Twenty hours after briefing Senator Flaherty's congressional subcommittee investigating the Vice President's death, Dr. Brisling stepped out of a chartered Learjet into the sweltering heat of an Atlanta afternoon. An air-conditioned limousine waited for him on the tarmac.
The limousine slipped through the city and deposited the doctor and his suitcase beneath the towering emerald glass of the CDC's new Global Health Center. As he trudged toward rhw main entrance, he caught a glimpse of his own reflection in the tinted glass, a fat, greenish ghost in a rumbled brown suit. All at once, the weight of years was on him.
It was 1983. R. K. Brisling was a rising star at the CDC's Epidemic Intelligence Service, the handsome blond doctor who had charged an outbreak of Lassa fever in the jungles of Sierra Leone and emerged victorious and unscathed. His accomplishments won him a major research grant from the Department of Defense. A tenured position at the CDC soon followed. He commanded a legion of talented post-docs and technicians armed with the best equipment money could buy. Surely, there was a place for R.K. Brisling among the pantheon of medical science, there next to Fleming, just to the left of Pasteur. The only thing that kept him grounded was Judith.
Carrying a child made her lovelier than ever. There was a glow in her face, a special sheen in her lush black hair, a contented fullness to her body. Easy was Brisling's surrender to domestic bliss, the floral bassinets, the fuzzy blankets, socks so tiny you could wear them on your thumbs. He had even started coming home from the lab in the middle of the afternoon to help paint the nursery. It was a dream.
Now, Brisling schlepped his suitcase through the automatic sliding doors and found himself standing in the middle of a vast lobby. Green-tinted sunlight splashed across the marble floor.
The lobby was virtually empty. But over by the elevators, an older Black woman, tall and graceful, chatted with the security guard. Her frizzy gray hair was up in a neat bun, but her long summer dress and Birkenstocks made her look like a hippie. Seeing Brisling standing there, she turned and approached swiftly, smiling as she seemed to dance across the lobby. She stopped a few paces short, arms wide. "Royal!"
It echoed through the lobby. Royal. Only three people had ever used his Christian name. There was Sergeant Dill back at Fort Knox, basic training. And of course there was Judith, but only when she was angry.
"Genevieve Gervin?" said Brisling.
"It's me, Gee-Gee."
Except for the gray hair and wrinkles at the corners of her wide-set eyes, the woman had not aged a goddamned day. The same brilliant smile, the same sweet Georgia drawl.
She stepped back, taking him in. "Has it really been thirty years?"
"That's what they say."
She let her arms fall, smile dimming. "How's Seattle?"
"The coffee's good."
"I still brew my own honey tea. Care for a glass?"
Genevieve led Brisling to her office on the eighth floor. Navigating the hive of cubicles, they came to a windowless nook in the corner, a temporary space formed by modular walls. But inside those walls, Genevieve had made a permanent home it seemed: shelves cluttered with books, framed photos on the desk, ballet posters on the walls. She even had an herb planter equipped with an indoor growing lamp. A luxuriant rug covered the cold linoleum floor.
Brisling sat in an old leather chair and watched Genevieve as she closed the door, kicked off her Birkenstocks, and danced on the rug. Standing on her bare tiptoes, she took a pair of drinking glasses from a high shelf, ducking now to open a mini fridge. She set the glasses on her desk and dropped in the ice cubes one by one, clink, clink, clink. Scissors in hand, she pirouetted over to the herb planter and snipped a few mint leaves. She set a great gallon jar on the desk and filled their glasses. Dropping in a few mint leaves, she handed Brisling his tea. Then she sat at her desk and flourished her long, graceful arm. "Welcome to my corner office."
"At least yours is above ground."
She raised her glass with a wry smile. "To ambition."
Brisling practically snorted. "To ambition." He put the glass to his lips. The tea was sweet with honey, but it went down with a chill.
Genevieve got up and stood with her back against the door, her expression serious. "Now, tell me what the hell's going on." Brisling was mid gulp, so she kept talking. "I'm in a meeting and someone pulls me out to say there's a US senator on the phone. Not just any senator, mind you, but Joseph Flaherty, the Massachusetts Messiah. And when I get on the phone, the good senator informs me I have exactly one hour to put together a presentation for someone I haven't seen in thirty years."
Brisling curled his lower lip and nodded. "Not much of a warning, I agree. But that's why I'm here."
"This has to be some sort of joke."
"I'm no joke."
She let her narrow shoulders slump. "You know that's not what I meant. What I mean is that I already presented everything I had on PML, and he didn't seem to think it was real."
