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

“What do you mean by ‘down and cold’?” I asked.

He explained that the hot zone had been completely sterilized with gas and opened up for routine maintenance. The rooms weren’t dangerous. Anyone could go into the lab without wearing a space suit. The hot freezers, too, had been moved out of the lab. Therefore, the lab was completely cold and safe.

“That’s not really what I had in mind,” I said.

“What did you have in mind?” he asked.

“I would like to experience the real thing, so that I can describe it. I’d like to go into a hot BL-4 lab and see how the scientists work with real Ebola.”

“That’s not possible,” he answered immediately.

Security at
USAMRIID
was extremely tight. Even so, it was not as tight as it would become. That day in the commander’s office was some nine years before the anthrax terror attacks of the autumn of 2001, shortly after 9/11. The anthrax attacks came to be known as the Amerithrax terror event, after the FBI’s name for the case. Small quantities of pure, powdered spores of anthrax—a natural bacterium that has been developed into a very powerful bioweapon—were placed in envelopes and mailed to several media organizations and to the offices of two United States senators. Five people died after inhaling the spores, while others became critically ill; some of the survivors have never fully recovered. For the most part the victims, including African-Americans and recent immigrants to the United States, were low-level employees of the post office who were just doing their jobs. No one has been charged with the Amerithrax crimes. The evidence suggests they were done by a serial killer or killers who intended to murder people and may have taken pleasure in causing the deaths while escaping punishment. The case remains open.

Officials at the United States Department of Justice named Steven Jay Hatfill, a former researcher at
USAMRIID
, as a “person of interest” in the case. Hatfill has never been charged with involvement in the crimes, though. At the same time, there was speculation in the news media that the exact strain of anthrax used in the attacks might have come out of an Army lab, even possibly from
USAMRIID
itself, where defensive medical research in anthrax had been going on for years. (The precise results of the FBI’s analysis of the anthrax strain have not been disclosed by the government, as of this writing.)
USAMRIID
scientists, in fact, played a key role in the forensic analysis of the anthrax that was collected from the envelopes.

Following the Amerithrax terror event, security at
USAMRIID
became astronomically tight. After that, it would have been useless for a journalist to ask to go into the space-suit labs. Back at the time when I was researching
The Hot Zone,
though, there was a slight amount of flexibility in the policy. On certain occasions, the Army
had
allowed untrained or inexperienced visitors to go into hot zones at
USAMRIID
. Unfortunately, as the commander explained to me, some of these visits had ended badly. People who were not familiar with space-suit work with hot agents had a tendency to panic in Level 4, he said.

In one such an incident, a medical doctor—a visitor—who had apparently never worn a biohazard space suit attended a human autopsy in a Level 4 morgue at the Institute. This hot morgue is called the Submarine. The Submarine is a sealed hot zone with an autopsy room and an autopsy table. The cadaver was believed to be infected with a Level 4 Unknown X virus. During the examination, while the space-suited autopsy team was removing organs from the cadaver, some members of the team noticed that the visiting doctor’s face seemed red. As the team members looked at him through his faceplate, they saw that his face was also dripping with sweat. Meanwhile, the outer surfaces of his space-suit gloves and sleeves were smeared with blood from the cadaver.

Reportedly, the man began saying, “Get me out!” Suddenly he tore off his helmet and ripped open his space suit, gasping for breath, taking in lungfuls of air from the hot morgue.

The members of the autopsy team took hold of him and hurried him to an air lock door leading to the exit. They opened the door, pushed him into the air lock. At least one of the team members accompanied him into the air lock. The air lock was closed, and the chemical shower was started.

The way I heard the story, the man stood or sat in the air lock while the chemicals ran down inside his opened space suit. The shower stopped automatically after seven minutes. The chemicals had flooded his suit. Then the team members helped him into the staging area—the so-called Level 3 area—and helped pull him out of his space suit. By this time, he was subdued and embarrassed.

The United States Army Medical Research Institute of Infectious Disesases (
USAMRIID
)
Getty Images

At
USAMRIID
, people who have had a verified exposure to a hot agent are put into a Level 4 quarantine hospital suite called the Slammer. The Slammer is a biocontainment unit where doctors and nurses wearing space suits can treat a patient without being exposed to a virus the patient may have. The man who had panicked was a possible candidate for quarantine in the Slammer. Even so, after an immediate review of the incident by a safety team, the Army felt that he did not need to be put in quarantine; there was no evidence that the cadaver had actually been infected with a virus. And the man never got sick.

“We can’t predict how someone who’s untrained might react in BL-4, so we can’t allow you to go in,” the commander explained to me.

I still wanted to go into Level 4. But I couldn’t see how to get there.

I
N NARRATIVE NONFICTION WRITING
, taking notes is an essential part of the creative process. We tend to think of a reporter’s notes as being a transcript of the words of someone speaking to the reporter. If you who are reading this happen to be a student of journalism, remember that you can take notes about anything. It can be quite useful to jot down observations on any and all details of a person and a scene, including sights, smells, and sounds, as well as the emotional aura of the scene. These kinds of observed details might be called deep notes. Deep notes are a record of the visceral reality in which the characters exist—notes on the soup. Deep notes can be details of how people move their bodies, what they wear, what sorts of tics and gestures they display. I always try to note the color of a person’s eyes, and, when possible, I try to observe their hands.

One of the main figures in
The Hot Zone
is Lieutenant Colonel Nancy Jaax, an Army space-suit scientist who specializes in Ebola virus. I met Nancy Jaax during my first visit to Fort Detrick, on a warm spring day. She turned out to be a pleasant, energetic, articulate officer who seemed incredibly committed to her work. I learned that she was a mother of two children, who were then in high school. Her eyes were blue-green and active, with flecks of gold encircling the irises. About fifteen minutes into my first interview with her, I asked her if she had ever had a scary experience with Ebola virus. “Oh, sure,” she answered. “That’s where you realize that habits can save your life.”

“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.