“They’ll bend the testing protocol a little if Tarnisher will send them a letter. That’ll speed things up a little.”

  “Hear that, Ted? I told you you were worrying too much. Now, about the antibiotic — Bob, why don’t you lead off?”

  Larson nodded. “To be brief, we’ve got a bit of a problem with this thing going on in Savannah.”

  “Terrible thing,” Mancini said. “I trust you people have got your thumb on it by now.”

  “Not exactly,” Ted Bettendorf said. “As you may have gathered from the newscasts.”

  “But with a little help from your people, John, we’re quite sure we can,” the President added.

  Mr. Lunch whispered into Mancini’s ear, and the Sealey man nodded. “Of course, of course. Anything we can do — within our rather severe limitations.”

  “Specifically,” Bettendorf said, “we need to expedite a field supply of Sealey 3147.”

  Mancini frowned. “Dr. Bettendorf, I’m aware that you seem to have a great deal of interest in 3147, and this may perhaps be unfortunate. You’re aware, of course, that the drug is still very much investigational — that is to say, experimental.” (Whisper, whisper from Mr. Lunch.) “Make that highly experimental. You people know that — yet we seem to be encountering unprecedented pressure to turn this substance loose on a city of three hundred thousand people.”

  “John,” the President said, “I understand the circumstances are extraordinary.”

  “But there are other antibiotics for controlling Yersinia. Streptomycin, chloramphenicol — why not use them?”

  “Because they don’t work very well against this new strain of Yersinia,” Bettendorf said. “That’s why. We used 3147 in Colorado, and it worked.”

  “That’s delightful, but we also have a question of toxicity, some rather unfortunate long-term side effects. I can’t imagine the FDA authorizing mass distribution at this point.”

  “Well, now … ” The FDA man coughed. “Dr. Bettendorf’s figures don’t seem so alarming. With the administration’s support, there are possibly some ways we could, um, authorize more, um, widespread clinical testing, even in the field-”

  “In a city of three hundred thousand people?”

  “Well, um, we’d have to review this very carefully, of course, exercise very close controls — ”

  “You’re not going to make any friends turning Savannah into an experimental drug farm, Mr. Tarnisher,” Mancini said. “But assuming you’re not interested in making friends, let’s get down to cases: could you get me formal approval of a clinical testing protocol for 3147 down there within, say, forty-eight hours?”

  “Well, now — there’d be a great deal of red tape to be cut through, but — I — I — ” Tarnisher glanced nervously at the President. “I’m sure it could be done if we had a great deal of cooperation on all sides.”

  “Fine, then that settles it,” the President said, beaming and rising from his chair.

  “Not quite,” Mancini said. “From Sealey’s point of view it doesn’t settle a thing.”

  “What’s the problem, John?”

  “Liability.”

  “But surely if you have authority from the legally constituted Federal regulating agencies — ”

  “Oh, that would be nice, but it really doesn’t even approach the problem. That’s why I drew Mr. Tarnisher into a commitment, which my associate Mr. Lunch here has duly noted down — I wanted to demonstrate how completely irrelevant government regulations are to the question. There’s no problem providing the drug — we already have a considerable quantity in stockpile. But the problems of making it available are formidable. Dr. Bettendorf can confirm the difficulty of obtaining truly informed consent from any of the people who might receive this drug — under conditions of plague and panic. How’s that?” He bent down to Mr. Lunch. “Oh, yes, a legally ironclad informed consent that would hold up anytime anybody might come back to us anytime in the future.”

  Bob Larson cleared his throat. “These are not ordinary circumstances, Mr. Mancini. We’re talking about a large number of people dying.”

