enforced by armed guards and the threat of execution if anyone violated their procedures. Had the Chinese been more open about the disease when it first appeared, many people might have spared.
It was Henry’s friend Carlo Urbani, the life-loving Italian doctor, who set up the rigorous protocol that prevented the disease from spreading more widely. Vietnam was one of the first countries to be declared free of the disease. But by then Carlo was also dead, a month and a day after being the first to identify the disease that would so quickly kill him. Thanks to his warning, and despite the absence of a vaccine, the SARS pandemic was contained within a hundred days and millions of lives were saved. Public health officials account it the most effective response to a pandemic in history. Henry considered Carlo a martyr.
* * *
—
HENRY WENT THROUGH Dr. Françoise Champey’s case notes more carefully. They dated from the arrival of the MSF at the camp in the last week of January. There was indeed a full-on HIV epidemic in the camp, more than the doctors had been prepared for, so that early cases of the new virus were shunted aside as being ordinary influenza. The dozen patients who reported symptoms during the first ten days were treated with Tylenol and Tamiflu. They all recovered. Then everything changed.
Patient Luhut Indrawati presents with severe fever, 40.5C. Obstructed breathing. Was asymptomatic HIV-1 until 31/01, then rapid progression to high fever, acute lethargy. Perhaps Stage 3 HIV. Rapid onset difficult to explain. Copious hemorrhages from nose and ears.
She described the patient as a rice farmer from Sumatra. Two days later, Dr. Champey tersely continued:
Patient Luhut died at 08:19. Cyanosis. Unknown cause. Five more cases.
She was working without laboratory equipment or even rudimentary diagnostics, but even if she had had them, she’d have been just as much in the dark as Henry was now. While the French doctors had been treating HIV, they had been exposing themselves to something new, something that was brewing and evolving. And what a perfect laboratory for the evolution of a newly transmissible human disease: a camp full of immune-suppressed individuals who couldn’t defend themselves against a novel infection.
“What did we do wrong?” Dr. Champey asked plaintively, a day before she died. She suspected that the disease might be a new strain of HIV. That made sense; there were many HIV subtypes, and the virus had a remarkable ability to recombine. But how did she and her coworkers get infected? They carefully followed the protocol. HIV was spread by sex or sharing syringes, not by washing, touching, or eating together. It was not spread by mosquitos. The transmission was too rapid to be anything other than an airborne disease, Henry had concluded, which ruled out HIV or any of its likely recombinations.
Henry got a call from Dr. Champey’s chief in Paris, Luc Barré, offering to send additional equipment or personnel. At the moment, there were more people in the camp than Henry could handle. “The problem, of course, will come if there is a breakout,” Henry told him. He suggested that Barré prepare emergency responders at the first hint that the disease had slipped through the quarantine.
Before Henry signed off, he asked Barré to talk about Dr. Champey. “Her case histories have been very helpful,” Henry said. “Meticulous, insightful. Obviously very well trained.”
Barré started to respond, but his voice caught, and he paused for a moment. “Ah, Françoise, yes, she was one of the best,” he said thickly.
“I pictured her as an athlete,” said Henry.
“Indeed, horses, her passion. Jumping them, you know. Quite a dangerous sport. Any doctor sees the injuries from such people who ride. So she knows this but she loves it too much to give it up. She was a confident person. She demanded the most dangerous missions. To be frank, I did not imagine this was so much dangerous for her. We deal with HIV all the time. So I did not think that I was sending her to her death. She was my fiancée, you see.”
* * *
—
THE SLENDER OFFICER WHO had pocketed Henry’s bribe was shivering with fever. His body was covered with bruises, indicating internal bleeding. But he held steady as Henry questioned him about the nature of the disease.
“Chahaya,” Henry said, reading his name off his chart.
The officer smiled weakly. “This is me. What remains.”
“What does it feel like?” Henry asked.
“Hard to breathe,” the officer said. “Like a mountain on me.” He coughed, and frothy