Chapter 17

BETHESDA, MARYLAND

Infection Date 22, 1700 GMT (1:00 p.m. Local)

From across the cafeteria, Isabel saw Rosenbaum and Street talking. She went to get a cup of coffee beside them. “Oh! Hi.” They nodded in greeting as she joined them.

“Even though the laws of evolution apply to viruses,” Street continued, “descent with modification, natural selection, adaptation—viruses aren’t alive. They’re just fiendishly simple subcellular assemblages of proteins, nucleic acids, lipids, and carbohydrates. They can’t even reproduce without coopting the machinery of a living cell. And while they’ve been biding their time in the permafrost, we built aqueducts and the space station and grew confident in our supreme mastery of all things.”

“Sounds like you think SED is punishment for our hubris,” Hank commented.

“You have a better theory?” Street then turned to Isabel to answer the question she hadn’t asked. “The jewel wasp, Ampulex compressa. It snakes its stinger into a cockroach’s brain, sensing its way to the regions that control movement, and releases a cocktail of neurotransmitters that causes the roach to lose all motivation to move until directed. It walks the cockroach around by its antenna like on a leash to someplace safe and lays eggs on its underside. The enslaved roach then stands guard until the eggs hatch.”

Isabel looked at Hank and said, “Good one.” Street seemed pleased.

Isabel and Hank joined Beth in the observation room. Next door, Emma was scribbling away. “What’s the latest?” Isabel asked.

Beth said, “She researched schizophrenia and multiple personality disorder.”

Hank snorted. “She can’t imagine having a self, and thinks you’re crazy.”

Emma was hunched over. Isabel asked, “What do you think she’s writing?”

“She’s still working on her Rules,” Beth said.

“What rules?” asked Isabel. A cringe creased Beth’s face as she looked at Hank.

“She’s writing rules,” Hank answered. “We got a copy when she was being tested.”

“So you just went in there and took them?” Isabel asked. Of course they did. “Can I see?” Hank rummaged through the bulging paper files he now carried. “You can keep this copy.” Isabel failed to muster a thank you. She felt guilty, but not guilty enough to give the printout back. Besides, everyone else had read them.

Emma had first written, “Spillover of P. horribilis from Neanderthals to humans,” then a few pages of random minor thoughts. Then columns of data, calculations Isabel couldn’t follow, scatter plots presumably corresponding to outputs, trend lines fit to clouds of dots, and slopes calculated for each line. She looked up at Hank utterly mystified.

“The head of immunology recognized some of the calculations instantly.” Hank explained the “SIR Model” from the mass action principle of mathematics, which divides populations into capital S susceptible, capital I infected, and capital R removed, which with SED means dead unless there’s natural immunity or vaccination. “The subscript is time, so when you see S(42), it’s number of susceptibles in month 42. Beta is the probability of a susceptible S contracting SED from an infectious I.” Emma’s math grew unrecognizable and ever more advanced. It was like watching Emma’s damaged brain slowly moving from recovery, to discovery of a new talent.

“Amazing,” Hank said, “isn’t it? In the end, Emma concluded we’d never attain disease-free equilibrium, struck DFE, and circled EE—endemic equilibrium. SED will continuously infect humanity forever, the conclusion also reached by Chicago and MIT. But unlike them, Emma concluded that the uninfected population never actually reaches zero. The university models artificially drop uninfected communities to zero at MVP—Minimum Viable Population—which Chicago thinks is 500, but MIT says is 750, both far south of the 5,000 necessary to avoid inbreeding. But Emma thinks that somewhere, in some remote cave, there’ll always be an uninfected Adam and Eve staving off extinction.”

Hank said some of the other variables, like theta, are baffling the epidemiologists. Isabel cleared the window and said into the microphone, “Emmy?” Her sister lowered her notebook, apparently without irritation. “Did you know we have a copy of your notes?” Emma nodded. “Can I ask you a few questions? First, what does theta stand for?”

“It’s the expected Uninfected suicide rate. I could use your help. What is the probability that an Uninfected will commit suicide if they’ve been exposed to SED, or anticipate imminent grievous violence, or suffer from depression caused by the loss of loved ones or bleak prospects, or because the voices in their heads told them to?”

Isabel said, “Most people, I guess, would probably hang on until the last, hoping for a miracle. But theta wouldn’t be zero.”

Emma said, “Can you make a deterministic estimate?”

Isabel held her hands up. “I dunno. Zero-point . . . eight percent?” Emma recorded her answer. “Emma, I have no idea. That was . . . a joke.”