Brisling drained his glass. "Who didn't?"
"Vince De Soto."
"He's head of EIS now?"
She shook her head. "No, he was just appointed interim head of the entire CDC. I thought you knew."
He tilted his glass for the last drop of tea, the ice cubes barging up against his upper lip. Lowering the glass, he wiped his mouth with the cuff of his shirt. "Well, good for him."
Genevieve responded with a sympathetic expression, head cocked a little, mouth half open. She knew the whole story, or at least most of it. When Brisling had first arrived at the CDC, Vincent De Soto was a junior scientist with the EIS, the Epidemic Intelligence Service. Judith was his secretary. And his girlfriend. It was at one of De Soto's pretentious garden parties in Ansley Park that Brisling first saw her, serving cocktails in a geisha costume. All night she floated silently from guest to guest, her face cold-white beauty, her blue eyes sharp and resentful. For the first time in his life, Brisling was in love.
Now he leaned forward, elbows on his knees, glass dangling from his fingertips. "The past is past," he whispered.
Genevieve sunk back into her chair. "God, you're right. I'm sorry."
"Don't be."
They shared a moment of silence.
At length, she spoke. "So, are you going to tell me why Congress is suddenly so interested in my data on PML?"
"Flaherty asked me not to say."
"Come on, it's me, Gee-Gee."
Brisling swirled the ice cubes in his glass, watching them spin out of control.
The ice.
Genevieve sighed. "Look, I have a lot of data, and it'll be a hell of lot easier to find what you're after if I know what you're looking for."
Her logic was as sound as ever. Besides, Flaherty had chosen him for his willingness to seek the truth no matter where it lay, no matter whom it pissed off. Because he had nothing to lose.
He looked up from his glass. "It's the Vice President."
Genevieve threw her hands into the air. "Lord, I knew it! As soon as Flaherty mentioned PML, I knew it had to do with Al Stone's death."
Brisling nodded. "The story about a stroke was just a cover. They suspected it was PML all along. The autopsy confirmed it. The man's brain was riddled with JC virus. That's why I'm here. They said you had data I'd be interested in."
She smiled grimly, donned reading glasses, and logged onto her computer. "Come on over, look at this. One of my epi technicians came across the signal three months ago. Each summer, we scour social media for any mention of flu-related symptomsâfever, chills, you know. When the number of hits starts rising, it's a pretty reliable indicator flu season is on us. So, my tech was using other symptoms as control searches. One of the symptoms she chose was 'seizure.'"
He set his glass down on the rug and approached the desk. "And you picked up a spike."
"Uh-huh. Then the tech started searching for other neurologic symptoms, and she found coincident spikes for "hallucination" and "dementia." That prompted me to crosscheck against our CDC databases for all diseases that could result in these symptoms. And of all those diseases, only one showed a corresponding blip."
"PML."
"Caused by the JC virus." Genevieve clicked her mouse a few times to pull up what appeared to be a simple line graph.
Brisling leaned over her desk for a better view and adjusted his glasses. "I can't make out the axis labels very well."
"Let me zoom in."
"Can't you just print it out?"
She gave him a pained look and sighed. Then she opened her filing cabinet and hauled out a fat manila folder. "I guess a part of me mistrusts computers too. Or maybe I'm just nostalgic. Or just old. At any rate, I still make hard copies of everything." She plopped the folder down and rifled through the papers until she found what she was after, a graph showing the number of monthly PML cases in the US going all the way back to 1975.
Brisling had seen the data a million times before. Prior to the 1980s, PML was exceedingly rare. But with the AIDS epidemic, the numbers skyrocketed, peaking in the mid-'90s before returning to pre-epidemic levels with the advent of effective HIV drugs.
"Look closely at the last six months," said Genevieve.
Again, Brisling adjusted his glasses. At the far-right-hand edge of the chart, the red line made a sharp upward turn, a wicked flip of the tail. "Is it just random noise?
"No chance. That's four straight months of increase. Compared to the four months prior, it's statistically significant. P values around ten to the minus tenth."
"Are these cases confirmed?"
"They're all confirmed."
"Jesus. How many are there?"
"About nine hundred excess cases as of July. That's a thousand-fold increase above baseline."
"Are they AIDS-related?"
"No. We checked. Almost none of these cases are in HIV-infected individuals."
"What about chemotherapy, or immune suppressants for autoimmunity, rheumatoid arthritis?"
"No, Royal. We checked. They all seem to be healthy individuals. I mean they were. I tried to get De Soto on board, but he wants me devoting all our resources to tracking influenza. He doesn't want the CDC getting caught with its pants down again."