  “Ah, yes, I know, and believe me, we’d like nothing better than to be more outreaching to those people. There was a time when people recognized that even the best of medications might occasionally have unfortunate side effects for some. That was simply considered the price we all paid to have the medication available for the vast number who might benefit, with no thought of making somebody pay when a bad effect did occur. Well, those were the days of innocence, gentlemen. Today Sealey Labs is being sued for alleged damages a forty-year-old man now claims to be suffering because the company may have manufactured a medicine that his mother took for excessive weight gain on two occasions while she was carrying him. He doesn’t even know what company made the medicine; all he can establish is that Sealey is one that might have made it. Yet on the basis of his claim, Sealey is now involved in a class-action suit demanding a total settlement of — what was that figure, Mr. Lunch? — $600 million. And if that case is decided in favor of the plaintiffs, as it may well be, regardless of any merit to the claim, you will not have to worry about Sealey Laboratories cluttering up the market with new antibiotics because Sealey Laboratories will be in receivership. And if that occurs, since Sealey is a privately held company, we will simply destroy our development records and retire to the Caribbean somewhere, out of reach of the court. Our new-development drugs will go to no one.”

  There was a long silence. Then Bob Larson said, “You couldn’t license 3147 to be manufactured by some company less concerned about this problem? Perhaps someone abroad?”

  “That wouldn’t change things a whit. If we license it, we’re liable. And we oppose licensing new-drug patents to anybody unless forced to do so.”

  “So what is it going to take to get 3147 to Savannah?” Ted Bettendorf asked.

  “Not much,” Mancini said. “Just legally binding indemnification of Sealey Laboratories against any and all claims that might arise — retroactive to Colorado, as Mr. Lunch insists. We must be held totally harmless, with absolute guarantees, in advance, or Sealey 3147 stays on the shelf.”

  “And I’m supposed to do this by executive order?” the President said. “No way.”

  “There are precedents. The Swine Flu business … ”

  “Yes, and now we know better. There’s no way I could do this without an Act of Congress.”

  “Then there’s no way Sealey could either,” Mancini said, rising and gathering up his papers. “Plague or no plague.”

  After they had gone, Ted Bettendorf looked around. “Mr. President?”

  “Mm?”

  “We need that drug,” Ted said. “How do we get an Act of Congress passed?”

  34

  In a small, expensive flat off Rittenhouse Square in Philadelphia, at two in the morning, Sally Grinstone suddenly sat bolt upright in bed, wide awake, staring into the darkness. “Just hold it a minute!” she said.

  Her companion, still not recovered after a full hour, stirred beside her. “Whazzat?”

  “Not you, dummy, go back to sleep. I’ve got to think.”

  Think she did, and never more clearly than when she’d just been laid. She lit a cigarette in the darkness, brushed a spark off her naked belly and clasped her arms around her knees. As an investigative reporter for the Philadelphia Inquirer, and a very good one indeed, Sally Grinstone was one of those rare people who survived almost exclusively on the product of her subconscious. She read voraciously and omnivorously and never forgot anything she read, watched innumerable movies, gorged on TV at all hours and talked to anybody who would hold still to be talked to. All the time, she was “shoving it into the garbage can,” as she put it, and when her subconscious shoved something back out at two in the morning, she had long since learned to pay attention — because this was where the red meat was going to be found.

  Sometimes, like now, she didn’t know what she was after. Something was wrong with something she had seen or heard or read — so often, in the past her first clue to a really juicy morsel, but always hard to pin down. Something she’d read. Several hours earlier, before Teddie had gotten her turned on and distracted, she’d been reading about things going on in Savannah — God, what a mess! She’d been following this plague business extra closely since her trip out to Colorado, everything she could find about it, because she was dead-eye certain there was going to be a big story turn up there if she could just get hold of it. Sure as God wiped up the floor with reporters, there was going to be a big story there — but she couldn’t see it yet. So what was her head trying to tell her now?

  Every cell in Sally’s chubby, bouncy little body told her it was something important. Something to do with the plague, that was sure. Medicine was her special bailiwick; she had a dozen major newsbreak exposés to her credit in that area, two of them had won prizes and brought cascades of indignant denial from the medical establishment and the government and supportive howls of indignation from her readers, and even, in one or two cases, some real prosecution and some real legislation, and man, was there going to be an exposé somewhere in this plague thing!

