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Chapter 1
St. Raphael's was an old Catholic hospital, struggling to maintain its
independence in the face of overtures--friendly and outright
aggressive--from Johns Hopkins and the University of Maryland. The
hospital sat in the middle of a decayed neighborhood in the southwestern
quadrant of the city, surrounded to the north and west by housing
projects and to the south and east by a mix of old factories and
abandoned row homes. The hospital served the needy in the immediate
area, but extended its reach to the working-class neighborhoods of
Pigtown and Locust Point. The last I heard, it was hemorrhaging money
and talks with Hopkins and Maryland had started up again, this time at
St. Raphe's behest. The former belle at the ball, now trying to dance
with anyone who'd have her. Rumor had it the powers that be--admin at
St. Raphe's, the Catholic archdiocese, the city, Hopkins, U of M--were
just going to shutter the old girl. As the dirty pile of bricks,
streaked black and dotted with a few forlorn statues of St. Raphael,
came into view, I thought a mercy killing might not be the worst thing.
Still, there was a soft spot in my heart for the place. I'd just spent
two weeks at St. Raphe's setting up a program to identify exactly the
kinds of things that seemed to be happening. Outbreaks. Bioterror
attacks. Bad things. St. Raphe's, in other words, needed me. Not like
Hopkins, who basically taught my employers, the Epidemic Intelligence
Service at CDC, how to play their game. If every employee at CDC were
suddenly to die or, worse, to take a job in the private sector, Hopkins
probably felt it could rebuild the Centers from scratch. No, St.
Raphael's was a third-tier hospital in a city dominated by some of the
best medicine in the world. My job was to get this old gal up to snuff.
Okay, my job. I am an officer in the Epidemic Intelligence Service, a
branch of the Centers for Disease Control and Prevention. Apropos of my
duties--to conduct surveillance for and investigations of outbreaks of
disease--the title of officer is a fitting one. The cop jargon
has been with us for a long time. Medical detectives was often
used to describe officers in the service by those on the outside and on
the inside, though the term long ago fell out of use, perhaps because it
sounded a little too self-aggrandizing at the same time it sounded a
little too trite. Anyway, that's what we do. We look for and hunt down
diseases.
As with many things--fashion, say, or diet plans--there is some
circularity to the history of the EIS. Originally conceived at the start
of the Korean War as an early-warning system for biological attack, the
EIS has spent decades searching for things to do. And it's done a pretty
good job of finding them. The Service was instrumental in restoring
public confidence after a polio vaccine scare in the fifties, it helped
erase smallpox from the world, in the late nineties and early '00s it
tracked down and set up surveillance for West Nile virus. And now the
country is back to freaking out about bioterrorism. Which is why I was
in Baltimore, helping to patch a hole in the country's
disease-surveillance net. Normally, an old hospital wouldn't merit much
attention, but St. Raphe's proximity to the nation's capital scared the
public health gods, who wanted to ensure that any outbreak in the area
was identified quickly. So, they sent me to set up a surveillance
program.
Excerpted from Isolation Ward by Joshua Spanogle Copyright © 2006 by Joshua Spanogle. Excerpted by permission of Delacorte Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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