Chapter 1
Something in the Air Journey Inward
OCTOBER 2-6, 2001
In the early nineteen seventies, a British photo retoucher named Robert Stevens arrived in south Florida to take a job at the National Enquirer, which is published in Palm Beach County. At the time, photo retouchers for supermarket tabloids used an airbrush (nowadays they use computers) to clarify news photographs of world leaders shaking hands with aliens or to give more punch to pictures of six-month-old babies who weigh three hundred pounds. Stevens was reputed to be one of the best photo retouchers in the business. The Enquirer was moving away from stories like "I Ate My Mother-in-Law's Head," and the editors recruited him to bring some class to the paper. They offered him much more than he made working for tabloids in Britain.
Stevens was in his early thirties when he moved to Florida. He bought a red Chevy pickup truck, and he put a CB radio in it and pasted an American-flag decal in the back window and installed a gun rack next to the flag. He didn't own a gun: the gun rack was for his fishing rods. Stevens spent a lot of time at lakes and canals around south Florida, where he would spin-cast for bass and panfish. He often stopped to drop a line in the water on his way to and from work. He became an American citizen. He would drink a Guinness or two in bars with his friends and explain the Constitution to them. "Bobby was the only English redneck I ever knew," Tom Wilbur, one of his best friends, said to me.
Stevens's best work tended to get the Enquirer sued. When the TV star Freddie Prinze shot himself to death, Stevens joined two photographs into a seamless image of Prinze and Raquel Welch at a party together. The implication was that they had been lovers, and this sparked a lawsuit. He enhanced a photograph of a woman with a long neck: "Giraffe Woman." Giraffe Woman sued. His most famous retouching job was on a photograph of Elvis lying dead in his coffin, which ran on the cover of the Enquirer. Elvis's bloated face looked a lot better in Stevens's version than it did in the handiwork of the mortician.
Robert Stevens was a kindhearted man. He filed the barbs off his fishing hooks so that he could release a lot of the fish he caught, and he took care of feral cats that lived in the swamps around his house. There was something boyish about him. Even when he was in his sixties, children in the neighborhood would knock on the door and ask his wife, Maureen, "Can Bobby come out and play?" Not long before he died, he began working for The Sun, a tabloid published by American Media, the company that also owns the National Enquirer. The two tabloids shared space in an office building in Boca Raton.
on thursday, September 27th, Robert Stevens and his wife drove to Charlotte, North Carolina, to visit their daughter Casey. They hiked at Chimney Rock Park, where each autumn brings the spectacular sight of five hundred or more migrating hawks soaring in the air at once, and Maureen took a photograph of her husband with the mountains behind him. By Sunday, Stevens was not feeling well. They left for Florida Sunday night, and he got sick to his stomach during the drive home. On Monday, he began running a high fever and became incoherent. At two o'clock on Tuesday morning, Maureen took him to the emergency room of the John F. Kennedy Medical Center in Palm Beach County. A doctor there thought he might have meningitis. Five hours later, Stevens started having convulsions.
The doctors performed a spinal tap on him, and the fluid came out cloudy. Dr. Larry Bush, an infectious-disease specialist, looked at slides of the fluid and saw that it was full of rod-shaped bacteria with flat ends, a little like slender macaroni. The bacteria were colored blue with Gram stain-they were Gram-positive. Dr. Bush thought, anthrax. Anthrax, or Bacillus anthracis, is a single-celled bacterial micro-organism that forms spores, and it grows explosively in lymph and blood. By Thursday, October 4th, a state lab had confirmed the diagnosis. Stevens's symptoms were consistent with inhalation anthrax, which is caused when a person breathes in the spores. The disease is extremely rare. There had been only eighteen cases of inhalation anthrax in the past hundred years in the United States, and the last reported case had been twenty-three years earlier. The fact that anthrax popped into Dr. Bush's mind had not a little to do with recent news reports about two of the September 11th hijackers casing airports around south Florida and inquiring about renting crop-dusting aircraft. Anthrax could be distributed from a small airplane.
