Tom Clancy's Jack Ryan Books 7-12 (279 page)

“Good morning, Doctor,” he said, in his most charming Creole accent. “What seems to be the problem?” She handed him the chart and started talking while he read.

“His wife brought him in. High fever, some disorientation, BP is low, probable internal bleed, bloody vomit and stool. And there are some marks on his face,” she reported. “And I’m not sure enough to say.”

“Okay, let’s take a look.” She sounded like a promising young doc, Alexandre thought pleasantly. She knew what she didn’t know, and she’d called for consultation ... but why not one of the internal-medicine guys? the former colonel asked himself, taking another look at her face. He put on mask and gloves and walked past the isolation curtain.

“Good morning, I’m Dr. Alexandre,” he said to the patient. The man’s eyes were listless, but it was the marks on his cheeks that made Alexandre’s breath stop. It was George Westphal’s face, come back from more than a decade in Alex’s past.

“How did he get here?”

“His personal physician told his wife to drive him in. He has privileges at Hopkins.”

“What’s he do? News photographer? Diplomat? Something to do with traveling?”

The resident shook her head. “He sells Winnebagos, RVs and like that, dealership over on Pulaski Highway.”

Alexandre looked around the area. There were a medical student and two nurses, in addition to the resident who was running the case. All gloved, all masked. Good. She was smart, and now Alex knew why she was scared.

“Blood?”

“Already taken, Doctor. Doing the cross-match now, and specimens for analysis in your lab.”

The professor nodded. “Good. Admit him right now. My unit. I need a container for the tubes. Be careful with all the sharps.” A nurse went off to get the things.

“Professor, this looks like—I mean, it can’t be, but—”

“It can’t be,” he agreed. “But it does look that way. Those are petechiae, right out of the book. So we’ll treat it like it is for the moment, okay?” The nurse returned with the proper containers. Alexandre took the extra blood specimens. “As soon as you send him upstairs, everybody strip, everybody scrub. There’s not that much danger involved, as long as you take the proper precautions. Is his wife around?”

“Yes, Doctor, out in the waiting room.”

“Have somebody bring her up to my office. I have to ask her some things. Questions?” There were none. “Then let’s get moving.”

Dr. Alexandre visually checked the plastic container for the blood and tucked it into the left-side pocket of his lab coat, after determining that it was properly sealed. The calm Doctor’s Look was gone, as he walked to the elevator. Looking at the burnished steel of the automatic doors, he told himself that, no, this wasn’t possible., Maybe something else. But what? Leukemia had some of the same symptoms, and as dreaded as that diagnosis was, it was preferable to what it looked like to him. The doors opened, and he headed off to his lab.

“Morning, Janet,” he said, walking into the hot lab.

“Alex,” replied Janet Clemenger, a Ph.D. molecular biologist.

He took the plastic box from his pocket. “I need this done in a hurry. Like, immediately.”

“What is it?” She wasn’t often told to stop everything she was doing, especially at the start of a working day.

“Looks like hemorrhagic fever. Treat it as level ... four.”

Her eyes went a little wide. “Here?” People were asking the same question all over America, but none of them knew it yet.

“They should be bringing the patient up now. I have to talk to his wife.”

She took the container and set it gently on the worktable. “The usual antibody tests?”

“Yes, and please be careful with it, Janet.”

“Always,” she assured him. Like Alexandre, she worked a lot of AIDS experiments.

Alexandre next went to his office to call Dave James.

“How certain are you?” the dean asked two minutes later.

“Dave, it’s just a heads-up for now, but—I’ve seen it before. Just like it was with George Westphal. I have Jan Clemenger working on it right now. Until further notice, I think we have to take this one seriously. If the lab results are what I expect, I get on the phone to Gus and we declare a for-real alert.”

“Well, Ralph gets back from London day after tomorrow. It’s your department for the moment, Alex. Keep me posted.”

“Roger,” the former soldier said. Then it was time to speak to the patient’s wife.

In the emergency room, orderlies were scrubbing the floor where the bed had been, overseen by the ER charge nurse. Overhead they could hear the distinctively powerful sound of a Sikorsky helicopter. The First Lady was coming to work.

