Videtur quod Author hic obiit.
The first case of which any record survives was reported in a small town daily in upstate New York. Tabitha Van Order, the brief item reads, age five, was brought into the county hospital's emergency room with "strange markings" on her face and hands. "She was playing with the newspaper," her mother reported. "I thought it was just the ink rubbed off on her." But the marks did not respond to soap or turpentine. At the hospital, initial examination determined that the marks were subcutaneous, and the child was admitted for observation. They looked, according to the triage nurse, as though someone had been striking the child with a large rubber stamp. "They look like bruises," the emergency-room physician told the Journal reporter. The department of social services was looking into the case.
This alone might not have warranted even three inches on page 8 of a sixteen-page paper. What attracted the attention of the editor at the county desk (whose sister, a nurse in the E.R., had phoned in the story), and earned Tabitha's case even that scanty initial notice, was one peculiar feature of those bruises, one fact about the case that stood out from the face of an otherwise unremarkable, seemingly healthy little girl. It was not that, over the next several days, the marks did not fade, nor exhibit any of the changes of hue or outline usual in a bruise--although this was puzzling. Nor was it the child's silence, which she maintained three days with a patient gravity that impressed the most casual of observers. What claimed the attention of everyone who saw the child over the three days of her illness was the unmistakable pattern in those marks. They formed a word.
A word, certainly: no one who saw doubted for an instant what they saw. And it was something more, as well. Everyone struck with the sight of that pale, silent face and that black sign reported the same response: each said that the shock of seeing it for the first time was almost physical. It was as if, the nurse on the day shift recalled, seeing it, you felt it on your own face--"like a blush." And indeed, after the initial shock, something like embarrassment did set in: the nurses could never bring themselves to utter the word, either to the child or among themselves; the physicians during their morning rounds half averted their eyes even as they palpated the affected areas. And although bruises were discussed day and night across the desk at the nursing station; although palpable purpura were the subject of long discussions in the cafeteria; although everyone down to the orderlies hazarded a guess as to the nature of the marks, the word itself went euphemized, persistently elided.
After embarrassment followed another response, something of which communicates itself even now in the tone of that first newspaper article, a kind of delicacy, a reticence over the details of the case: a hush. That respectful silence grows ambivalently louder in the two pieces that in as many days followed, lengthened, and moved forward toward page one. As for the child herself, she made no complaint, nor in fact did she utter any word at all until just before the end, when she was heard to pronounce, in tones audible as far as the nursing station, the word spelled out by the bruise across her hands, cheeks, jaw, and (most plainly) forehead. She spoke the word in a piercing falsetto three times, and then, before the nurse could reach the room, the child coded, as the physician's assistant said, and died.
I learned much of this, of course, later, by which time several of the principals--the nurses, the orderlies, the mother, and the physicians--were beyond the reach of my own inquiries. But I believe the editor told me as much of the truth as he knew before he died.
Which was more than he told his readers. Even in the third article, which appeared on the fourth day following Tabitha's admission to the hospital, and where the headline type has grown to fifty-four points, the text is most significant for what it does not say. It does not tell the precise form of those bruises that darkened across the child's features in her last twelve hours and then faded completely within minutes of her death--although the darkening and the fading both are faithfully set down. Nor does it transcribe the syllables the child voiced three times before she died--although the fact of her crying out is also given. It does not even mention that the bruises formed a word.
There was this aspect of the affair notable from the start: that embarrassment that overcame all who saw the word, as if the thing were shameful. Not, I believe, for what it said, but for being so patently, inscrutably significant: for being a sign. Few people could bring themselves, at first, even to acknowledge what they saw. It was as if an angel had planted one bare foot in Central Park, another on the Battery, and cast the shadow of a brazen horn over Newark. If such had happened, how many minutes might we suppose to have elapsed before anyone could have brought himself to turn to his neighbor and ask: Do you see? How could any of us discuss it without feeling implicated? So it was in the case of Tabitha's word: it was too plainly part of a world we no longer knew how to address.
