should have him killed,” she said. “It’s the most economical reaction in the short run.”
The president thought for a moment, then wrote another item on his list.
40
Suez
Henry was in the pharmacy when he heard a scream. He rushed to the dormitory where the sound was coming from. The other crewmen in the dorm were trying to restrain a panicked sailor, who was fighting them off. “Lemme go! I’m sick, I’m sick!” he yelled. The other men immediately backed away.
His name was Jackson. Henry persuaded him to come to the pharmacy for an examination. He had no fever, no swollen lymph nodes, no symptoms at all except for the elevated blood pressure caused by his distress. “I’m not sick?” Jackson asked in disbelief. “I felt strange. I couldn’t catch my breath. I thought I was going to suffocate.”
“At the moment, your vital signs are fine.”
“Are you telling me I’m just scared?”
“Everybody is.”
Jackson shook his head and stared at the floor. “I’m a fucking coward,” he said. “I guess I always knew that. Now everybody knows. I don’t think I can face the other guys.”
“What scares people the most is having no control,” Henry said. “It scares me, too. Maybe me more than you because I’m trained to fight this particular enemy, and I just don’t know how.”
Once again, Henry slept restlessly, kept awake by the muffled clunk of the damaged piston. He thought about Captain Dixon’s plea to do something to save his panicked crew, the grief-stricken SEAL in the mess hall, poor frightened Jackson. Each day the roll of infected sailors grew, and more bodies were stored in the chill box. These were vigorous young people who should have been the most resistant to the infection, but their powerful immune response was killing them, just as in 1918, by filling the lungs with fluids to fight the infection but drowning the body in the process.
Henry ransacked his memory, going through everything he knew or thought he knew about treating influenza. He considered taking nasal secretions from contagious patients, microwaving them to kill the virus, then swabbing the inactivated virus into the noses of the uninfected submariners. But at best, there would be one to ten million virion particles per microliter—nowhere near enough to engender an immune response even if it were injected.
He recalled the example of smallpox, one of the most infectious diseases that ever afflicted humanity, and also one of the most merciless. Once inhaled, the virus moved from the lungs and lymph nodes into the bloodstream and the bone marrow. It felt like influenza at first: cough, fever, muscle pain, followed by nausea and vomiting. Two weeks after the infection, red spots appeared on the tongue, throat, and mucus membranes. As those lesions grew and erupted, new lesions appeared on the forehead, then began their march across the body’s entire surface, forming swollen and dimpled pustules that gave the appearance of a body densely covered by bees. When the pustules dried up, they turned into scabs. In survivors, these lesions finally resolved as characteristic disfiguring smallpox scars.
In 1796, an English physician named Edward Jenner realized that one group of people enjoyed a curious immunity from smallpox: milkmaids. Jenner knew nothing about viruses at the time—no one did. But he fervently believed that the key to immunity could be found among the young women previously infected with cowpox, a similar but milder disease primarily found in animals. The disease was detected in humans who had touched the udders of infected cows. So persuaded was Jenner of his theory that he extracted some tissue from the hand of a cowpox-infected milkmaid named Sarah Nelmes and injected it into James Phipps, the eight-year-old son of his gardener. Jenner called the procedure a “vaccination.” The word itself comes from vacca, Latin for “cow.” Six weeks later, to prove his point, Jenner injected young Phipps with smallpox pus. Phipps did not get ill. It was a reckless and unethical but legendary moment in the history of medicine. Jenner’s decision to risk the boy’s life must be weighed against the fact that the toll extracted by smallpox in Europe alone was about 400,000 people a year. At one point, roughly 10 percent of the world’s population died of the disease. Of the survivors, a third became blind.
Cowpox was a European disease, uncommonly found in the Americas. Responding to a widespread outbreak of smallpox in the Spanish colonies, King Charles IV ordered a corvette to ferry the vaccine to the New World. At the time,