“Should I laugh?” Emma asked, apparently willing to try.

“No,” replied Isabel. “Can you just give us the gist of what you’ve concluded?”

Emma didn’t once refer to her notes. “Rates of infection and death by violence are directly proportional to population density. On an urban block with 2,500 residents, people would be infected or killed at one hundred times the rate as on a suburban block with twenty-five residents. New York City has densities exceeding 3,000 residents per block, the highest force of spread F in America. After attempts at orderly evacuation of the city culminates in desperate flight, 60 to 90 percent of its remaining population two days after outbreak there will be infected or dead.”

“How?” Isabel asked. “For a few days everybody would just stay put at home.”

“Doors can be broken,” Emma explained. “Buildings burned. Water, power, and heat shut off. Some Uninfecteds would ban together to fight. Others couldn’t resist responding to calls for help. Others would make a belated run for it, or a premature isolation breach for foraging, or suffer a nervous breakdown.”

“Do you mean that Infecteds will break down doors or burn people out of their hiding places?” Isabel asked.

“Uninfecteds will kill Infecteds. So Infecteds will kill Uninfecteds.” Her answer left Isabel, Hank, and Beth speechless. Emma elaborated. At first, Uninfecteds will break through doors to kill Infecteds. Then it reverses as the numbers tilt in favor of the Infecteds. Beth rushed from the room looking terrified. “The question,” Emma continued, blind to their distress, “is whether Uninfecteds kill more Infecteds than vice versa.”

The two Uninfecteds had no questions, so Emma continued. “The American coasts should turn first, then the center, with remote areas in Nevada and Montana last. When you don’t know where SED will break out, the most at-risk regions statistically lie between major cities. The single greatest risk is in rural northeastern Pennsylvania because of its proximity to New York, Philadelphia, Boston, and Washington.”

Isabel asked, “What about isolation? Hide somewhere?” Our plan! she thought.

“At the individual level, that works until it fails,” Emma said, “which it always does given enough time. Nations will close borders. Then states, provinces, counties, and cities. Then neighborhoods, homes, and finally individual rooms. But in each case, the isolation will be breached either from the outside by Infecteds or from the inside by Uninfecteds.”

Hank rubbed his eyes under his glasses. Isabel, slumping, stared into the abyss.

“It will spread anisotropically, and is best modeled mathematically by fractals. Tendrils will follow transportation networks toward population centers. The heterogeneity of population density means isolated pockets of Uninfecteds will survive well into the pandemic. And the outbreak will appear to halt several times before resuming inexorably. We’re currently experiencing that in northern China, at least as seen from our distance.”

Isabel realized her eyes were closed in silent prayer, like on take-offs and landings.

“At the micro-level, network science describes how SED will spread among intimate contacts. The first to contract it will be family members, health workers, law enforcement, and caregivers. Assuming long bonds are severed, travel is shut down, SED will propagate like agricultural infestations across a two-dimensional terrestrial lattice. But instead of drifting on atmospheric currents, the pathogen will travel by foot.”

“Okay,” Isabel said. “I think that’s enough.” Emma returned to her notebook. Hank hunched forward. Isabel flipped through Emma’s notes without really seeing them. Math was ultimately replaced with text. At the top of the latter was the word, Rules.

“Before you get into that,” Hank asked, “may I interrupt you?” It took a moment for Isabel to look up. “I have a question.” He held a pen poised over a sheaf of papers. “Could you complete this sentence for me: I am [blank].”

Isabel was slow to register that he’d asked a question. “What?”

“It’s just a . . .” he began before faltering. Beth returned, composed but drained. Hank said, “I wanted to get a list of characteristics that you might ascribe to yourself. You know, how would you fill in the blank? I am . . . ?”

“Is this another stupid questionnaire, Hank?” He gave a half-shrug. He too seemed to be losing interest in their research given what they were facing. “So you had Emma answer that question?” He nodded. “And what did she say?” He replied that he’d rather get her responses first. “You’re not getting my responses. How did Emma answer?”

Hank said, “After some back and forth over the pronoun I, she finally said,” he read, “‘I am female. I am smart. I am capable. I am . . .’ and this is interesting, ‘under control. I am an epidemiologist.’ And ‘I am attractive.’ I wanta get a baseline from you.”

“Okay. I am pissed because there’s a lot of shit going on that I’m not privy to.”

“You’re not privy? I’m not the one running off to the White House every other day.”

Beth clearly wanted something. “Yes, Beth?” Hank asked.

“Right before Emma added ‘I am attractive,’ she looked in the mirror.”

