Panic in Level 4: Cannibals, Killer Viruses, and Other Journeys to the Edge of Science, Page 2

  “What sort of habits?” I asked.

  She explained that when you’re working with a hot virus like Ebola, it’s essential to constantly check your space suit. A suit can get a hole in it. The person inside the suit might not notice the creation of the breach. Nancy Jaax had been trained to frequently check her space suit for leaks. One day, she was cutting open a dead Ebola-infected monkey, and her space suit was splashed with Ebola-infected monkey blood up to the forearms. Then, during a routine safety check, she discovered a hole in the arm of the suit, near the glove. Ebola-infected blood had run down into the hole and was oozing around inside her space suit and had soaked her arm and wrist. “I had an open cut on my hand, with a Band-Aid on it,” she said. She’d gotten the cut opening a can of beans for her children. The incident “fell into the category of a close call,” she said. In the end, she survived her encounter with Ebola only because her habit of checking her space suit for leaks enabled her to get out of the hot zone fast and remove her bloody space suit. Her narrative left me mesmerized.

  There’s a useful technique for capturing important moments during an interview that I call the delayed note. When someone is saying something powerful, you don’t always want to draw attention to the fact that you’re writing down their words, because they may pull back and stop talking. So, on rare occasions, I may stop writing. I put down my notebook. I try to get a neutral expression on my face, as if I’m not that interested. Meanwhile, I’m trying to memorize exactly what the person is saying. When I sense that my short-term memory is getting full, I change the subject and ask a question that I expect will result in a dull answer. The person begins giving the dull answer, and I begin jotting delayed notes in my notebook. I’m writing down what the person said moments earlier, while I was not taking notes. (I learned this technique from John McPhee, who teaches an undergraduate writing course at Princeton University called The Literature of Fact. I had taken his course as a graduate student.) So, as Nancy Jaax began to talk about the blood in her space suit, I put down my notes and listened.

  This was just the beginning of the research for a key scene in The Hot Zone, narrating how Nancy Jaax got a hole in her space suit and Ebola blood flowed inside it. At one point, much later, I spent twenty minutes sitting with Jaax at her kitchen table, taking notes on her hands. I examined her hands minutely, left and right, back and front, staring at them like a palm reader. Hands are a window into character. Jaax kindly submitted to my study of her hands, though I think it weirded her out just a little.

  “Where did you get that scar on your knuckle?” I asked.

  “Which one? That one? That’s where a goat bit me when I was nine,” she answered, touching the scar. It had been a goat on her family’s farm in Kansas, she explained, and she could still recall how much the bite had hurt.

  Deep notes can also be notes on what a person is thinking. Of course, since you can’t read minds, you have to ask people what they are thinking or were thinking. After I’ve written a passage describing a person’s stream of thoughts—a type of narrative that fiction writers refer to as interior monologue—I always fact-check it with the person later. I read the passage aloud, usually on the telephone. I ask the person, “Do these sentences accurately reflect your recollection of what was going through your mind at that moment?”

  Often, the person answers, “Not exactly,” and proceeds to correct what I’ve written to make it more faithful to their own memory. If it was an especially dramatic, emotional, or terrifying moment, the person can often give a consistent account of what they were thinking and feeling. (Witnesses to crimes often don’t accurately remember the facts of what they saw—but they do remember their feelings with clarity.)

  After Jaax had realized that Ebola blood was slopping around inside her space suit, she had to make an emergency exit from Level 4. She went into the air lock and stood in the chemical shower, feeling the blood squishing around on her arm and hand.

  “Were you thinking you would die?” I asked her.

  “No,” she replied. Instead, she had been thinking about the fact that she had forgotten to go to the bank to get money for the babysitter who was taking care of her kids that day. If she was infected with Ebola, the authorities would lock her in the Slammer, and who was going to pay the babysitter?

  I don’t think a novelist would be likely to invent this. And if it appeared in a novel, it might not ring true. Yet Jaax’s account of what she was thinking is completely believable because it occurs in a nonfiction narrative. It seems to reverberate with general human truth. It is a statement about mothers, children, and death, and it cut me to the heart when I heard it. I could not have made it up.

