The Nightmare Scenario (3 page)

“They’re expecting the Director-General of WHO giving his views on the main global health threats, not an Assistant-Director talking about birth-related problems in Africa. Also, you know that ‘The Others’ hate it when you do this.”

“First of all, this audience will just have to make do with what it gets. This is a
fundraiser
for Christ’s sake. And as to whether the person sent is happy or not, I couldn’t care less. This is the price they pay for the autonomy I’ve granted them in their own areas.”

“Ryokai!”

Aeolus recognized the distinct murmur of his 1962 Bentley S2 Continental Flying Spur’s motor before Leonard turned the corner of Cockspur Street. The engine mellowed to a purr as the majestic forest-green car pulled up, ready to take him home.

As he stepped into the car a young man, arts or music student based on the looks of him, passed by. He had the volume of his iPod turned up way too loud and Aeolus instantly recognized the opening of Mozart’s Requiem. Aeolus, although not surprised, shook his head in disapproval. He briefly pondered whether there was ever a piece of music that had been so exploited and hence destroyed by being played as background cover to such a broad series of poorly written movies and TV shows, ranging from romance to drama to horror. Pondering it a second more, he realized he could actually think of not just one, but two
such pieces: Carl Orff’s “Carmina Burana” and Johann Sebastian Bach’s “Air on a G String.”

He stepped into the car and Leonard drove off. Aeolus rested his head on the back of the seat, pinched the bridge of his nose with his left hand and began to contemplate how to handle the unavoidable upcoming confrontation with Hank Wiley. Hank was the Director of the American CDC – The Centers for Disease Control and Prevention. He was Aeolus’s counterpart in the US. Aeolus despised Hank and Hank hated him. It went back a long way.

JULY 8
^TH
, AROUND 10 PM, 18 KENSINGTON SQUARE, FORMER RESIDENCE OF JOHN STUART MILL

A
eolus left the kitchen and ascended the stairs to his study, balancing a freshly poured, steaming cup of Tieguanyin tea in his right hand and a stack of medical journals in his left. Once in his study, he turned on Clifford Brown’s 1952 live recording of “I Come from Jamaica.” Regular jazz bored him, but great jazz was something different altogether.

Halfway through a report of a newly discovered coronavirus, his phone finally rang, with Jitsuko announcing she had Rebecca Summers on video.

Rebecca appeared on the screen of his phone. She was wearing a white lab coat and looked like a typical research nerd with all the stereotypical attributes: the pocket protector full of pens, the protective glasses, the lack of makeup, her chestnut hair carelessly tied up in a bun. Still, her body had those rare contours
that owed their definition to a combination of luck with genetics and continuous effort in exercise. Even more noticeable was the energy that radiated from, and the sharp attentive focus of, her clear, piercing green eyes. Aeolus was not attracted to women, but he could see why some men, in spite of her lack of customary emphasis of femininity, would find her an object of desire.

“Dr. Hughes,” she said, breaking out in a smile as she removed her glasses and brushed a tangled lock of hair out her face. “It’s good to see you again. What can I do for you? I assume this isn’t about my recent paper on the tuberculosis mutations in Africa?”

“No, not at all, although I must admit the paper wasn’t too bad,” Aeolus said, and cleared his throat. “We have a bit of a situation in Indonesia and we need to send a team. I want you to lead it.”

Rebecca frowned ever so slightly and paused in surprise before she replied: “Dr. Hughes…”

“Aeolus is fine.”

“Well, Aeolus. Look, I’m obviously flattered, but I’m relatively inexperienced. Surely there’s someone more qualified? If not within your own staff, what about the European CDC?”

“The ECDC? They have no one. I’ve already hired every member of their staff worth their salt. I’ve seen your work. Your field studies are impressive. You have good instincts, and you’re one of very few who have held your own in a scientific debate with me for quite some time. I want you to lead it. That’s all the reason you need. Will you go?”

Rebecca’s frown was gradually replaced with a smile – a smile with a hint of pride.

“Yes,” she responded, “of course I will. What do we have?”

“A nun, nurse by training, working as a missionary in Papua, called our local office and claimed she had a whole village wiped out by what she thought was an infection. She described the symptoms as varied and in verbatim: ‘pneumonia-like with additional discolorations of the skin.’”