Stevens went into a coma, and at around four o'clock in the afternoon of Friday, October 5th, he suffered a fatal breathing arrest. Minutes later, one of his doctors made a telephone call to the Federal Centers for Disease Control and Prevention-the CDC-in Atlanta, and spoke with Dr. Sherif Zaki, the chief of infectious-diseases pathology.
Sherif Zaki inhabits a tiny office on the second floor of Building 1 at the CDC. The hallway is made of white cinder block, and the floor is linoleum. The buildings of the CDC sit jammed together and joined by walkways on a tight little campus in a green and hilly neighborhood in northeast Atlanta. Building 1 is a brick oblong with aluminum-framed windows. It was built in the nineteen fifties, and the windows look as if they haven't been cleaned since then.
Sherif Zaki is a shy, quiet man in his late forties, with a gentle demeanor, a slight stoop in his posture, a round face, and pale green eyes distinguished by dazzling pupils, which give him a piercing gaze. He speaks precisely, in a low voice. Zaki went out into the hallway, where his pathology group often gathered to talk about ongoing cases. "Mr. Stevens has passed away," he said.
"Who's going to do the post?" someone asked. A post is a postmortem exam, an autopsy.
Zaki and his team were going to do the post.
early the next morning, on Saturday, October 6th, Sherif Zaki and his team of CDC pathologists arrived in West Palm Beach in a chartered jet, and a van took them to the Palm Beach County medical examiner's office, which takes up two modern, one-story buildings set under palm trees on a stretch of industrial land near the airport. They went straight to the autopsy suite, carrying bags of tools and gear. The autopsy suite is a large, open room in the center of one of the buildings. Two autopsies were in progress. Palm Beach medical examiners were bending over opened bodies on tables, and there was an odor of fecal matter in the air, which is the normal smell of an autopsy. The examiners stopped work when the CDC people entered.
"We're here to assist you," Zaki said in his quiet way.
The examiners were polite and helpful but did not make eye contact, and Zaki sensed that they were afraid. Stevens's body contained anthrax cells, although he had not been dead long enough for the cells to become large numbers of spores. In any case, any spores in his body were wet, and wet anthrax spores are nowhere near as dangerous as dry spores, which can float in the air like dandelion seeds, looking for fertile ground.
The CDC people opened a door in the morgue refrigerator and pulled out a tray. The body had been zipped up inside a Tyvek body bag. Without opening the bag, they lifted the body up by the shoulders and feet and placed it on a bare metal gurney. They rolled the gurney into a supply room and closed the door behind them. They would do the autopsy on the gurney in a closed room, to prevent the autopsy tables from being contaminated with spores.
The chief medical examiner of Palm Beach County, Dr. Lisa Flannagan, was going to do the primary incisions, while Zaki and his people would do the organ exams. Flannagan is a slender, self-assured woman, with a reputation as a top-notch examiner. Everybody gowned up, and they put on N-100 biohazard masks, clear plastic face shields, hair covers, rubber boots, and three layers of gloves. The middle glove was reinforced with Kevlar. Then they unzipped the bag.
The CDC team lifted the body up, gripping it beneath the shoulders and legs, and someone snatched the bag out from underneath it. They lowered the body back onto the bare metal deck of the gurney. Stevens had been a pleasant-looking man with a cheerful appearance. He was a bluish color now, and his eyes were half open.
Heraclitus said that when a man dies, a world passes away. The terribly human look on the face of the deceased man disturbed Sherif Zaki. It was so hard to picture this man in life and then to connect that picture with the body on the gurney. This was the toughest thing for a prosector, and you never got over it, really. Zaki did not want to connect the living man with the body. You had to put it aside, and you could not think about it. His duty now was to identify the exact type of disease that Stevens had, to learn if he had inhaled spores or perhaps had become infected some other way. This might help save lives. Yet cutting into an unfathomed body was difficult, and after a hard post, Sherif Zaki would not feel like himself for a week afterward. "It's not an uplifting process," Zaki said to me.
The team rolled Stevens onto his side and inspected his back under bright lights for signs of cutaneous anthrax-skin anthrax. They didn't find any, and they laid him back down.
Copyright © 2002 by Richard Preston. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
