Unlocked: An Oral History of Haden's Syndrome, Page 2

  Benjamin Moldanado:

  Two weeks after Super Bowl Sunday we had a billion people infected worldwide, including fifty million in the United States—roughly one in seven people in both cases. By the end of four weeks it was two billion and eighty million. By the end of the year, 2.75 billion worldwide, ninety-five million in the US. One in three people across the planet got sick. 400 million died—one in every eighteen, just about.

  Natasha Lawrence:

  The irony today, if you want to call it that, is that people have almost forgotten just how genuinely terrifying that first stage of Haden’s was. Almost four million people died in the US alone, mostly in those first couple of months. That’s like wiping out the entire city of Los Angeles. In an average year, only about two and a half million people die in the US, total. We were barely equipped to deal with all the deaths, simply from the point of infrastructure.

  Outside the US and industrialized nations the death toll was even higher as a percentage, and their ability to deal with the dead much lower. And that caused a huge number of problems in terms of secondary waves of disease, infection, and general political and social instability. As bad as it got for us, much of the planet had it much, much worse. There are places on the globe that still haven’t entirely recovered, either in population or in terms of social structures.

  Irving Bennett:

  Here’s an interesting fact that I learned from one of the anniversary stories coming up—it was only last year that the global population passed what it was when Haden’s first struck. They used to think we’d be at something over eight and a half billion people by now. We’re a billion and a quarter people short. That’s not just because Haden’s killed 400 million people. It’s that many of those 400 million were of childbearing age, and that in the aftermath of the disease, particularly in the developing world, a whole bunch more who would have been parents died in the messes that came after. There aren’t that many things that have ever put that much of a divot into humanity’s growth curve. The only other thing I can think of that most other people know about is the Black Death. That’s pretty impressive company, if “impressive” is the right word to use here.

  And even the Black Death usually only attacked each of its victims once.

  Monique Davis:

  After the first several days of the Super Bowl flu we started getting some of the same patients back into the ER, only this time suffering from symptoms that resembled meningitis. After the first few, those of us on staff started looking at each other like, you have got to be kidding me. There was no way it could be coincidence that the same people who had been coming in for the flu were coming back with meningitis-like symptoms. The patients were different races, sexes, economic classes—the only thing they had in common was that they had the Super Bowl flu first.

  We started checking around at the other ERs to see if they had the same thing happening, and they did. Patients were coming back with what looked like meningitis. A lot fewer of them than in the first round. Maybe one in four or five. But it was definitely a second stage of some sort. Now, it’s possible for meningitis to be diagnosed as a flu. They share some initial symptoms. But for the same virus to exhibit flu-like symptoms, recede in most patients and then return like meningitis in a select few, that was new. And really sort of frightening.

  Benjamin Moldanado:

  One of the things that researchers don’t want to admit, because it sounds more than a little bit sociopathic, is how interesting the Haden’s virus was and what things we were hypothesizing in order to explain how it was doing what it was doing. With the meningitis-like symptoms we were confronted with the idea that a virus would attack a body, have the body’s immune response beat it back to greater or lesser extent and then as a result wholly reconfigure the way it was attacking the body—but only in a small number of the infected.

  Some of the early hypotheses included reactions to blood type or specific antibodies, a signal dependent on total viral load, or a response to specific environmental inputs, like temperature or air quality or even wireless signal. The last of those is an example of how just because it’s a hypothesis doesn’t mean it’s good, or useful. The point was that we were looking for some reason for the virus to apparently mutate, and that led us to be occasionally wildly imaginative in our speculation. It was the most intriguing puzzle that most of us had worked with, and we’re talking about a room full of people whose job it is to work on genetic material and other natural puzzles every day. It was fun—or as fun as anything could be up to the point when you remembered people were out there dying from the thing, and you were supposed to be putting a stop to that.

  Our problem was that none of our hypotheses fit the data. There was no obvious single environmental or physical factor we could find that would precipitate the change we saw in the virus. At least not in the short term. This was a problem because everyone wanted to know what they could do to counteract or at least avoid the second phase of the virus attack. And we had nothing to tell them. The only way you’d know whether or not you’d get the second phase of the attack was the headache, the stiff neck, and the other symptoms. You got it or you didn’t.

  This was widely considered an unhelpful response from the CDC researchers, and I don’t disagree with that. We were some of the smartest scientists, geneticists, and virologists in the world. We were working as hard as we could on the problem. And it seemed like the problem was working equally hard to elude us.

  Natasha Lawrence:

  The meningitis phase affected substantially fewer people than the flu phase but the mortality rate was substantially higher. About a quarter of the deaths associated with Haden’s came from people who died in the second phase. That’s because the phase didn’t just present meningitis-like symptoms. The virus invaded deep into the brain and started altering brain structure in significant ways. It was literally making the brain rewire its own connections. That was another thing we didn’t know a virus could really do.