But there was more to this evasion, of course, than met the eye, and it is this that I find truly remarkable about the case. It is the function of that evasion, and the unmistakable conclusion it urges, that most impresses me: that everyone who saw the word, immediately, without understanding, without conscious thought or any evidence at all, knew that to see the word in print was a sentence of death.
No one, at the time, had any empirical reason for suspecting such, but in every account, even the first, I trace an instinctive recognition that the word carried the contagion. It was several months, of course, before the means of transmission was identified, through the work of the Centers for Disease Control and Prevention in Atlanta and Lucerne, and ultimately the heroic sacrifice of the interdisciplinary team at the École des Hautes Études en Sciènces Sociales in Paris. So how do we find, in this first written record, the prudence that spared until a later date so many lives? And how do we balance that seeming prudence with the other inescapable fact about the word: that as the end approached, all seemed seized--as was Tabitha herself--with an impulse to speak it. It was as if the word struggled to speak itself, as if in answer to some drive to propagate that would not be denied.
The elucidation of the mechanism was complicated by the discovery that mere speech was harmless, as was hearing: it was the eye through which the plague entered, and the eye only. The hand that wrote, so long as the person behind it did not look, was spared (with the notorious exception of the blind, who took the illness in Braille, and broke out before they died in portentous boils). But to see the word in print (ink or video, it did not matter) was to sicken, and invariably to die.
Experimental studies were hampered, of course, by a number of complicating factors, not least of which was the obvious difficulty in conducting tests on other than human subjects. A late attempt was made, by some accounts, to incorporate the word into the ideogrammatic code taught to chimpanzees at the Yerkes Center for Primatology; results were fragmentary, the experiment ending prematurely with the incapacitation of the staff. One significant datum did emerge from all studies, however: illiteracy was no defense. Even those incapable of deciphering the dialogue from comic strips were found to be susceptible. The only exceptions were those functioning, for whatever reason, below the mental age of thirty months.
But all of this knowledge came later. Although this most important aspect of the disease did ultimately receive full measure of publicity, in the case of Tabitha Van Order the initial reports were mute. Indeed, were it not owing to the early curiosity of one researcher in virology at a nearby university, the epidemiological particulars of this first case might have passed almost entirely unrecorded. This virologist, one Taylor Salomon, happened to have been a patient on the same floor as the child, incapacitated with pneumonia, which she had contracted while at work in her laboratory. On the day that Tabitha gave up the ghost in a room four doors down from hers, Professor Salomon was sitting up in bed for the first time in two weeks, taking some clear broth and attempting to organize notes from her research.
The attempt was futile, owing to the extreme weakness that had kept her semiconscious for the previous two weeks, and was disrupted forever by the unearthly cry that heralded Tabitha's demise. Professor Salomon was fortunate in this, however: her own illness had kept her from visiting the child's room, or even glimpsing her mottled face through the open door, before the marks had faded entirely away. And the research project that had hospitalized Professor Salomon soon faded from her thoughts as well, supplanted by a new question as soon as the nurse appeared, visibly shaken, in answer to the professor's call.
The nurse could relate the sequel of the child's cry, but not its meaning; she could only echo, with the distracted air that had come to typify the medical staff in the last hours of Tabitha's life, the helpless distress of her colleagues at finding their patient so unaccountably dead. To Salomon's more pertinent questions about the disease's course and etiology, the nurse could only wring her hands and look back over her shoulder, as if she harbored a guilty secret. Her curiosity piqued, Dr. Salomon managed to rise from her bed and stumble down the hall before the orderlies arrived to wheel the body away. The marks had apparently disappeared no more than five minutes before her arrival.