“And you think that’s in any way significant?” Hank obviously didn’t.

“She was out of things to say, so she looked at the mirror and said she was pretty. Like she didn’t know till she looked. Who doesn’t already know something like that?”

Isabel said, “Good observation. Log it.” What would have been Beth’s grin at her triumph just days ago was now only a fleeting break in her dismal visage.

Isabel went to her “office” in the cafeteria and settled in to read Emma’s notes. At first, each entry was like Beth’s logbook: a random, serial list of experiential knowledge. “Negative pressure. Four seal breaks a day. Six cameras.” Then they grew more abstract. “Balance is more sustainable in an unstable system. Economies of scale require centralized organization. Biological interconnectedness is the most natural bonding mechanism.”

They were organized by color. Red was “social order.” When she discussed laws, breaches of the peace, limits on gathering size, social contracts like, “Parents raise children; children care for parents,” Emma used a red pen. Why red? Was it random?

Blue was reserved for economic issues. Water, food, shelter, clothing, medicine, energy, machine tools, metallurgy, raw materials. Barter vs. currency. Private vs. public ownership. Labor compensation. Capital allocation. Market vs. command economy. And, most interestingly, use of “Uninfecteds”—capitalized—“for their creativity and ingenuity.”

Emma used green for musings about population. Pages of calculations culminated in US estimates two years hence. I(24)—Infected—139 million. S(24)—Uninfected—11 million. Isabel rocked back. She couldn’t even begin to imagine what was coming. But Emma had precisely calculated the horror without the slightest flutter of trepidation. She seemed, in her green notes, to give no consideration to governance. No communism vs. capitalism, or liberal vs. conservative. The closest she came to blue vs. red was, “Government testing and elimination of the unproductive vs. market-based, Malthusian solution and self-help?” Whatever that means.

Purple was “geography.” The need for defensible borders, internal IDs and external passports, border guards, immigration, a demilitarized buffer to prevent friction, and a list of infrastructure required for housing and agriculture.

The final color, black, was for “security.” Equip with small arms, not complex systems. Equip whom? How large of a standing force the economy could support—four to five million. Jesus. Most interesting were three black notes, randomly scattered. “Overcome survival instinct by concentrating.” Did Emma think crowd excitation could be harnessed by herding Infecteds together? “War is unproductive; avoid.” That was encouraging, until Emma found the only observation anywhere written in capital letters. “NUCLEAR WEAPONS?” Isabel placed all her hope on the question mark.

It was a fascinating journey through a brilliant, damaged but recovering mind. She lost track of time. When a covey of white lab coats appeared, it was dark outside.

“There you are,” Nielsen said on spying her. “We’re ready to introduce other Infecteds into your sister’s room. You should observe . . . in case it goes wrong.”

“What others?”

“The other subjects we have under observation,” Nielsen replied.

“What?” Isabel snapped. “Why wasn’t I told there were others?”

“I am telling you. The Pentagon wants you to determine if they can engage in cooperative behavior. Raise an army, build pyramids, or whatever. The chairman of the Joint Chiefs asked for you by name.”

Isabel tried not to smile at the important mission as she demanded to see the other Infecteds first. There were eight. Four were too dangerous. Four were acceptable candidates for introduction to Emma’s room, one marginal. “Subject Zero Zero Eight tests closest to your sister in cognitive function, so we’re introducing her first. And she won’t pose a threat. She’s twelve. The daughter of our ambassador to China.” Nielsen flipped through the girl’s chart as they walked. “She’s lived all over the world. Gone to American schools. Speaks English, Mandarin, a little French, a little Arabic. Straight-A student.”

Stapled to Nielsen’s paper chart was a photo of a waifish, expressionless blond girl. With braided hair and black eyes, she looked like a possessed Heidi. They entered a wing Isabel had never visited and passed repeated security checks. The little girl had contracted SED in Beijing during the embassy’s evacuation.

A Marine scrutinized Isabel and summoned a sergeant. Nielsen said, “What’s the holdup?” The sergeant held Isabel’s ID in two gloved hands. “Oh-for-God’s-sake!” Nielsen snapped. “It’s her twin sister.” They were allowed to pass and joined a nurse in a tiny observation room adjacent to a small hospital room. Sitting erect in a chair, every strand of her long blond hair in place, was “Sam”—Subject Zero Zero Eight. Her forearms were bandaged from wrist to elbow. “She got hurt during the evacuation,” Nielsen said.

Isabel pulled the lone microphone close. “Samantha?” The little girl tilted her head but still stared into space. “How are your arms doing?”