  In the bloody space-suit scene, when Nancy Jaax emerged from the chemical shower and took off her suit to examine her hand, to see if there was any Ebola blood on it, I described her hands in detail as her gloves came off. Just a couple of sentences. These sentences were the result of the long examination of her hands at her kitchen table. I mentioned the scar on her knuckle and that she’d gotten it as a girl from a goat bite at her family’s farm in Kansas. The scar was a microstory. It told the reader that Nancy Jaax was a Kansas farm girl; she was Dorothy in Level 4.

  While I often take photographs to supplement my notes, I almost never use a tape recorder. Apart from the fact that a tape recorder always seems to fail when it’s most needed, the device makes the person who’s being recorded self-conscious. An interviewee will stare at the tape recorder while his or her speech becomes awkward, not like the natural, lively voice of a person in real life. Indeed, cameras and sound recorders aren’t sufficient for deep notes. No electronic recording device can capture the interplay of the human senses. For capturing sensual reality, it seems that only an old-fashioned reporter’s notebook has sufficiently advanced technology. I take notes in longhand in little spiral notebooks. They are small enough to fit in a shirt pocket. I use a mechanical pencil.

  TWO ARMY VIRUS RESEARCHERS walked down one of the long corridors of USAMRIID, at Fort Detrick. I had been hanging around with them that day. My shirt pocket had a magnetic security card clipped to it, with the word VISITOR on it. My shirt pocket also contained a small reporter’s notebook and a mechanical pencil. The walls of the corridor were cinder block, painted the color of sputum. Thick glass windows looked into sealed laboratory suites—Biosafety Level 2, Level 3, and Level 4. The corridor was filled with a weird, burning, moist smell. This smell, which will never leave my mind, was the odor of giant autoclaves—huge, pressurized steam ovens, full of equipment and waste from the labs, cooking the stuff at high heat and pressure, to make it sterile.

  The researchers’ names will be given here as Martha and Jeremy; those are not their real names.

  Jeremy glanced at Martha. “I was thinking it might be a good day for going into BL-4,” he said.

  “I was thinking so, too,” she answered. She was looking at me.

  Jeremy turned to me and said, casually, “Are you up for BL-4 today?”

  We were standing before an inconspicuous door marked AA-5. It led to one of the Ebola suites, a group of rooms where Ebola research was actively being done. “What will we be doing in there?” I asked.

  “Somebody died,” Jeremy answered ominously. “The blood samples came in the other day. We’re doing tests to try to identify any virus in the samples.”

  The dead person’s identity had not been disclosed to the Army researchers. They had been told he was a “John Doe” male. He had apparently been a U.S. government employee. He might have been a soldier. Or he might have been a diplomat. Or, possibly, John Doe had worked for an intelligence agency such as the CIA. The researchers would never learn his name, the circumstances of his death, where he had died, or who his employer had been.

  The Institute had relationships with various U.S. government agencies and offices. They were known as clients. The Institute’s clients included the White House, the Department of Defense, and, almost certainly, a number of intelligence
agencies. The Institute performed research for its clients. Whichever client John Doe had worked for, he had died with symptoms that suggested a hot virus. His death had apparently involved tiny, starlike pools of blood under his skin, and blood might have been flowing from his orifices.

  “I don’t know where the samples came from,” Jeremy said. “They didn’t tell me. Maybe the Middle East. The X virus, if it’s there, seems to be Marburg-like.”

  Marburg virus is a type of Ebola that is associated with Kitum Cave, in the rain forest on the eastern side of Mount Elgon, an extinct volcano in East Africa. On at least two occasions, people who went inside Kitum Cave died shortly afterward of Marburg virus, having apparently caught the virus inside or near the cave.

  “If there’s a virus in the blood samples, it’s considered a Biosafety Level 4 agent,” Jeremy continued. “This is because the guy died and because it [the putative X virus] hasn’t been identified. It’s an Unknown,” he said.