“Hmm… Well, it’s probably something in the water supply.”

“I would agree.”

“I mean, ‘pneumonia-like symptoms’ could simply mean that they were coughing. But the combination with discolorations of the skin sounds odd. Surely she’s mistaken? A whole village wiped out? Not many things around that could do that. The only thing I can think of would be prions, but that takes years. It’s just impossible that they would all have died at the same time.”

“That’s exactly what I said.”

“Unless, of course,” Rebecca went on, twirling a lock of her hair between her fingers, “they’ve been isolated and don’t have our basic immunities.”

“And the penny drops,” responded Aeolus. The remark was meant as flattery, not condescension, and was clearly understood as such.

“I’ll clear it with Hank,” Aeolus continued in a distant tone, his mind already moving on to the next problem at hand. “My assistant will get back to you on logistics. Start packing, you’ll be on site within twenty-four hours.”

“You realize you’re sending me halfway around the world to investigate something which is either a regular flu, or, even worse, a simple case of food poisoning.”

“Yes, young lady. But that’s what we’re paid for.”

“Yes, on our good days… Thanks for the opportunity. I’ve been in the lab for too long. I was never meant for this. It’ll be a relief to get out into the field again.”

“All the equipment you need will be there. Video link to Geneva when you’re on site.”

“See you on the other side,” she said and hung up.

Aeolus recalled the first time he had met Rebecca. It was at an Epidemic Intelligence Service conference a year ago. She was standing beside her poster on some fieldwork she’d done on the spread of multi-resistant tuberculosis in western Africa. It was solid work, but the conclusion had been pushed too far, or so Aeolus thought at the time. After violent debate, first by the poster, then over drinks and finally dinner, she managed to convince him otherwise; a rare experience for Aeolus.

Arthur Conan Doyle once wrote in
The Valley of Fear
: “Mediocrity knows nothing higher than itself, but talent instantly recognizes genius.” Aeolus had that talent, and he recognized in Rebecca just what it took to be good at what he and a few other people around the world specialized in: Stopping epidemics and fighting lethal diseases on a global scale.

The sound of his phone brought him back to reality. Jitsuko informed him that logistics were taken care of and that she had Hank Wiley on the line. As Jitsuko connected the call, Aeolus took a deep breath and braced himself for what was to come.

JULY 10
^TH
, 6 AM, STRATEGIC HEALTH AND OPERATIONS CENTRE, WHO HEADQUARTERS, GENEVA

T
he mood in the room referred to as “The Strategic Health Operations Centre,” – “the SHOC” for short – at the WHO headquarters was tense. The room was the nerve center of the WHO’s global epidemic response – the nexus through which health operations around the world were coordinated and led. In the middle was a large, horseshoe-shaped conference table, with computers hooked up to the Global Alert and Response Network. There were several large display screens on the wall, as well as video conferencing links and secure communication channels to all WHO-related operations and major hospitals around the world. Today the room was packed to the brim with staffers sitting at the table and leaning against the walls. The silence was complete.

Aeolus presided at the head of the table, leaning forward in his chair, supporting himself with his cane. To his left sat Walt, whose quirky appearance made him even more of a peculiar character than all his odd mannerisms. Walt sported, as always, a rather bold red polka dot bowtie and a pair of horn-rimmed glasses that gave him an uncanny resemblance to the character Smithers from “The Simpsons.” There were both senior staffers there for support and some junior staffers, who sat in for their own learning benefit. Aeolus hoped to God none of the younger ones would do something to embarrass him in front of Hank Wiley, who had just appeared on one of the screens.

“Good morning Hank. I realize it’s a bit late for you, but thank you for joining us,” said Aeolus.

“Good morning,
old boy,”
replied Hank in his deep Texan accent, accentuating the word so as to make it an open mockery of Aeolus’s East Coast enunciation. “Let’s see what pointless mission you’ve sent one of my best people on. You really don’t have anything better to do over there than checking out polluted water on the other side of the world?”

“No one would be happier than I if that is indeed what it turns out to be,” Aeolus replied, making a point of emphasizing his British-tinted Boston accent more than usual. Theirs was the archetypical American conflict. On the one side, a conservative, commonsensical, self-made, Southern Republican military man; on the other a well-bred, Ivy-League educated, culturally snobbish, elitist, East Coast Yankee.

