A Medical Detective Story THE ANTHRAX LETTERS

Description

Synopsis At 2:00am on October 2, 2001, Robert Stevens entered a hospital emergency room. Feverish, nauseated, and barely conscious, no one knew what was making him sick. Three days later he was dead. Stevens was the first fatal victim of bioterrorism in America. Bioterrorism expert Leonard Cole has written the definitive account of the Anthrax attacks. Cole is the only person outside law enforcement to have interviewed every one of the surviving inhalation-anthrax victims, along with the relatives, friends, and associates of those who died, as well as the public health officials, scientists, researchers, hospital workers, and treating physicians. Fast paced and riveting, this minute-by-minute chronicle of the anthrax attacks recounts more than a history of recent current events, it uncovers the untold and perhaps even more important story of how scientists, doctors, and researchers perform life-saving work under intense pressure and public scrutiny. Updated with new information about Ivins and a series of upcoming Congressional hearings into the FBI's conduct in this case, The Anthrax Letters amply demonstrates how vulnerable America was in 2001 and whether we are better prepared now for a bioterror attack.

First Sentence

[Excerpt from Chapter 6] For 14 years, beginning in 1977, Henderson served as dean of the Johns Hopkins School of Public Health. But before then he had already become a legendary figure in public health. From 1966 to 1977 he directed the World Health Organization's campaign to eradicate smallpox. His last year as director was the last year that a naturally occurring case of smallpox occurred anywhere in the world. As he sat at home that Sunday afternoon, the phone rang. "Dr. Henderson? Hello, Dr. Henderson. This is Eric Noji, calling from the Department of Health and Human Services [HHS]. Secretary Tommy Thompson asked me to contact you immediately." Dr. Noji, a specialist in "disaster medicine" at the Centers for Disease Control had recently come up from Atlanta to help establish an Emergency Command Center in the Secretary's office. "Secretary Thompson would like you to come over for a meeting at 7 o'clock." Henderson had worked in the previous administration as Deputy Assistant Secretary at HHS under Donna Shalala. He had never met Thompson and much appreciated the invitation. "Seven tomorrow morning? Or do you mean tomorrow evening?" Henderson asked. "No, no, no. Tonight!," Noji answered. Henderson caught the sense of urgency. "Yes, of course I'll be there." Soon after, he was driving south on Interstate 95 for the hour-long trip to Washington, D.C. Once in the city, he worked his way quickly along Independence Avenue -- Sunday traffic is light. As he approached Third Street, the open mall on the left offered a stunning view of the Capitol building. To the right, still on Independence Avenue, stood the Hubert H. Humphrey Building, the headquarters of HHS. The seven-story structure, constructed 25 years earlier, is covered with recessed windows that give the appearance of a giant waffle. Henderson parked on the street and walked to the building. As he entered the lobby, high on the wall to his left he could see a portrait of Humphrey and a gold-leaf inscription. The text declares that the manner in which a government treats children, the elderly, the sick, and the needy is, in Humphrey's words, "the model test of a government." Six floors up, Henderson got off the elevator and turned right. Before him was a glass partition beyond which lay the red-carpeted suite of Secretary Thompson. He was escorted by Noji into Deputy Secretary Claude Allen's conference room. Propped up on a rectangular conference table were a computer laptop and a portable printer "donated" by Dr. Noji -- a rudimentary command center soon to be vastly expanded. A couch stool in front of one wall, and soft chairs were off to the side. "I'm very glad you're here," Secretary Thompson said to Henderson. They were joined by Allen, Noji, and Dr. Scott Lillibridge, who had just been appointed Director of the Command Center. Thompson began the discussion by inviting comments about the current situation. Lillibridge and CDC's Noji were absolutely convinced that there would be a terrorism sequel to the September 11 attacks. But what form would it take? Henderson recalled the moment: "...We sort of worked our way through the discussion. Doing something with an airplane again was going to be much harder now than it had been, we decided. I think we all came to the conclusion that it could very well be a biological event. And it was quite apparent to me that this was Thompson's view too..." The secretary rose from his seat and paced back and forth. "He was obviously extremely distressed," Henderson said. Then, referring to his contacts in the White House, Thompson said, "They just don't understand." "What don't they understand?" Henderson asked. "Biological weapons," Thompson answered. Secretary Thompson repeated his concern, emphasizing that the country was "unprepared, grossly unprepared. For a biological attack." During the next two weeks, Henderson was repeatedly invited back to confer with Thompson, Lillibridge and Noji about the possibility of further terrorism. Then, on October 4, Bob Stevens, in Florida, was diagnosed with anthrax. The same day federal and state authorities publicly dismissed bioterrorism as a likely cause of Stevens's illness. Thompson himself emphasized that the case was an isolated incident. He implied that Stevens might have contracted the disease from water: "We do know that he drank water out of a stream when he was traveling to North Carolina last week." Thompson's closest aides, Claude Allen, NIH's Tony Fauci and Doctors Lillibridge and Noji were caught completely by surprise. When Henderson heard this, he was mystified. Thompson's statement was uninformed. Water is not known to convey anthrax, and drinking would be unlikely to cause the inhalation form of a disease. Having minimized the possibility of bioterrorism, the secretary was later criticized as being naive, as not appreciating the serious implications of the incident. In fact, according to Henderson, Thompson's concerns were very real. Henderson realizes this view seems "contrary to what came out when Thompson got on television and assured everybody that everything was in great shape." But Henderson is convinced that Thompson did not believe everything he was saying publicly: "He did what I have seen happen in many disease outbreaks. The political figure gets out in front and says, 'Everything is under control. Please relax.' You know, to calm everybody down. And that isn't necessarily the right thing to do." What would Henderson have advised the secretary to say that first day? To acknowledge that there is a problem. That there's a lot of work to be done. To say that he will keep in close touch with the public. In other words, be open about it. But the tendency is to say, "Every- thing is in good order. We've got everything under control, so don't worry." I think that's wrong. A few days later the presence of anthrax spores was confirmed on Stevens's computer keyboard and elsewhere in the American Media building, where he worked.

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