THE COURIER ARRIVED at CDC, carrying his “hatbox,” and handed it over to one of Lorenz’s lab technicians. From there everything was fast-tracked. The antibody tests were already set up on the lab benches, and under exquisitely precise handling precautions, a drop of blood was dipped into a small glass tube. The liquid in the tube changed color almost instantly.

“It’s Ebola, Doctor,” the technician reported. In another room a sample was being set up for the scanning electron microscope. Lorenz walked there, his legs feeling tired for so early in the morning. The instrument was already switched on. It was just a matter of getting things aimed properly before the images appeared on the TV display.

“Take your pick, Gus.” This was a senior physician, not a lab tech. As the magnification was adjusted, the picture was instantly clear. This blood sample was alive with the tiny strands. And soon it would be alive with nothing else. “Where’s this one from?”

“Chicago,” Lorenz answered.

“Welcome to the New World,” he told the screen as he worked the fine control to isolate one particular strand for full magnification. “You little son of a bitch.”

Next came a closer examination to see if they could sub-type it. That would take a while.

“AND SO HE has not traveled out of the country?” Alex was running down his list of stock questions.

“No, no he hasn’t,” she assured him. “Just to the big RV show. He goes to that every year.”

“Ma’am, I have to ask a number of questions, and some of them may seem offensive. Please understand that I have to do this in order to help your husband.” She nodded. Alexandre had a quiet way of getting past that problem. “Do you have any reason to suspect that your husband has been seeing other women?”

“No.”

“Sorry, I had to ask that. Do you have any exotic pets?”

“Just two Chesapeake Bay retrievers,” she replied, surprised at the question.

“Monkeys? Anything from out of the country?”

“No, nothing like that.”

This isn’t going anywhere.
Alex couldn’t think of another relevant question. They were supposed to say
yes
to the travel one. “Do you know anybody, family member, friend, whatever, who does a lot of traveling?”

“No—can I see him?”

“Yes, you can, but first we have to get him settled into his room and get some treatment going.”

“Is he going to—I mean, he’s never been sick at all, he runs and doesn’t smoke and doesn’t drink much and we’ve always been careful.” And then she started losing control.

“I won’t lie to you. Your husband appears to be a very sick man, but your family doctor sent you to the best hospital in the world. I just started here. I spent more than twenty years in the Army, all of that in the area of infectious diseases. So you are in the right place, and I am the right doc.” You had to say things like that, empty words though they might be. The one thing you could never, ever, do was take hope away. The phone rang.

“Dr. Alexandre.”

“Alex, it’s Janet. Antibody test is positive for Ebola. I ran it twice,” she told him. “I have the spare tube packaged to go to CDC, and the microscopy will be ready to go in about fifteen minutes.”

“Very well. I’ll be over for that.” He hung up. “Here,” he told the patient’s wife. “Let me get you out to the waiting room and introduce you to the nurses. We have some very good ones on my unit.”

This was not the fun part, even though infectious diseases was not a particularly fun field. In trying to give her hope, he’d probably given her too much. Now she’d listen to him, thinking that he spoke with God’s voice, but right now God didn’t have any answers, and next he had to explain to her that the nurses would be taking some of her blood for examination, too.

“WHAT GIVES, SCOTT?” Ryan asked across thirteen time zones.

“Well, they sure as hell tossed a wrench into it. Jack?”

“Yes?”

“This guy Zhang, I’ve met him twice now. He doesn’t talk a hell of a lot, but he’s a bigger fish than we thought. I think he’s the one keeping an eye on the Foreign Minister. He’s a player, Mr. President. Tell the Foleys to open a file on the guy and put a big flag on it.”

“Will Taipei spring for compensation?” SWORDSMAN asked.

“Would you?”

“My instinct would be to tell them where they could shove it, but I’m not supposed to lose my temper, remember?”

“They will listen to the demand, and then they will ask me where the United States of America stands. What do I tell them?”

“For the moment, we stand for renewed peace and stability.”

“I can make that last an hour, maybe two hours. Then what?” SecState persisted.

“You know that area better than I do. What’s the game, Scott?”

