Sunday, May 31, 2009

Book Review: Demon in the Freezer

Lawrence Brilliant hadn’t been studying long with Neem Karoli Baba before the guru began hitting him with apples during meditation sessions.

It was the summer of 1970 and Larry, a recent medical school graduate, had traveled overland with his wife and his friend "Wavy Gravy" in a “rotten old British Leyland bus they bought cheap in London. They painted it psychedelic colors and filled the bus with medicine and food and a bunch of hippie friends," hoping hoped to make it to Bhola in southwestern Bangladesh, which had been hard-hit by a recent cyclone.

But civil war on the border led them instead to an Ashram at the foot of the Himalayas, where an unexpectedly forceful guru had an unusual message for his new pupil.

“You are going to eradicate smallpox,” said Neem Karoli Baba to Larry. “Go to New Delhi. Go to the office of the World Health Organization. Go get your job.”

As Larry, then short, bearded, and ponytailed, recalls: “…there was this tall guy sitting in the lobby of the WHO office. He looked up and said, ‘Who are you? What are you doing here?’"

“I’ve come to work for the smallpox program.”

“There isn’t much of a program here.”

“My guru says it will be eradicated. Who are you?”

“I’m DA Henderson. I’m the head of the program.”

Richard Preston’s Demon in the Freezer is full of encounters like this one. Although his writing is very much based in fact—he performs background research and conducts extensive interviews with his subjects—“What makes these scenes powerful,” as Preston explains on his website, “is that the people are verifiably real and the universe is the actual one we live in, not the universe of a novelist's imagination. Thus the scenes have a versimilitude that can exceed that of the novel, and can take us into the heart of human experience.”

Preston’s dramatic approach to nonfiction may prove gripping or infuriating, depending on what you’re into. Demon reads like a thriller novel, sweeping readers through a meandering array of infectious disease topics centering on the story of smallpox eradication and the debate over the fate of its remaining stocks.

Preston’s writing style goes a bit over the top at points, as in his discussion of smallpox containment:

“The smallpox at the CDC’s repository may be kept in mirrored form…[but] people at the CDC do not discuss the details of the storage, and many of them may not know of the existence of the vault. They don’t know, and they don’t ask.”

If Preston, a journalist, can write about "the vault" in a widely-acclaimed book, clearly the CDC’s employees might know something about it. But such claims are in the service of a good story, and, overall, Preston does a fantastic job of using his style to make the facts of smallpox come to life.

The drama is best justified when, as with Brilliant’s story, Preston focuses on individuals. One of the best characters in Demon is Lisa Hensley, an Ebola researcher with USAMRIID, the US Army’s Medical Research Institute of Infectious Diseases. We follow her through a large part of the book, first to an Ebola lab, and later to the CDC, where she is commissioned to perform smallpox experiments on monkeys. We learn about Lisa’s childhood and family—her father, who “took her into his laboratory and taught her to grow bacteria on petri dishes”—her romantic life, and her professional doubts.

Preston’s descriptions of Lisa’s first experiences working in a “space suit” give a fantastic sense of what the nearly-deadly, yet oddly peaceful, world of Level 4 containment might be like. Later, we witness a terrifying scene in which Hensley pricks a glove with scissors in the Level 4 Lab, and is potentially exposed to Ebola.

“Hensley felt a sudden rise of fear, which turned into a little bit of panic. What was the last thing I had touched with my hand? What was I doing? What were the scissors touching? Was there any [Ebola] on the scissors? The mind goes sticky in a moment of fear. She blanked. She couldn’t remember what she had been doing with her hands. There was nobody to ask.”

The scene itself is gripping enough—but it was the connection I already felt with Lisa, from learning about her family and her story, that made me genuinely scared while reading.

Preston’s literary liberties do seem to come at the expense of a few facts. These are mainly one-word inaccuracies, as when he calls "primates" the “closest relatives of humans” and makes statements like “when a person dies of AIDS…”. I don’t think that the degree or number of those slip-ups, however, detracts in any significant way from the purpose of the book.

Occasionally, in the service of his style, Preston also makes statements that should perhaps be phrased as opinion; for example, “In order to develop drugs and a new vaccine for smallpox, it would be necessary to do experiments with live Variola.” These seem more serious than the factual slip-ups. But again, when considered in light of the vast amount of information Preston is able to convey in such an accessible manner, the number of inaccuracies seems negligible.

Preston accomplishes something incredibly rare in science writing: he writes, to put it bluntly, very well. This is no small accomplishment. It is hard to get the public past a Hollywood-level interest in infectious disease, and into the nuts and bolts of research or smallpox containment, largely because there is no middle ground between Hollywood thriller and ultra-dense scientific papers.

Preston provides that middle ground. At one point, by going to a lab himself and describing his experiences working with a technician, Preston makes a gripping chapter out of the subject of mousepox virus modification. The equivalent information in an infectious disease journal wouldn't be touched by a non-researcher.

For his ability to bring such information to the public in Demon and in his other books, Preston has been recognized by the scientific community: he is the only non-medical doctor to receive the CDC’s “Champion of Prevention Award” for public health.

It is well-deserved. If you can accept Demon for the unique "educational thriller" that it is, it has quite a lot to offer. It does a memorable, entertaining, and educated job of capturing the stories and debate surrounding smallpox eradication and containment.


No comments:

Post a Comment