  She hopped out of bed, naked and sweaty in the close air of the flat, and went into the little alcove office off the living room. Something she’d read or remembered, but not directly connected with Savannah. There’d been a meeting in Washington, at the White House — no statement from the President, just a Press Secretary’s report. Sally rooted around on her desk, a four-inch-deep clutter of junk beside her typewriter. Yes, here it was, Bernie’d sent it over, dear guy, or she’d have missed it completely. The President, some underling from H2S she’d never heard of before, an FDA advisor, and Mr. John Mancini — that was it! On the scene in Colorado, she’d seen him there, Vice-President in charge of production at Sealey Laboratories, Makers of Fine Pharmaceuticals, now in Washington talking to the President, flanked by a certain Mr. Lunch — ah, yes, she knew about Mr. Lunch from other sources. An indecisive meeting: the President urging FDA and H2S and Mr. Mancini to get together and resolve their differences and find ways to get around some awkward testing regulations on new drugs, on an emergency basis, of course, in order to get a new antiplague antibiotic drug on line fast, because they needed it in quantity in Savannah yesterday, not tomorrow. Odd that the President was doing the urging personally, that was what he had H2S around for in the first place, but that’s what it said. Mancini’s response was very indecisive for a drug man with a potential hot one on his hands. Some unfortunate problems, Mr. President. Some untoward side effects that turned up in preliminary animal testing made them very cautious about rushing into production — (Production? Preliminary testing? Wait a minute. They must have done their preliminary testing long since, they’d been using that drug on people in Colorado, from what CDC relief people had told her … ). The President assuring Mancini of administration cooperation in any possible way to speed up resolving these problems — and then Mancini springing his trump: federal indemnification against all claims in perpetuity if they released the drug now in a “major population center,” i.e., Savannah. An impossible demand, of course, what could the President say? More indecisive talk. End of report.

  Sally lit a cigarette, frowning, and sat back in her desk chair. That was part of it, all right, but it wasn’t that which set the bell jangling. Damn strange story, though — why report it at all? Unless the President was setting up some brownie points against something coming up. But what did set the bell jangling? She turned on a fan to cool her skin a little and sat chain-smoking for almost an hour, poking through the garbage can, begging the old subconscious to spit out something else. They’d certainly used a new drug in Colorado, but not without “preliminary testing,” far too much risk of side effects, even in an emergency …

  Side effects. Sally dove into a thick file and pulled out a very brief item from the Denver Post. Several people from the Canon City area were reporting progressive visual disturbances following recovery from the plague infection there. Similar but not identical to retinitis pigmentosa. Also, a few had associated intention tremors — yeah, she knew all about that, her granddad had Parkinsonism. Thought to be cerebral side effects of some kind of plague toxin among those who survived the infection. Fine. But why did those people survive? Because they were fed a new antibiotic? If so, maybe the side effects were due to the antibiotic, not the infection …

  Still there was a hole, something missing. She knew she’d seen something, several weeks ago. She tried key words to see if she could spring anything. Names. Places. Something in there was on the right track …

  Fort Collins. That was it, a dateline, someplace in northern Colorado. A TV newsclip that she’d seen, some woman from the CDC working there — what was her name? Janrette? Something like that — and they’d been testing a new antibiotic agent against the plague bug. What had hit Sally was how excited the woman had been, really high on this drug. They’d tested it against infected lab animals and it had been amazing, hit the bug hard and fast almost a hundred percent of the time, and no side effects of any kind. Safe as tetracycline, she’d said, two or three times. Half a dozen people in the lab there had taken it, too, to measure human blood levels and be sure of the no-side-effects bit. She’d recommended it for use in Canon City …

  Yes. That was it. Sally Grinstone sat back and smoked. That was what her subconscious had been worrying about and finally coughed up. First of all a splendid new drug, highly effective, a miracle drug right when they needed it. And then, suddenly, side effects, nasty side effects, people going blind, for God’s sake, and Sealey Labs backing off from the President himself …

  Something stank.