Sam raised them and looked at the bandages. “They’re fine.”

“My name is Dr. Isabel Miller. My sister, Dr. Emma Miller, is a patient in the hospital just like you. We’re going to move you into Emma’s room, okay?”

Sam squeaked out, “Okay,” then returned her gaze to empty space. No, Isabel realized. Not empty space. She was looking at the door, and had been when Isabel arrived.

The next few subjects were Zero One Zero, an African-American Marine guard, also from the Beijing embassy, Zero Zero Nine, a middle-aged Caucasian housewife who had been touring the Great Wall, and a non-talkative “borderline,” Zero Zero Five, who was a Chinese-American industrial engineer on assignment to Harbin. All but the last had well-functioning verbal skills. On the way back to Emma’s room, Nielsen led Isabel past more closed doors.

Isabel stopped. “Who’s in here?”

“Not one of the candidates,” Nielsen replied. “Too dangerous.”

Isabel entered. The observation room was empty. The lights next door were dim. “Dr. Miller!” Isabel sat at the window. The patient may have lain among the piles of twisted bedding, but Isabel could make nothing out so she raised the lights slightly.

A blur of berserk flailing erupted in Isabel’s face. “Ah!” she exclaimed, flinging herself backwards, away from the fury that sprung from beneath the window to pound the shatterproof glass. The crazed woman’s gray hair flew wildly. But for the smart glass between them, Isabel knew, she would’ve sustained severe if not fatal injuries.

The woman quickly exhausted herself. Her futile mauling of the person unseen behind the frosted glass lost its vigor. The shock Isabel felt morphed into . . . disgust? The black-eyed woman’s snarling attempts at savagery—clawing and butting the window, heedless of pain—were both pathetic and deeply disturbing. Her final blows were little more than open-palmed slaps that finger-painted in the blood from the cut on her forehead.

“I guess,” Isabel said, “someone now needs to go in there and suture that cut.”

But Nielsen looked back at her, biting lips curled over her teeth, and shook her head. “We can’t open her door without, probably, having to shoot her.”

“How do you feed her?” Isabel asked.

“We don’t.” Isabel’s mouth gaped. “She’s dying, Isabel. In the wild, she’d be dead in hours. Minutes. If we open that door, she’ll die in seconds.”

“So you’re just going to starve her to death?” Isabel asked. “This is a hospital!”

“We’re waiting on guidance,” Nielsen replied, “from the medical ethics office. We’ve got feeding tubes, obviously, but she’ll outrun a tranq gun. Captain Ramirez is training on Tasers, but Plan B—a bullet—comes about a half second after a miss with the Taser.”

The woman crawled to her bed. Her chart said she was fifty-four. A doctor volunteering at a hospital in northern China. The waste can was upended. A chair lay on its side. Towels covered the bathroom floor. Nielsen said, “She was recovering from leukemia and was immuno-compromised. If the Chinese hospital staff hadn’t bundled her up in an old straight jacket that we removed while she was sedated, she’d have become an indirect SED fatality. And she may yet end up one.”

Isabel headed for the door, but looked back. “Why isn’t there a nurse in here?”

“Too disturbing,” Nielsen said. “We were losing staff.”

* * * *

They joined Beth in Emma’s observation room, which now had three empty beds. Emma scribbled in her notebook. It seemed almost normal back in this wing. The room behind the three women began to fill with scientists, including Hank, Street, and Brandon. The phone on the desk chirped. Nielsen answered and said, “Okay, send her in.”

The door to the hospital room buzzed open. In walked the small girl in a pink hospital gown taking tentative steps. She surveyed the room, pausing on seeing Emma only as long as she paused on inventorying the furniture. Emma watched the three guards, who departed upon confirming the Infecteds wouldn’t immediately rip each other apart.

“This is mine,” Emma said of her bed.

The girl checked out the other three beds, settling onto the one closest to Emma’s. The two Pandoravirus sufferers then sat, unmoving, for what Hank clocked at five minutes until the little girl said, “Nothing hurts anymore. What are they doing with us?”

“They’re watching us,” Emma said, gesturing toward the opaque observation window and pointing up at each of the six cameras. Samantha’s gaze dutifully followed Isabel’s finger. “And they’re listening to us and recording everything we say and do.”

“Was that a warning?” Nielsen asked. As minutes wore on in silence, Emma’s comment did in fact seem more and more like a caution against speaking freely.

“I’m going to sleep,” Emma finally announced. “A bird is building a nest on that windowsill. If you see it, wake me up.”

Samantha moved to the opposite side of her bed, sat, and stared up at the sill.