Luck was with her again, in that her appearance in the room was followed almost immediately by that of the medical examiner. The examiner, already irritated at the interruption of lunch, was inclined to order Salomon from the room, and her recitation of her credentials did nothing, at first, to soothe him. But being in no mood to take up the investigation himself, his irritation was no match for Salomon's persistence, and in the end he agreed to provide the samples she required. In an additional example of the good fortune that marked so much of Salomon's involvement with the case, the M.E.'s cooperative attitude was not shared by the hospital staff, which refused to release the child's chart to anyone but the M.E., citing doctor-patient confidentiality. But the samples, Salomon felt, would prove more valuable than any M.D.'s scribble, and she was content with the oral recitation of the child's history she eventually wrung from the nurses. The samples, iced and isolated according to protocols, waited another two weeks before Salomon was able to return to her lab, where she found, of course, nothing. The blood, nerve tissue, and other fragments of Tabitha's clay were apparently those of a healthy five-year-old girl, and nothing an extremely well-funded laboratory could bring to bear on them was able to add anything to the story.
Stymied in the laboratory, Salomon turned to a colleague in epidemiology, and, swearing him to secrecy, initiated field studies of the child's home, school, and other haunts. The season was late spring; the child's backyard abutted on a swamp: insect traps were set and their prey examined (at this point the impromptu task force expanded to include an entomologist). Once again, nothing significant appeared.
Time was running out for Salomon and her hope of scoring a coup. Five weeks after Tabitha's admission to the hospital, the child's mother, the triage nurse, four orderlies, the emergency-room physician's assistant, three floor nurses, and two doctors were admitted with livid bruises on the palms of their hands, cheeks, jaws, and (most plainly) foreheads.
In this first wave of cases, the disease exhibited additional symptoms, not observed (or not reported) in the case of Tabitha Van Order. In the triage nurse, onset was marked by a vague dreaminess that overtook her at work one morning. By lunchtime, she was incapable of entering insurance information correctly on her forms, and by midafternoon she had wandered from her desk. She was found on one of the high floors of the hospital, staring out a window at the lake, where a sailboat regatta was in progress. It was only at this point that the marks on her face were noticed. At about this time (the precise time is unavailable, owing to the nurse's absence from her desk), Julia Van Order arrived at the emergency room, brought in by a neighbor who had found her laughing uncontrollably in the street outside her home. The third symptom, glossolalia, was observed in two of the orderlies and one physician, who were admitted over the course of the evening. By midnight, there were twelve patients on the floor.
Recognizing an incipient epidemic, the chief of infectious disease imposed strict quarantine that evening. Staff on the floor were issued the customary isolation gear, and strict contact precautions were imposed. Who could blame the man for not issuing blindfolds? Such measures were in fact tried, much later, but by then, of course, it was much too late. He failed as well to confiscate pens.
Professor Salomon, on hearing of these new admissions, realized that her time was running out, and did the only thing left to her. After one visit to the hospital, during which she conducted interviews with those of the victims able to respond, she wrote up as full a description of the disease as she could, took her best guess (which turned out, in the end, to be wrong) as to its cause, sealed the four typewritten pages in a dated envelope, and sent the sealed article, with a cover letter, to The New England Journal of Medicine. It was not at that time the policy of the New England Journal to accept so-called plis cachetés, the practice having fallen into disrepute over a generation earlier, and Salomon's contribution might have been returned unopened had it not been for yet another fortuitous circumstance.
A reporter specializing in science and medicine was visiting Salomon's university that week, lecturing graduate students in journalism. On the day he was scheduled to return to New York, he happened to hear of the dozen deaths that had occurred the previous night at the county hospital. Sensing a career opportunity, he filed a story, complete with an interview with Salomon, and the item ran prominently in the Health section of the following week's issue.
The reporter, who had conducted his interviews with the hospital staff over the phone, and filed in the same way, was fortunate. Professor Salomon was not; time had in fact run out for her in more ways than one. Before she died, however, she had the satisfaction of seeing her report in print, its publication in the New England Journal spurred on by the article in Time.