  Sally sat there a long time, more and more certain that something was wrong. She knew a little bit about drug testing. With any major toxic reaction, you either got it in the face right at the start, or you didn’t get it at all, at least nothing big. Unless they had a bunch of blind Parkinsonian rats running around that lab in Fort Collins, Colorado, and just weren’t talking about it. She looked at the telephone, started calculating the time difference to Denver — Maybe they stay up late out there — but shook her head. That’s no good. You can’t go for blood over the phone, it doesn’t work …

  She heard Teddie padding out behind her, felt a touch on her shoulder, a kiss on her neck, a gentle hand cupping her breast.

  “Honey?”

  “Not now, sweet.” Sally slipped to her feet. “Got to get some sleep. I’ve got a long trip tomorrow.”

  35

  In cadence with the dull hoofbeats of the Horseman, plague moved relentlessly in on Savannah. At first people responded only slowly to Jack Cheney’s public-health directives going out on the emergency Civil Defense radio and TV. For one thing, it was altogether too hot to pay attention; the scalding sun beat down every day in the longest, most merciless early September heat wave in recent memory, day after steaming day of 105-degree heat. Nobody stayed inside by the radio or TV in that kind of heat, especially in the long miles of stinking, heat-creaking frame tenements that stretched across the middle of the city, where air-conditioning was seldom to be found and then rarely, if ever, still working. There were few trees gracing those parts of the city, but the only breathable air was outdoors and the tenements themselves threw some shade, so people sat on their rickety porches, gazing at the heaps of trash and garbage in the vacant lots across the street, where the rats wended their way through their mazes of tunnels. When the afternoon thunderstorms would strike, the gutters would fill and overflow for a while and nobody would seem to notice how very many dead rats were washing down to the drainholes. And then, the storm’s momentary coolness merely tantalizing, the streets would start steaming again in the afternoon sun and the dense, humid miasma of hot heavy air would press down upon them for the rest of the night.

  The earliest response to the public-health warnings came, predictably, from the city’s doctors, and they defined the problems that lay ahead. It came first from the crowded offices and free clinics in the vast tenement areas, then from the middle-class and upper-class doctor’s offices and private clinics and group practices. Suddenly doctors everywhere were seeing a sharp influx of very sick people. Many became abruptly, devastatingly ill, spiking 105-degree fevers, shaking with chills, coughing and gasping and spitting into blood-filled handkerchiefs. Others — far fewer, but still some — were breathing all right but presenting more classical symptoms: septicemic shock and prostration; great ugly, swollen purple-black lumps under their arms and in the groin; nausea and sudden uncontrollable vomiting; all the marks of the raging toxicity as the bacteria spread and grew.

  They knew what they were seeing, the doctors did, and they scrambled to get the vaccinations they had neglected to get a few days earlier for themselves and their nurses and receptionists — the old vaccine first and then, finally, finally, in a dribble that was earmarked first for medical workers only, a tiny supply of the new vaccine said to provide up to sixty percent protection from the mutated bacteria. But unfortunately, just knowing what they were dealing with didn’t in itself tell the doctors what to do about it. Jack Cheney and his public health crew, aided by Carlos Quintana’s CDC team, mounted a major effort early on to reach every doctor, lay out ground rules for handling the sick, mailing them photocopied guide sheets, bulletins, updates, but still the Health Department switchboards were flooded twenty-four hours a day with thousands of calls asking for specific advice — calls for information, supplies, directions — the demand billowed in from all parts of the city. Most doctors and their nurses made some sort of attempt at establishing isolation techniques in their offices. They all worked in gloves and gowns, caps and masks, and — short of urgent emergencies — some of them turned away all the patients who didn’t have plague and sent them home in order to spare them possible exposure. Some clapped surgical masks on everybody who walked in the door. But at best, all such impromptu efforts proved terribly imperfect. What was worse, antibiotics and vaccine could not be improvised, and soon the tiny stockpiles of these vital necessities began dwindling. When more new vaccine came in, it immediately went out to the public-health workers, the police, the five-hundred member rat squad hastily mobilizing a rat-control program to hit the major concentrations of the vermin and all others trying to fight the epidemic’s ravages, including the garbage men.