“I’ve been told the team has arrived on site, we should have them on screen now,” Aeolus told Hank.

The large screen in the center of the wall flickered and came to life. Rebecca appeared in a HAZMAT suit, the roofs of the village huts barely visible a fair distance behind her. Her first words were: “What is it you’ve gotten me into now, Dr. Hughes?” apparently choosing not to use his first name in this more formal gathering. “Do we really have to wear this gear? It’s not like we’re expecting anthrax, are we?”

“I know it might seem silly,” responded Aeolus, “but we take no chances – ever – and especially not with staff that Hank has graciously lent us. What do we have?”

She started walking toward the village. As it came into view, the camera panned over a dozen huts on wooden poles, constructed with half rotten planks and straw roofs. The camera followed Rebecca around as she carefully surveyed the small village. Every glimpse into a new hut showed a new set of bodies. Corpses – everywhere.

“What do you make of it?” Hank barked in his staccato military manner.

Rebecca’s voice came through with the typical digital distortions of a low bitrate transmission: “I’ve never seen anything like it. It’s clearly an infection of some kind. Visible symptoms are varied. Some were coughing blood at the time of death. Several have far progressed cyanosis across the face. A couple of them have darkened feet, almost black, but not gangrene. The only observation that seems consistent for all is bleeding from the ears and petechial hemorrhages
around the neck. Two are bleeding through the eyes and various lesions across the body. Furthermore, we have bloodshot eyes and fetal positions, which make me think high fever at time of death.”

“Looks like a hemorrhagic fever outbreak to me,” said Hank. “We’ve had them all over Africa and in South America. It’s was only a matter of time before it showed up in in Southeast Asia.”

“I doubt it,” replied Aeolus in a contemplative voice. He interlaced his fingers, leaned backwards in his chair and looked up at the ceiling. “The only hemorrhagic fever we’ve seen outside Africa and South America is the Congo-Crimean and that little devil looks nothing like this. If it was hemorrhagic in nature, there should have been more bleeding, and it would have been consistent through all cases. This is something else.”

“Prions?” suggested a junior staffer.

“Hitting everyone simultaneously within a week?” came Aeolus’s clipped reply. “Are you out of your mind?”

“What about a freak immune system response to something ordinary, like the cold the nun brought with her? We’ve seen similar things in South America during colonization and more recently among Eskimos,” tried a more senior staffer.

“Does anyone have the nun?” asked Aeolus.

“Yes, I do,” came the voice from someone on the local team “She’s dead.”

“Well,” sighed Aeolus, “that pretty much rules out an ordinary cold.”

“How about babesiosis,” tried the junior staffer who had mentioned prions earlier, in an all-too-obvious
attempt to recover from having fallen out of Aeolus’s good graces.

“Okay, that’s it,” said Aeolus, without bestowing him a glance. “Pack your stuff. Leave your badge at reception on your way out.”

“But…”

Walt interrupted the staffer’s protest with a slow wave of his index finger, indicating that Aeolus’s decision was final and there was no point in arguing.

The junior staffer picked up his notebook and retreated out of the room with a confused look on his face, as if he had yet to fully realize what had just happened.

“Can we get a closer look, please?” Aeolus asked Rebecca. “Can you do a quick field autopsy on one of the villagers who were coughing blood?”

“Yes, I think so.” Rebecca knelt down next to a body of a man who looked to be in his thirties. “Can someone hand me an autopsy knife, please?”

A local team member came into view on the screen, handing over a set of medical tools. Everyone in the SHOC was silent as Rebecca slipped a chain mail glove onto her left hand to protect herself from accidental cuts and went to work.

She made a Y-shaped incision starting at the top of each shoulder and running down the front of the chest, meeting at the lower point of the sternum. An assistant produced a set of rib shears, which Rebecca used to cut through the chest bones. Then she cracked the collarbones with a chisel, freeing the lungs for inspection.

The lungs had a dark red color and had a spongy texture while at the same time being tense, almost as
balloons. As Rebecca made an incision in the right lung, a grayish blood-stained substance poured out. She continued to make incisions in the vital organs.