In the four weeks that followed the first wave, mortality in the county was misleadingly low. The local daily never having printed the word, the contagion was spread almost exclusively among the hospital staff, in whom the disease lay latent for the month of July. At the end of the first week of August, the marks broke out over the hands, cheeks, jaws, and (most prominently) foreheads of approximately eighty-five doctors, nurses, orderlies, speech therapists, and social workers, most of whom were brought in by their families in various stages of confusion, euphoria, and glossolalia.
In this second wave, observers reported yet another symptom, which followed those exhibited in the first wave in a distinct progression. Whether the onset was marked by dreamy confusion, giddiness, or fluently unintelligible speech, within twelve hours all such symptoms had lapsed into one: an uncontrollable paranoia, in which the sufferer was convinced that every object in the world, animate or inanimate, was involved in a vast conspiracy to do the patient harm.
Without exception, in this stage of the disease its victims spoke continuously for periods of up to twenty-four hours, offering elaborately detailed descriptions of the delusional system in which they were enmeshed. And without exception, the attending physicians reported that they had at times to fight off the conviction that their patients' dreams were real. Who can blame them? Confronted with an undeniable health emergency, swift to spread, invariably fatal, and marked at its heart by the inscrutable symbol of the word, little wonder that those who struggled to understand the disease struggled as well with fear. Unlike their patients, who had evolved an explanation for the menace within them, their doctors had no such comfort, and could only watch their patients die, and wonder helplessly if they had contracted the plague as well.
For plague, by the end of the first week of September, it had become. There is little point in going over the statistics of that hellish week: the figures beggar comprehension, and mere repetition will not suffice to make them meaningful. Certainly their import was dulled by the more immediate, personal tragedies that struck almost every household in the country at that time. And as the numbers grew to embrace other nations, other languages, their meaning became in no way more intelligible. No more than did the word, which, as it appeared in different nations, took on different forms, but everywhere with the same effect.
At this time, little remains to report, but I would like to offer before I close two or three items that strike me as significant. The first, as I have hinted, was almost lost in the events that followed so quickly on the disease's emergence into the public eye. But Professor Salomon's team, in the weeks between her death and theirs, continued its research into the origins of the contagion. And though the trail had by then grown cold, the scent was not so faint that they could find in this an excuse for the failure of their investigations: the disease was untraceable, they claimed, because it had no physical cause.
And here I find one of the most pathetic effects of this disease--the kind of case in which its action was so grievous because so clearly marked. One of Salomon's survivors, a geneticist, whom I had known slightly during our years together at the university, and who was one of the few men I have ever met who might have deserved to be called a genius, telephoned me on the day the disease took hold of him. While I kept him on the phone, in the thirty minutes before help arrived, I listened as he spun out the delusion that had come on him with the word. The spectacle, if I may call it that, of a mind of his caliber reduced to raving brought me close to tears.
But I feel obligated to report what he said to me that day, in part because it was my only immediate contact with a victim of the plague. And also because one aspect of the encounter still strikes me, somehow, as significant. I believed. All the time I was speaking to him, I found myself fighting off conviction. Naturally, the feeling passed, but I still find myself, several weeks later, struggling with a sense of opportunity missed: I felt at the time, and still in my weaker moments do, as though I had come close to penetrating the mystery of the word. This is, of course, one of the effects most frequently reported by those attending on the dying.
The disease, my caller insisted, was not, properly speaking, a plague. That is to say, it was not spread by any of the infectious mechanisms. The word was not a pathogen: it was a catalyst, and the disease itself immanent in humanity at large. He had deciphered a sequence, he claimed, in the human genome, which matched, in the repetitive arrangement of its amino acids, the structure of the word. It seemed the word, processed in the temporal lobe in the presence of sufficient quantities of norepinephrine--the quantities released at levels of anxiety commonly associated with fear of bodily harm--acted as a trigger for this hitherto unnoticed gene. The gene, once stimulated, distorted the chemical function of the cerebral cortex, and the result was the familiar progression of stigmata, hallucination, convulsion, death.
