“I agree. But you have to resist the impulse to try to muscle her into the boat,” the Majority Leader warned.
“You’ve caught a lot of tuna in your day, have you?” the President suggested.
“I do pretty well.”
26.
I ARRIVED AT THE NIH OFFICES BEFORE DAWN. SOMEHOW I had lost my key card, and I had to search the lobby for a security guard to buzz me in. “Something’s going on up there,” he said as he tapped his pass on a pad beside the elevator. “They’ve been working all night.” Tie Guy met me at the elevator. He had not shaved in several days and his face had an oily sheen. He was not wearing shoes. “Do you want me to get you a cup of coffee or something?” I asked.
“That’s the last thing I need,” he said. “If I have any more caffeine I might have a heart attack.” I looked around the floor. A few people were working at computers, but most of the people I could see were loitering happily, as if they were working on a group project in graduate school—which, as far as they knew, was broadly similar to what they were doing. A young woman walked toward us, typing intently on her phone. When she noticed Tie Guy she said, “Hey, we’re going out for breakfast. You want to come?”
“No, thanks. I need to review the slides,” he said. We had agreed that Tie Guy would brief me as soon as he was finished analyzing the new data. At eight, the NIH Director would arrive and we would do a more formal briefing for her. The Director and I would then do a briefing at the White House later that morning.
“How does it look?” I asked.
“The data are pretty good,” he said. “The numbers are more or less what I expected. No huge surprises, but there are some quirky patterns. We might be able to exploit the patterns to get some traction.”
My phone beeped, not my normal phone, but the secure TransferPhone that the White House had given me a few days earlier. It was text from the Chief of Staff: “Please keep briefing to four or five slides, eight tops.” I looked at my watch. It was five-fifteen in the morning. How long had she been up?
Tie Guy nodded at my clunky black device. “So you’re carrying one of those now, are you?” he said.
“So it would appear,” I replied, hoping to defuse the situation with humor. “Looks like we’ll need a short version of the presentation, maybe five slides.”
“Are you fucking kidding me?” he asked incredulously, almost yelling. “I’ve been up all night. My deck has one hundred and seventeen slides.”
“We need a summary,” I said.
“Who is ‘we’?” he asked.
“It’s a working group the Director pulled together,” I said.
“Five slides?”
“Yeah. Maybe seven or eight, if you really need them.”
Tie Guy looked at me, shaking his head as he processed the request. “Either these people are really, really important, or they’re complete fucking idiots.”
“They’re not complete fucking idiots.”
“Then I’ve got work to do,” he said, walking away angrily.
“Show me what you have,” I said, following him. “I can help you winnow the slides.”
Tie Guy walked into a small conference room littered with the detritus of meals past. He moved a half-empty coffee cup out of the way and opened his laptop. Without looking up from the screen, he motioned to an open pizza box with one slice left in it, the cheese hardened and congealed. “There’s pizza if you want it,” he said.
“I’m good, thanks.”
Tie Guy projected his presentation on the white wall, clicking quickly through some introductory slides: the team members, a mission statement, and so on. “Cut all that,” I said. He nodded, still refusing to make eye contact with me. He clicked through a few more slides, stopping at a map of the United States with a purple blotch running across the northern part of the country from west to east, starting at the Rockies and stretching all the way through New England. “Do you know what that is?” he asked.
“No clue,” I answered.
“That’s where you find Dermatophagoides mensfarinae. Dust mites. A subspecies of the American dust mite, to be exact.” He advanced to the next slide, which was a highly magnified image of a dust mite. It looked like some nasty invader from outer space in a bad horror film. “That’s it,” he continued. “Endemic to North America.”
“The dust mite is the vector.”
“Okay, but now watch this.” He clicked to the next slide, which had the same map of the United States with the purple band, only now there were large green patches that roughly overlapped with the purple. “Those are your counties where more than twenty-five percent of the population tests positive for Capellaviridae.”
“That makes sense,” I said. “Where you find the dust mite.”
“Okay, now watch this.” He advanced to the next slide, which had the map of the United States, the same purple band, and myriad red dots spread randomly across the map with no obvious pattern. “Do you see a pattern?” he asked.
“With what, the red dots?”
“Yes.”
“What are they?”
“Just tell me, do you see a pattern?”
“Well, the red dots—whatever they are—seem to be pretty random,” I said.
“Exactly,” Tie Guy agreed. “I ran the numbers, and there is actually a negative correlation.”
“You still haven’t told me what I’m looking at.”
“Sorry,” he said, growing more excited. “The red dots are the deaths and serious cases: the people who died of Capellaviridae or became sick and were treated successfully with Dormigen.”
“That doesn’t make any sense at all,” I protested. “There is no obvious connection with the dust mite.”
“I know, crazy, isn’t it? The people most likely to get sick don’t live anywhere near the dust mite that transmits the virus—except for five or six places where there seem to be concentrated outbreaks.”
“That can’t be right,” I said. “It makes no sense. Are you sure you have the right vector? Maybe it’s a coding error. You guys have been working all night—”
“Watch this,” Tie Guy said, now nearly squirming in his seat with excitement. He tapped a key on his computer, though as far as I could tell, the next slide looked exactly the same: the map of the United States, the purple band, and the red dots. “Just watch,” Tie Guy said, sensing my puzzlement.
Slowly the red dots began moving on the map, one at a time, from their random locations into the purple band. The pace picked up; the red dots moved more quickly into the purple band. After a few seconds, the motion stopped, with nearly all the red dots in or near the purple band. “Not so random anymore, right?” he said. “That’s where those people lived for an extended period of time before moving away.”
“So they were infected before they left?”
“Presumably, yeah. Remember the cluster at the College of Charleston?”
“No.”
“There were two deaths and three or four people who got really sick. Charleston is five hundred miles from anywhere you’ll find that kind of dust mite, but each of those students came from somewhere else—Michigan, New Hampshire, upstate New York.”
“Okay,” I said, trying to digest what he was telling me. “So they acquired the virus at home, and got sick in Charleston. That’s indicative of the pattern we’re seeing.”
“Yes.”
“Go back two slides,” I told him. Tie Guy tapped aggressively on the computer and once again we were looking at the red dots strewn randomly across the map. “But if I’m seeing this right,” I said, “people are not getting sick in the places where the virus is most common, other than a few clusters.”