about Emma’s fascination with nature. A beaming Beth put her hand over her heart and said, “Awww.”

“That bird in the window is her ambulance,” Isabel said.

“Let’s see.” On the laptop, Hank pulled up the old “Cookie Theft” cartoon picture from the Boston Diagnostic Aphasia Exam. In it, a boy teetered atop an unstable stool trying to steal two cookies from a jar in a high cabinet. His sister sat at the kitchen table watching expectantly while their mother, doing dishes, was distracted by an overflowing sink. The entire scene was instantly understandable by an uninjured brain. “Dr. Miller,” Hank said to Emma, “I’m displaying a picture on the monitor. Can you describe it?”

Emma, oblivious to her unkempt hair from which protruded wires, Medusa-like, stared intently at the screen. The picture was all trees, no forest. “There’s a window, curtains, a counter, dishes, a sink, water pouring out of the sink, a woman in an apron holding a dish rag, a cookie jar, a girl, a boy on an unstable stool, cabinets.”

Hank said to Isabel: “Wow. Classic simultanagnosia.”

Isabel pressed the Talk button. “Emma, can you describe what’s happening in that picture?” Emma didn’t answer. “What’s the boy doing?”

“He’s putting two cookies in a jar.”

“Could he be stealing cookies for his sister and himself without his mother seeing?”

There was a long delay. “How do you know that’s his mother, or his sister?”

“Well, there’s a woman, in an apron, in a kitchen, doing dishes. The girl is sitting at a table in front of a dirty plate. An adventurous boy is taking advantage of the sink accidentally overflowing to steal two cookies while his nervous sister watches. See that?”

Emma said, “How do you know that the boy is adventurous, the girl is nervous, the woman is distracted or the sink is accidentally overflowing? How do you know the boy is stealing cookies, or that one is for the girl?”

“I think you’re right, Hank,” Isabel said. Curiously, Emma’s brain waves had registered the same level of activity during the diagnostic test as when Emma returned her attention inward upon its conclusion. What’s going on in there, Emma? On a hunch, Isabel said, “Sweetie, if you ever need anything, just let me know. Okay?”

“There are three things,” Emma replied. Isabel looked at Hank with eyes wide. “A notepad, a supply of pens in different colors, and a straight edge.”

“Hah!” Isabel said, intrigued. Hank phoned in the order. The military pushed back. The head of biosecurity said he was headed their way.

“May I take these off?” Emma asked, raising a hand to the wires on her head.

Hank raised the hospital room lights. Emma looked awful. “Not yet,” he said to Isabel.

But Isabel pushed the Talk button and said, “Sure! Go ahead.” Emma peeled electrodes and hair out with nary a wince, and sat before the mirror to brush through the tangles. Thank God grooming and hygiene were ingrained habits.

When she finished, Beth said, “Twelve strokes with the brush. Same as yesterday.”

“Let’s call the president!” Hank snapped, clearly irritated at Isabel, not Beth. The young nurse looked like a spanked puppy but still noted the factoid on her tablet.

The observation room door opened. A swarthy, handsome Marine in camouflage wearing a sidearm introduced himself. “Capt. Angel Ramirez,” he said, pronouncing the “g” like an English “h.” “Head of biosecurity.”

“So you have a problem with our request?” Hank asked.

“I think we can get you most of what you want. My men are working on it. But I have a problem with a ruler. Too easy to fashion into a weapon.”

“Your men have guns, Captain,” Hank said.

“And all an Infected needs to do is poke a hole in my men’s PPE.”

Hank looked at Isabel, who shrugged. Ramirez said they’d get pens and a notebook to Emma at next seal break, which was breakfast.

Isabel asked him, “Do you monitor what’s going on in my sister’s hospital room?”

“Twenty-four-seven, ma’am. And in this room too. Do you have a laptop?” Isabel held up her iPad. Ramirez navigated on it somewhere and explained he was installing an app that would VPN into secure Pentagon servers to allow her to communicate directly with their security station. When he handed it back, a window was open in which sat two boys, heads shaved, who waved. Isabel returned the greeting, then closed the cover.

Beth attempted to comb her hair inconspicuously with her fingers, and alternated stolen glances with Ramirez, both avoiding direct eye contact. “Captain Ramirez,” Isabel said before he left. “Do you know a Capt. Rick Townsend? He’s also a Marine.”

Ramirez smiled wryly. Beth grinned, but had no idea why. “May I ask what this Captain Townsend might have done, ma’am?”

“Oh . . . nothing! I mean, I just met him, so . . . I was wondering. Never mind!”

“Yeah, I know Poonhound. We were classmates at the Academy, deployed together on our first tours to Afghanistan and are both at 8th & I. Tell him Ramirez said to watch his six.” He left with a grin on his face, last directed toward a smiling but demure Beth.

Isabel avoided Beth and Hank’s gazes. With faux nonchalance, Hank covered his notes, but not before Isabel saw, “Capt. Rick Townsend, USMC,” written on his pad.

In a lowered voice, Isabel asked, “What’s a poonhound? Is it a type of dog?”

Beth shrugged. Rosenbaum said, “In a sense, yeah.”

Fifteen minutes later, Beth’s phone binged and she departed, soon reappearing in Emma’s room in full PPE, covered by an armed Marine. Beth carried breakfast, a notebook, and five pens in different colors whose barrels had been sawed in half and whose open ends had been taped. Harder to turn into stabbing weapons, Isabel guessed.

Emma paid no attention as Beth pointed to sausages, eggs, and coffee like a room-service waiter, but flinched when Beth laid a sympathetic hand on her shoulder, which Beth withdrew as if her limb were at risk. Emma’s eyes remained fixed on the Marine and her hands gripped wads of bed linens just like the Russian executive before he was shot.

The Marine backed through the exit, weapon in hand, after Beth. The door closed with a clack. Emma cleared her ears and took deep breaths before releasing the sheets. She ate and dabbed her lips with a napkin just like the instructor had taught before their club’s first cotillion. Emma tore a page from the notebook, folded it to make a straight edge, and began writing at a furious pace with stubs of variously colored pens. Hank tried several camera angles on the laptop, but Emma’s back obscured her notebook from view.

“She’ll change positions soon,” Isabel said. But she didn’t. Emma wrote continuously, obsessively, for over an hour before going to the bathroom. While seated on the toilet, she clutched the closed notebook in her claw-like grip, her thumbnails bearing down on its leather cover.

“We’ll have to get in there to see what she’s writing,” Hank said.

“Or we could ask her,” Isabel suggested.

Emma resumed writing, again blocking their view. It wasn’t an accident. She’d figured out the camera angles. What are you hiding, Emmy? From me?