“I don’t know. I thought I did, but I don’t. First, I kinda hoped it was an accident. Then I thought they might be rattling their cage—Taiwan’s, I mean. No, it’s not that. They’re pushing too hard and in the wrong way for that. Third option, they’re doing all this to test you. If so, they’re playing very rough—too rough. They don’t know you well enough yet, Jack. It’s too big a pot for the first hand of the night. Bottom line, I do not know what they’re thinking. Without that, I can’t tell you how to play it out.”

“We know they were behind Japan—Zhang personally was behind that Yamata bastard and—”

“Yes, I know. And they must know that we know, and that’s one more reason not to piss us off. There are a lot of chips on the table, Jack,” Adler emphasized again. “And I do not see a reason for this.”

“Tell Taiwan we’re behind them?”

“Okay, if you do that, and it gets out, and the PRC ups the ante, we have thousands—hell, close to a hundred thousand citizens over here, and they’re hostages. I won’t go into the trade considerations, but that’s a big chip in political-economic terms.”

“But if we don’t back Taiwan up, then they’ll think they’re on their own and cornered—”

“Yes, sir, and the same thing happens from the other direction. My best suggestion is to ride with it. I deliver the demand, Taipei says no, then I suggest that they suggest the issue is held in abeyance until the issue of the airliner is determined. For that, we call in the U.N. We, that is, the United States, call the question before the Security Council. That strings it out. Sooner or later, their friggin’ navy’s gotta run out of fuel. We have a carrier group in the neighborhood, and so nothing
can
happen, really.”

Ryan frowned. “I won’t say I like it, but run with it. It’ll last a day or two anyway. My instinct is to back up Taiwan and tell the PRC to suck wind.”

“The world isn’t that simple, and you know it,” Adler’s voice told him.

“Ain’t it the truth. Run with what you said, Scott, and keep me posted.”

“Yes, sir.”

ALEX CHECKED HIS watch. Next to the electron microscope was Dr. Clemenger’s notebook. At 10:16, she lifted it, made a time notation, and described how both she and her fellow associate professor confirmed the presence of the Ebola virus. On the other side of the lab, a technician was running a test on blood drawn from the wife of Patient Zero. It was positive for Ebola antibodies. She had it, too, though she didn’t know it yet.

“They have any children?” Janet asked, when the news arrived.

“Two, both away in school.”

“Alex, unless you know something I don’t ... I hope their insurance is paid up.” Clemenger didn’t quite have the status of an M.D. here, but at moments like this she didn’t mind. Physicians got to know the patients a lot better than the pure scientists did.

“What else can you tell me?”

“I need to map the genes out a little, but look here.” She tapped the screen. “See the way the protein loops are grouped, and this structure down here?” Janet was the lab’s top expert on how viruses were formed.

“Mayinga?”
Christ, that’s what got George ...
And nobody knew how George had gotten it, and he didn’t know now how this patient ...

“Too early to be sure. You know what I have to do to run that down, but ...”

“It fits. No known risk factors for him, maybe not for her, either. Jesus, Janet, if this is airborne.”

“I know, Alex. You call Atlanta or me?”

“I’ll do it.”

“I’ll start picking the little bastard apart,” she promised.

It seemed a long walk from the lab back to his office. His secretary was in now, and noticed his mood.

“DR. LORENZ IS in a meeting now,” another secretary said. That usually put people off. Not this time:

“Break in, if you would, please. Tell him it’s Pierre Alexandre at Johns Hopkins, and it’s important.”

“Yes, Doctor. Please hold.” She pressed one button and then another, ringing the line in the conference room down the hall. “Dr. Lorenz, please, it’s urgent.”

“Yes, Marjorie?”

“I have Dr. Alexandre holding on three. He says it’s important, sir.”

“Thank you.” Gus switched lines. “Talk fast, Alex, we have a developing situation here,” he said in an unusually businesslike voice.

“I know. Ebola’s made it to this side of the world,” Alexandre announced.

“Have you been talking to Mark, too?”

“Mark? Mark who?” the professor asked.

“Wait, wait, back up, Alex. Why did you call here?”

“We have two patients on my unit, and they’ve both got it, Gus.”