  In the lab we would talk about this virus like it was an evil genius. Like it was a Bond villain. It was a joke, and a way to have a little bit of levity in an otherwise depressing race against time. But in some ways it wasn’t a joke at all. I think the general thought around the CDC was that this virus was actually the closest thing to malicious that a virus could get.

  Monique Davis:

  You could see how the second phase of the virus was working in our patients, the ones that were conscious, anyway. It would be like a series of little strokes. A little aphasia here, some loss of hearing or sight there, someone having a bit of Bell’s Palsy over on the next bed. Sometimes the patient would snap back immediately—the brain rewiring itself on the fly, I guess—and sometimes they’d just get worse. Some of them didn’t progress, they just died. I had one patient stop talking to me mid-sentence. It took me a minute to realize she had passed. I honestly thought she had paused to collect her thoughts.

  With the meningitis phase a lot of what we were doing, to be entirely upfront about it, was keeping the patients as comfortable as we could while we waited out whatever the virus was doing to their brain. A lot of people we couldn’t help, and their bodies just sort of let go. Most survived and most of them seemed to recover all right, with lesser or greater short-term cognitive shortfalls that were eventually addressed with therapies similar to what stroke victims get after an incident. Some experienced permanent brain damage, again to a greater or lesser extent—there was no way to tell how bad it was going to be until it was over.

  And then there were the people who experienced Lock In.

  PART TWO: HADEN’S SYNDROME

  Neal Joseph, Biographer and Author of “The President’s Crucible: The First Year of Haden’s Syndrome”:

  I talked to David Haden, President Haden’s younger brother, and the thing he told me that stuck in my head was that the President absolutely hated when the disease started being called “Haden’s syndrome.” Absolutely hated it. David said, and I remember this cl
early, that it was, “Not because it reminded everyone that he was President when it hit. It was because it was named for Margie. He hated that from the minute it stuck until the end of time, everyone would think of Margie as being sick. Of being trapped in her own self. As being the person you thought of, when you thought of Haden’s syndrome. Ben married this wonderful, physical, healthy, gorgeous woman and no one but him would ever think of her that way again.”

  Janis Massey, Chief of Staff for Margaret Haden, First Lady of the United States of America:

  After Margie got sick we looked at her schedule to see when it might have happened, when that first contact with the virus might have been. After ten minutes we threw up our hands. The First Lady’s schedule for the couple of weeks before she got sick had her at six events a day across five time zones in two different countries. One of those days she came into contact with school children, hospital patients, and the Prime Minister of Canada within six hours of each other. The only people who come into contact with more people on a daily basis than the First Lady are toll booth operators.

  She could have gotten it from any of the people she met. She could have gotten it from us, her staff; some of us got sick around the same time and at one point half of us were out of the office with it. She could have gotten it from Ben’s staff, many of whom also got sick. It was impossible to pinpoint. Which makes Margie like nearly everyone else who got sick with the virus.

  Col. Lydia Harvey, MD (Ret.), Physician to the President:

  The First Lady came to see me on the afternoon of the 13th, after a staff meeting, and said she was feeling achy and wanted to know if I could do anything about it. As I examined her we talked about our upcoming plans for Valentine’s Day—well, she talked about hers and I admitted I had no plans because my husband was as romantic as a fish, and I’m really not much better. She laughed and said the President was the same way, but she liked an excuse to have a nice dinner for just the two of them.

  By this time I was obviously aware of what was then still called the Super Bowl flu—the President had been briefed on it by the CDC and I had been allowed to sit in on the briefing because of my position as presidential physician. But the presentation initially seemed much more like the bird flu variant that had been present at the time, and I knew that the First Lady had missed her flu vaccination—an oversight on the part of my staff. I told her it was likely to be that, though it might be the Super Bowl flu instead, and that in either case she should consider cancelling her schedule for the next couple of days and resting. She agreed to reduce her schedule for the next day but was adamant about her dinner date with the President. I told her that would probably be fine.

  Elizabeth Torres, Personal Assistant to the First Lady:

  The First Lady was under the weather for Valentine’s Day and for a few days afterward but it didn’t seem like whatever flu she had was getting the better of her. She trimmed down her schedule mostly to planning sessions with the staff, made only a few unavoidable personal appearances and kept herself hydrated. She was sick but it was a highly functional sick, if you know what I mean.

  At the end of the week she decided that she was feeling better and that she could do a full weekend schedule. This included the Maryland Winter Girl Scout Jamboree, where she was going to give a speech at the closing ceremonies. She had been a Girl Scout herself, so this was something she didn’t want to miss if she could avoid it.

  Saturday she was fine. If she was feeling poorly she kept it to herself. She spent the morning using the White House studio for radio interviews and then had personal time for the rest of the day. When I left she seemed good. No more or less tired than she might have otherwise been. I assumed that she was over the flu.

  Sunday morning she said she felt stiff and had a headache, but she said she thought it was probably due to a large margarita she had while she was binge watching old episodes of Orange is the New Black and then sleeping poorly. I suggested she might want to see the doctor on staff that morning, but she waved me off and took Tylenol instead and then we headed off to the Jamboree.