  Martha swiped her ID card across a sensor, and a computer-synthesized voice issued from a speaker by the door: “RTU downloading.” There was a chime. “One moment please,” the computer said. A green light went on, and there was a click. The entry door had unlocked.

  Martha went through the entry door and closed it behind her. The light over the door went from green to red.

  Meanwhile, Jeremy and I waited in the corridor. Beyond the door was a locker room. Martha would take off all her clothing in the locker room and then would proceed inward through some other rooms, where she would put on her space suit and head into the Ebola zone.

  In a few minutes, the light turned green again. This meant that Martha had left the locker room and had gone farther inward. Now we could enter.

  Jeremy swiped his security card on a pad by the door, I swiped mine, and we entered the locker room. As we went into the room, we passed through an additional security system that won’t be described here.

  In the end, I never found out what role the commander had in my visit to Level 4. But I think he must have known about it. Jeremy and Martha were experienced, cautious professionals with impeccable safety records. I speculated that the commander had decided to permit me to visit Level 4 with these two people, so long as the visit was kept low-key—though not unofficial. The main building of USAMRIID had security guards who sat in a control room, monitoring the movements of people in the building. I guessed that the security people had known that I would be going into a hot zone even before I knew it myself. The magnetic security card that I wore clipped to my shirt could show the security staff my location in the building; it would also tell them that I was entering the hot area.

  The locker room was small and gritty-looking, with a wooden bench and some steel gym lockers, banged up and dented. Jeremy and I stripped down to nothing and put our clothing in the lockers.

  “You need to take off your glasses and leave them, too,” he said. “They’d fog up inside the suit, anyway.”

  People had to take out contact lenses, as well. They also had to remove jewelry, including engagement rings. (Women were allowed to wear a tampon in Level 4, but they had to remove it on their way out of the lab.)

  I put my glasses in the locker. As I took off my shirt, I slipped the notebook out of my pocket, and I clipped the mechanical pencil to the notebook. Holding these two items, but otherwise stark naked, I followed Jeremy through a doorway that led inward.

  The doorway was actually a tiled shower stall, with a water shower-head in it and a drain in the floor. The shower stall glowed deep purple with ultraviolet lights. On their way out of the hot zone, after having worked in a space suit with dangerous organisms, the researchers would pass naked through the water shower, washing their skin with detergent and bathing their bodies in ultraviolet light, before they went into the locker room to get dressed.

  On the inward side of the ultraviolet doorway was a small room considered to be at Biosafety Level 2—the mildest degree of biocontainment. Some metal shelves stood against one wall, and there was a toilet. The shelves were piled with blue cotton surgical scrub suits and other items of surgical wear, along with rolls of tape. We put on scrubs—no underwear was allowed. We also put on white socks, surgical hair coverings, and surgical gloves. Jeremy showed me how to tape the socks and the gloves to the cuffs of my scrub suit, wrapping the tape around the cuff to make a seal. “It’s a good idea to empty your bladder,” Jeremy said. “You won’t get a chance to once you’re in a suit.”

  I took up my notebook and pencil, and we pushed through a door into Level 3—this was a staging area leading to Level 4. It was a large room with cinder-block walls and a concrete floor. We heard a rumble of air-filtering machinery overhead. The staging area was crowded with pieces of laboratory equipment. Along the left-hand wall hung an array of biohazard space suits. They were made of soft blue plastic, with flexible plastic helmet hoods. Most of the suits had the owners’ names written on them with a Magic Marker.

  “People are touchy about their suits,” Jeremy remarked. “It’s like the Three Bears: ‘Somebody’s been wearing my suit.’”

  Martha had already donned her space suit, and she was preparing things in the staging area. While Jeremy got into his suit, Martha took a space suit down from the wall and helped me put it on. She opened the suit, peeling apart a sort of large Ziploc-style zipper that ran across the chest, and handed the opened suit to me.

  There was no name on my space suit.

  I sat down on a bench and slipped my feet through the chest opening, down into the suit’s legs. My feet ended up inside a pair of soft plastic bunny feet attached to the suit’s legs. I drew the suit over my body, and slid my arms into the sleeves, and into heavy rubber gloves attached to the ends of the sleeves.

