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One week later she was in Letterman Hospital in San Francisco. The diagnosis was septicemic plague.

Which is finally where I come into the story. My name is Keith Harmon. B.A. in history with a special emphasis on epidemics. I probably know as much as anyone about the plague of Athens. Typhus. Tarantism. Tsutsugamushi fever. It’s an odder historical specialty than it ought to be. More battles have been decided by disease than by generals — and if you don’t believe me, take a closer look at the Crusades or the fall of the Roman Empire or Napoleon’s Russian campaign.

My M.A. is in public administration. Vietnam veteran, too, but in 1962 I worked for the state of California as part of the plague-monitoring team. When Letterman’s reported a plague victim, Sacramento sent me down to talk to her.

Caroline had been moved to a private room. “You’re going to be fine,” I told her. Of course, she was. We still lose people to the pneumonic plague, but the slower form is easily cured. The only tricky part is making the diagnosis.

“I don’t feel well. I don’t like the food,” she said. She pointed out Letterman’s Tuesday menu. “Hawaiian Delight. You know what that is? Green Jell-O with a canned pineapple ring on top. What’s delightful about that?” She was feverish and lethargic. Her hair lay limply about her head, and she kept tangling it in her fingers as she talked. “I’m missing a lot of school.” Impossible to tell if this last was a complaint or a boast. She raised her bed to a sitting position and spent most of the rest of the interview looking out the window, making it clear that a view of the Letterman parking lot was more arresting than a conversation with an old man like me. She seemed younger than fifteen. Of course, everyone in a hospital bed feels young. Helpless. “Will you ask them to let me wash and set my hair?”

I pulled a chair over to the bed. “I need to know if you’ve been anywhere unusual recently. We know about Yosemite. Anywhere else. Hiking out around the airport, for instance.” The plague is endemic in the San Bruno Mountains by the San Francisco Airport. That particular species of flea doesn’t bite humans, though. Or so we’d always thought. “It’s kind of a romantic spot for some teenagers, isn’t it?”

I’ve seen some withering adolescent stares in my time, but this one was practiced. I still remember it. I may be sick, it said, but at least I’m not an idiot. “Out by the airport?” she said. “Oh, right. Real romantic. The radio playing and those 727s overhead. Give me a break.”

“Let’s talk about Yosemite, then.”

She softened a little. “In Palo Alto we go to the water temple,” she informed me. “And, no, I haven’t been there, either. My parents made me go to Yosemite. And now I’ve got bubonic plague.” Her tone was one of satisfaction. “I think it was the powdered eggs. They made me eat them. I’ve been sick ever since.”

“Did you see any unusual wildlife there? Did you play with any squirrels?”

“Oh, right,” she said. “I always play with squirrels. Birds sit on my fingers.” She resumed the stare. “My parents didn’t tell you what I saw?”

“No,” I said.

“Figures.” Caroline combed her fingers through her hair. “If I had a brush, I could at least rat it. Will you ask the doctors to bring me a brush?”

“What did you see, Caroline?”

“Nothing. According to my parents. No big deal.” She looked out at the parking lot. “I saw a boy.”

She wouldn’t look at me, but she finished her story. I heard about the mummy bag and the overnight party she missed. I heard about the eggs. Apparently, the altercation over breakfast had escalated, culminating in Caroline’s refusal to accompany her parents on a brisk hike to Ireland Lake. She stayed behind, lying on top of her sleeping bag and reading the part of Green Mansions where Abel eats a fine meal of anteater flesh. “After the breakfast I had, my mouth was watering,” she told me. Something made her look up suddenly from her book. She said it wasn’t a sound. She said it was a silence.

A naked boy dipped his hands into the stream and licked the water from his fingers. His fingernails curled toward his palms like claws. “Hey,” Caroline told me she told him. She could see his penis and everything. The boy gave her a quick look and then backed away into the trees. She went back to her book.

She described him to her family when they returned. “Real dirty,” she said. “Real hairy.”

“You have a very superior attitude,” her mother noted. “It’s going to get you in trouble someday.”

“Fine,” said Caroline, feeling superior. “Don’t believe me.” She made a vow never to tell her parents anything again. “And I never will,” she told me. “Not if I have to eat powdered eggs until I die.”

At this time there started a plague. It appeared not in one part of the world only, not in one race of men only, and not in any particular season; but it spread over the entire earth, and afflicted all without mercy of both sexes and of every age. It began in Egypt, at Pelusium; thence it spread to Alexandria and to the rest of Egypt; then went to Palestine, and from there over the whole world…

In the second year, in the spring, it reached Byzantium and began in the following manner: to many there appeared phantoms in human form. Those who were so encountered were struck by a blow from the phantom, and so contracted the disease. Others locked themselves into their houses. But then the phantoms appeared to them in dreams, or they heard voices that told them that they had been selected for death.

This comes from Procopius’s account of the first pandemic. A.D. 541, De Bello Persico, Chapter XXII. It’s the only explanation I can give you for why Caroline’s story made me so uneasy, why I chose not to mention it to anyone. I thought she’d had a fever dream, but thinking this didn’t settle me any. I talked to her parents briefly and then went back to Sacramento to write my report.

We have no way of calculating the deaths in the first pandemic. Gibbon says that during three months, five to ten thousand people died daily in Constantinople, and many Eastern cities were completely abandoned.

The second pandemic began in 1346. It was the darkest time the planet has known. A third of the world died. The Jews were blamed, and, throughout Europe, pogroms occurred wherever sufficient health remained for the activity. When murdering Jews provided no alleviation, a committee of doctors at the University of Paris concluded the plague was the result of an unfortunate conjunction of Saturn, Jupiter, and Mars.

The third pandemic occurred in Europe during the fifteenth to eighteenth centuries. The fourth began in China in 1855. It reached Hong Kong in 1894, where Alexandre Yersin of the Institut Pasteur at least identified the responsible bacilli. By 1898 the disease had killed six million people in India. Dr. Paul-Louis Simond, also working for the Institut Pasteur, but stationed in Bombay, finally identified fleas as the primary carriers. “On June 2, 1898, I was overwhelmed,” he wrote. “I had just unveiled a secret which had tormented man for so long.”

His discoveries went unnoticed for another decade or so. On June 27, 1899, the disease came to San Francisco. The governor of California, acting in protection of business interests, made it a felony to publicize the presence of the plague. People died instead of syphilitic septicemia. Because of this deception, thirteen of the Western states are still designated plague areas.

The state team went into the high country in early October. Think of us as soldiers. One of the great mysteries of history is why the plague finally disappeared. The rats are still here. The fleas are still here. The disease is still here; it shows up in isolated cases like Caroline’s. Only the epidemic is missing. We’re in the middle of the fourth assault. The enemy is elusive. The war is unwinnable. We remain vigilant.