  Ann Watson, former Reporter, WHAG-TV:

  I was supposed to get three minutes with the First Lady before she went up and gave her speech, but when we arrived we were told by her press secretary Jean Allison that she wasn’t going to give any pre-speech interviews. Well, I was more than a little annoyed by this. The only reason we were at the Jamboree at all was because we were promised face time, otherwise we would have just had a cameraman do crowd shots for the last two minutes of the 6:30 broadcast. I told Jean that, and reminded her that it was her office who set up the interview, not us. She apologized and kind of ducked in toward me and said “look, she’s really not feeling well and we’re just trying to get her through this thing,” and that she would make it up to me. Then she walked off.

  As she’s saying this I can see the First Lady greeting some of the Girl Scouts. Margie Haden was very good at the public appearance face—the look of being interested or excited about something even if you don’t care—and she was doing her best to use it. But you could see it slip the second she lost focus. I can’t say she looked like she was in pain, but I can say that she looked very, very unhappy.

  Elizabeth Torres:

  By the time we arrived to the campground she said her headache had become a migraine. I was worried because as long as I knew the First Lady she had never gotten a headache that would qualify as a migraine. I asked her if she wanted to back out but she said no, she could get through it. Celia Williams and Davis Armstrong, who were in charge of her security detail, also suggested that she cancel or at the very least limit her public time at the event. She didn’t want to do that. She didn’t want to disappoint the scouts.

  Ann Watson:

  About a half hour before the closing ceremonies were supposed to start, the organizers started trying to herd all the Girl Scouts into the bleachers. They were being told that the First Lady had had something come up and she would have to give her speech early. I could hear the youngest Girl Scouts complain, because they were there for the other activities. They hardly knew who the First Lady was at all. But they were all pushed along to the bleachers.

  We set up at the front with the other media and had to do a little elbow throwing because we’re a small market crew, but got a good spot. Off to the side we could see the First Lady, in her winter coat, conferring with a young lady I think was her assistant and with what were obviously her Secret Service people. By now the First Lady’s public appearance face was long gone. But she wasn’t on stage so it probably isn’t fair to note that.

  She was introduced very briefly by the head scout, I think, and then she came on. The Girl Scouts started cheering and screaming for her, and if you look at the video feed and know the context, you can tell for her it was like being stabbed in the eardrums. But she smiled and waved and got out her notes and talked like a trouper for five minutes. Then she stopped, smiled and looked off stage.

  Elizabeth Torres:

  She looked over directly to me, said, “I think I may be having a stroke,” and collapsed.

  Ann Watson:

  I don’t think I have ever seen people move as fast as I saw those Secret Service people move when she hit the floor up there.

  Col. Lydia Harvey:

  When I learned that the First Lady collapsed in Maryland, after having been sick and without a member of my staff being present, I, after an appropriate time, tendered my resignation to the President. He refused it, on the basis that the First Lady did not check in with the staff to let us know she was feeling poorly. Nevertheless, it was made clear to me immediately afterwards that the refusal came counter to the suggestion of some of the top members of his team. They had questioned my treatment of the First Lady’s earlier phase of the disease and blamed me for her progressing to the second, meningitis-like phase.

  Of course we know now that there was nothing that I or any physician could have done that could have changed the progression of the d
isease. But this is the wife of the President we’re discussing. As ridiculous as it sounds, within the White House itself, it became political, quickly.

  In any event, within minutes of her collapse she was on her way to Walter Reed, and so was I.

  Wesley Auchincloss, Deputy Chief of Staff for President Haden:

  The President was in Arizona for a meeting with western governors when he’d gotten word his wife had collapsed. They were discussing the border wall with Mexico when [Presidential Assistant] Clay Strickland leaned in and told him. The President stood up immediately and started to exit the room. The governor of Texas, who had been a primary opponent of his, started to complain, and the President held up his hand and said, “Bill, at this very moment, I could not give a single god damn for your miserable wall,” and walked out. I’m certain the governor of Texas never forgave the President for that comment. I am equally certain the President did not, as he put it, give a single god damn about that.

  Neal Joseph:

  What was really underappreciated at the time—even after that bruising election cycle—was how much Benjamin Haden relied on Margie Haden. Much was made of the closeness of their relationship, and how it humanized him despite him being a generally unlovable character. But most people missed just how deeply he needed her, both politically and emotionally. He wouldn’t have made it into the White House without her, simply put. And when she collapsed and it looked like she might have had a serious stroke, you could not have more effectively pulled the rug out from under the man than that. People were surprised that he literally put everything on pause to get back to her. They shouldn’t have been surprised. It would have been surprising if he hadn’t.

  Col. Lydia Harvey:

  The President’s face when he got to Walter Reed and saw his wife in the hospital bed. You would have thought someone had torn out his heart and stamped it into the floor.