  I pulled the hood and faceplate down over my head. The space suit’s zipper ran diagonally across the chest. I sealed the zipper, running my thumb and fingers along the seal, which closed me into the suit. The zipper was coated with a kind of grease that felt like Vaseline. The seals made a lip-smacking sound as I squeezed the zipper shut.

  A number of bright yellow air hoses dangled from the ceiling. They were the source of clean air for people’s space suits. Each room in the hot zone had its own set of air hoses hanging from the ceiling. When you moved from one room to another, you had to detach your air hose and get connected to a different air hose in the new room.

  I reached up, grabbed an air hose, pulled it downward (it came down from a spring coil). I plugged the hose into a socket near my waist.

  My suit inflated with a roaring sound. Cool, dry air began flowing around my body. The air was constantly being bled from exhaust ports in the suit, while the suit remained inflated. I felt the air blowing downward past my face, coming from vents inside the helmet. The airflow was designed to keep the suit under constant positive pressure, so that if the fabric developed a hole or a breach, air would flow out of the suit, and wouldn’t allow any dangerous organisms to flow in.

  The high flow of air inside the suit created an almost deafening roar, which made it difficult to hear anything. The researchers had to shout to carry on a conversation in Level 4.

  Jeremy closed his suit and pressurized it.

  In front of us was a stainless steel door. It had a biohazard symbol on it, dark red, and the words

  BL-4 AREA. BIOHAZARD.

  NO UNAUTHORIZED ENTRY.

  FULL SUIT PROTECTION REQUIRED.

  Martha took a hose and socketed it into her suit, pressurizing it. Then she turned and faced me. She placed herself between me and the steel door. Our suits bumped together. She pushed herself up against me until our faceplates made contact. “HOW ARE YOU DOING?” she asked. It was hard to hear her voice over the roar of the air.

  “I’M FINE.”

  She looked into my eyes. I thought she was examining me for any signs of claustrophobia—flushed skin, sweat standing on my face, wide staring eyes.

  Evidently I looked all right. She caught Jeremy’s eye and steppe
d aside.

  I took up my notebook and pencil, holding them awkwardly in one of my suit gloves, and we faced the steel door.

  Martha looked down at my glove. “WHERE ARE YOU GOING WITH THAT NOTEBOOK?”

  “IN THERE,” I shouted, indicating the door leading to Level 4.

  She began laughing behind her faceplate. “IT’S FINE TO BRING YOUR NOTEBOOK INTO BL-4, BUT IT WILL NEVER COME OUT AGAIN. IT WOULD HAVE TO BE AUTOCLAVED”—cooked in a pressure oven. “THE PAPER WOULD DISSOLVE.”

  So I couldn’t take notes. We would be in Level 4 for at least an hour. I wouldn’t be able to recall nearly enough. “I NEED SOME WAY OF TAKING NOTES. WHAT AM I GOING TO DO?”

  “YOU COULD TRY THIS.” She handed me a sheet of flexible white plastic material, rather like paper, but, she explained, it was coated with Teflon. The researchers used this material in place of paper in a hot zone. You could write on it with a pen. It could be sterilized without damage.

  “WHAT ABOUT MY PENCIL?” I asked. “CAN I TAKE THAT IN?”

  “UH-UH,” Jeremy said, inspecting my mechanical pencil and shaking his head. “THAT’S GOT A SHARP TIP. PUNCTURE YOUR SUIT. SHE’LL GIVE YOU SOMETHING TO WRITE WITH WHEN WE GET TO THE HOT SIDE.”

  When you moved from one room to another, you had to detach your air hose momentarily, walk without pressure in the suit, and then plug into the next air hose. As soon as the air hose was disconnected, your space suit would deflate.

  Martha unclipped her air hose, and her suit went limp around her, shrinking down. She opened the steel door and stepped into the air lock and closed the door behind her. A moment later, Jeremy unclipped his air hose, and his suit went limp, and he stepped through the air lock door.