We were stationed at the lab to help with the deluge of specimens to be tested for the presence of anthrax spores. It was hectic. New Yorkers had white powder fever in the fall of 2001 and were seeing danger in ordinary items they had previously taken for granted. Mail was carefully inspected and thrown away unless it contained a check or bill. The sugary remains at the bottom of a package of Little Debbie snack cakes or flour spilled innocently on the floor became suspected conveyances of anthrax. All of these specimens were being brought to the city's lab by cops only too happy to drop their packages and run away.
Denis built a database and we spent our days logging in samples and reporting the results to the Health Commissioner, Mayor, NYPD, FBI and an assortment of politicians and dignitaries. We had not heard of a new case of skin anthrax in nearly a week and were looking forward to getting back to our regular jobs and lives outside of work. Sixteen hour days were getting old. On Sunday a doctor from an uptown hospital called, he had a worrisome case. The 61-year-woman didn't work with the mail, but appeared to be in the throes of a serious infectious pneumonia. By late Monday afternoon the hospital lab had isolated a large bacillus in the woman's blood. It was growing in long filamentous threads. Our hopes of returning to normalcy dashed, Denis and I hopped the uptown subway and met the lab director in the empty lab. Excitedly he ushered us over to a microscope. I peered down the barrel, adjusted the focus remembering my days in the emergency department looking at gram stains of cerebral spinal fluid searching for bacteria and white blood cells. Oil immersion, 100x. The lab director had taking a drop of the blood culture media and prepared a gram stain. Unlike my sparse csf gram stains, this one was a chaotic mix of red and blue. It took me several moments to orient myself, but I began to see the white blood cells in a matrix of what looked like blue thread. As I looked closer I could see that the threads were composed of long, brick-like cells. I had seen this before, not under a microscope but in a book. It was anthrax. He handed us a slant: a screw-top test tube filled with media and inoculated with a sample of the growing bacteria. I slid it into the steel canister we brought with us and placed it into my jacket pocket. Only specialized labs could make the definitive diagnosis of anthrax and we had to get it back to the city lab to know for sure.
Before we left we met the head of infection control who took us to the patient's bedside. Beneath the wires, tubes and tape lay an unconscious woman. Sedated, on special drugs to maintain her blood pressure and high powered antibiotics to beat back the infection, she was waging a war we couldn't see, except on the X-ray, which showed her chest and lungs filled with blood and fluid. On the subway ride downtown Denis and I tried not to speak and act non-chalant, but there were too many questions.
"Do you think it is?" he asked.
"I don't know," I replied. "It fits clinically, and the gram stain is suspicious." I didn't want to say what I felt. Denis wasn't a physician and although he had been an EIS officer I couldn't be sure how he'd react and after all we were straphanging in a rush hour subway car. He smiled, the nervous smile that sometimes creeps across the faces of people facing really bad news.
"Where would she have gotten it?"he asked.
I looked around, maybe it was my baseline paranoia but some riders seemed to be listening to our conversation with interest. Others were lost in the complications of their lives.
"I don't want to think about it," I replied. I knew the only persons to contract the inhalation form of anthrax during the outbreak had either been postal workers or at the AMI building in Florida. None in NYC. Terrorists had long eyed the NYC subway as a target. I re-examined our fellow riders. This changed everything. Our lives wouldn't be returning to normal, in fact, craziness was about to be cubed...
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