"Too late for that," said Brisling, not entirely sure what he meant. The words had simply slipped out of his mouth. He felt his heart skip through a light run of beats then settled down again. There was something familiar about this situation. "These numbers are from July. What about August and September?"
"We don't have those yet."
Brisling pinned the tail of the graph with his index finger. "But that's a geometric rise."
"I know. The rate's doubling every three weeks. There could be thousands of cases out there we don't know about yet."
Brisling shook his head. "But none of this makes any sense."
She frowned. "De Soto said the same thing. What is it you used to tell your post-docs all the time? The data is the data. No matter what you want, no matter what Santa Claus promised for Christmas. The data is the data."
"The data are the data." He returned to his chair, sat down, and leaned forward to pick up his glass. The mint leaves had washed up and stuck to the sides. What remained of the ice cubes huddled in the meltwater.
The ice. The goddamned ice.
And there he was, back in that dark December. Judith was expecting any day now. They were on their way home from a baby shower in Alpharetta when the ice storm hit, turning the freeway into a skating rink. A semi-trailer bound for Charlotte lost control and smashed through the center divide. Brisling woke up in the hospital with a concussion, a broken arm and several bruised ribs. Judith's thighbone was fractured in three places, but she and the baby were stable. Except she could not quite catch her breath. It was just anxiety, they said, nothing a little Valium could not fix. When Judith's breathing got worse, they called the intern, a young woman who had just graduated top of her medical school class at Hopkins, summa cum laude. She ordered more Valium. Summa cum laude, that arrogant mantra. Forty-four minutes later, records showed, nurses found Judith unresponsive, pale and pulseless. It was too late. They could not revive her, or save the baby. The autopsy revealed a massive pulmonary embolus, a blood clot that had formed in the veins of Judith's shattered leg, broken loose, and lodged in her lungs. The fetus was female, thirty-five weeks gestational age, six pounds, three ounces. A perfect little head of black hair.
Genevieve was at his side. "Are you all right?"
He waved her off. "I'm fine." But he caught a glimpse of her expression, the slightly tilted head, the worried brow, the embarrassed half smileâvariables that added up to the one emotion Brisling least desired from a woman, pity. He might as well have soiled himself in front of her.
"Royal?"
"I'm fine. I'm fine!"
She retreated to her desk.
Brisling picked up the glass that had somehow slipped from his fingertips and retrieved a stray sliver of ice from the rug. He sighed and shook the memories from his mind. "Now, I assume you ignored that jackass De Soto and went right on collecting data."
She smiled. "Here, look at this and tell me what you think."
He got up and leaned over a US map showing the location of each of the nine hundred PML cased the CDC was tracking. "Urban clustering. Concentrated on the West Coast," Brisling commented.
"Oregon alone accounts for twenty percent of the cases. Do you think there's been a mutation in the JC virus?"
"Mutation? In all these people, and at the same time? Did you even read my articles?"
Genevieve pursed her lips.
"Look. I didn't mean it that way. It's just that what you're showing me makes no sense at all. JCV is a ubiquitous virus that infects nearly everyone early in life, and usually through close family contacts. So, if it mutated somewhere and started reactivating abnormally, we'd only see it in families and close communities, not all across the US like this. What about other countries? Are they seeing the same thing?"
"I checked with the World Health Organization, and they're seeing possible trends in Europe and Japan, but nothing for sure. As usual, there's radio silence from China." She tossed out a bar graph showing the age and sex distribution of all cases to date.
"Yeah? Sex distribution is similar to the general population, slightly more female than male."
"But look at the age distribution."
"Wait. Why is the axis cut off at age twenty-five?"
"Because there are no cases in people younger than that. It's a clean cutoff."
"Are you sure?"
"Absolutely. I ran the numbers myself. I've been racking my brain over this for a couple weeks now, and I can't explain it. I can't think of any risk factor that would only affect people over the age of twenty-five."
"What about alcohol?"
"Please."
"Sexual activity?"
"Oh, Royal."
"What?"
Genevieve shook her head. "It's like this thing isn't following the rules."
Brisling looked up. "What do you mean by that?"
Before she could answer, Brisling's cell phone began to vibrate from inside his breast pocket, and he took it out, frowning at the screen.
"Who is it?" asked Genevieve.
"The Seattle Police Department."
________________________
Author's note:
Thank you for reading Chapter 16!
We learn a lot more about Brisling's past. What do you think about him now?
There's a viral epidemic looming. How bad will it get?
I'd love to answer any questions you have.
-Frode
Image: CDC's Global Health Center in Atlanta, GA