It was, of course, palpable nonsense. I did not tell him so. Pity restrained me. He needed me, he went on, to spread the word. I chided him, gently, on his phraseology. His response was impatient to the point of fury. I had to help, he insisted: my own expertise in linguistics dovetailed so neatly with his findings. The two of us, he said, could broadcast the key needed to unlock a cure. I allowed him to speak as long as he needed to, until the ambulance arrived and the receiver was quietly set down. Triage, in those days, was performed upon the spot.
The man's ravings were, of course, merely one more instance of the paranoia that marks the final hours of the victims of the plague. But, like all paranoid fantasies, his had some germ of truth in them, and it tantalized me. If we accept that the disease came into this world without phenomenal cause, another possibility remains. The disease is, I grant, born in the brain. But it is not the product of any mechanism so vulgar as genetic coding. It is purely a product of the human mind.
I offer this as a message of hope. For if the plague had its origins in the human mind, might it not be fought by the same powers that called it forth? Tabitha had been "playing with the newspapers," her mother reported. So, this night, have I. I have before me the pages, already growing yellow, of the I---- Journal in the first weeks of June. I visited the newspaper's offices last night, forced to break in with a wrecking bar. The streets of the town were still, but for someone singing in the upper floor above a nearby shop. The words of the song were unintelligible: only the tune came through, a wandering melody, almost familiar.
I have spread them out here before me, these pages from the morgue, my fingers trembling, the paper brittle, my breath unsteady in my chest. I read the stories there: they are the old familiar ones, always the same. Family burned in a fire. Two held in convenience-store murder. Ultimatum issued over Balkan genocide. Plague in the Middle East. Old news. These portents and omens reduced to columns of fading ink.
I know, of course, the risk I am taking. I know only too well how fragile has been the chain of circumstances that has protected me from the infection. I listen even now to the stillness outside my window and am awed by the hush there, and what it says to me of my own great fortune. It is a mournful silence, broken only by the eternal singing of the katydids. They call, as they always have, of the coming of winter: mournful, and yet somehow pleasant, as all melancholy is.
But before I digress again, I would report the last significant item I have in my possession, and then I must go back to my own work, which has been too long interrupted. The information is this. In the later stages of the plague, the word disappeared. Almost as if it were no longer necessary, the last victims sickened, raved, and died without any visible sign of illness. I have a theory, of course. And although there is no means at my disposal to prove it even to my own satisfaction, I am convinced it is true.
The word, whatever it meant, whatever form it took in whatever language, was not the carrier of plague: not in any of the ways we sought to understand. Understanding was beside the point: for how could Tabitha, herself illiterate, have understood? The answer, plainly, is that she did not. I can imagine the scene vividly, even now, as the child turned the pages of the newspaper, rehearsing in her thoughts such anxieties as she had heard adults around her voice over pages such as these. Anxieties she did not understand, yet could not help but share: anxieties that, for all she knew, were made of words. Words she could not understand, but still she searched among them for some clue, some answer to the riddle of her life.
Children are suggestible, reader. To go from fear of unintelligible danger to a physical expression of that fear required only one word, any word, any arbitrary sequence of letters that happened to come to her as she "read." That word, written in blood on her features, took her to the hospital, confirming all her fears--fears that conspired, after three days and nights of what must have been pure, unremitting terror, to stop her heart.
Do you doubt me, reader? What more would you have? Letters of fire across the sky? A voice speaking prophecy in your sleep? A look in the mirror at your own forehead? A list, perhaps, of the ways death can come to you, even as you read here, safe in your home?
What is it you want? The word?
I give you this, and then I must be gone. All you need is here before you--and the knowledge that what kills us now is any word at all, read in the belief that words can kill.
I know this now. I have been convinced for several days.