Information about the book
PROLOGUE
He stands silently in the moonlight against the wall of the
temple, the small bundle held tightly under his arm. The
sisal wrapping chafes against his skin, but he welcomes
the feeling. It reassures him. In this drought-stricken city,
he would not trade this package, even for water. The
ground beneath his sandals is cracked and dry. The green
world of his childhood is gone, and he is beginning to
wonder if soon he will be too.
Satisfied that the temple guards haven’t detected his
presence, he hurries toward the central square, where artisans and tattoo-painters once thrived. Now it is populated
only by beggars, and beggars, when hungry, can be dangerous. But tonight he is lucky. There are only two men
standing by the east temple. They have seen him before,
and they know he gives to them what he can. Still, he
holds the bundle close as he goes.
At the boundary between the central square and the
maize silos, there is a guard posted. No more than a boy.
For a moment, he considers burying the bundle and
returning for it later, but the earth is dust, and the winds
drive through fields where trees once stood. Nothing in
this parched city remains buried for long.
He takes a breath and continues walking forward.
‘Royal and Holy One,’ calls the boy. ‘Where are you
going?’ The boy’s eyes are tired, hungry, but spark when
they take in the bundle under the man’s arm.
‘To my fasting cave.’
‘What are you carrying?’
‘Incense for my dedications.’
The man tightens his arm around the parcel and prays
silently to Itzamnaaj.
‘But there has been no incense at the market for days,
Royal and Holy One.’ The guard’s voice is jaded. As if all
men lie now to survive. As if all innocence has fled with
the rains. ‘Give it to me.’
‘Warrior, you are right. It is not incense but a gift for
the king.’ He has no choice but to invoke the king’s name,
though the king would have his heart ripped out if he
knew what he was carrying.
‘Give it to me,’ the boy says again.
The man reluctantly obeys.
The boy’s fingers unwrap the bundle roughly, but when
the sisal falls away, he sees disappointment in the young
guard’s eyes. What had he been hoping for? Maize? Cacao?
He does not understand what he has seen. Like most boys
in these times, he understands only hunger.
Rewrapping it quickly, the man hurries away from the
guard, offering thanks to the gods for his good fortune.
His small cave lies at the eastern edge of the city, and he
slips through the opening undetected.
There are cloths spread across the floor, placed here in
preparation for this moment. He lights his candle, sets the
bundle at a careful distance from the wax, then carefully
wipes his hands. He drops to his knees and reaches for the
sisal. Inside is a folded stack of pages made from the bark
of a fig tree, hardened with a glaze of limestone paste.
With the great but seemingly effortless care of a man
who has trained for this act his entire life, he unfolds the
paper. Twenty-five times it has been doubled back on
itself, and when it is completely unfurled, the blank pages
stretch across the width of the cave.
From behind his hearth, he gathers three small bowls
of paint. He has scraped cooking pots to make black ink,
shaved rust from the rocks to make red, and searched
fields and riverbeds for anil and clay to make indigo.
Finally, he makes a puncture in the skin of his arm. He
watches the crimson rivulets run over his wrist and into
the bowls of paint before him, sanctifying the ink with his
blood.
Then he begins to write.
12.19.19.17.10
December 11, 2012
Dr Gabriel Stanton’s condo sat at the end of the Boardwalk, before the Venice Beach footpath morphed into
lush lawns where the tai chi lovers gathered. The modest
duplex wasn’t entirely to Stanton’s taste. He would have
preferred something with more history. But on this odd
stretch of the California coastline, the only options to
choose between were run-down shacks and contemporary stone and glass. Stanton left his home just after
seven a.m. on his old Gary Fisher bike and headed south
with Dogma, his yellow Labrador, running beside him.
Groundwork, the best coffee in LA, was only six blocks
away, and there Jillian would have a triple shot of Black
Gold ready for him the minute he walked in.
Dogma loved the mornings as much as his owner did.
But the dog wasn’t allowed into Groundwork, so after
Stanton tied him up, he made his way inside alone, waved
at Jillian, collected his cup, and checked out the scene.
A lot of the early clientele were surfers, their wetsuits still
dripping. Stanton was usually up by six, but these guys had
been up for hours.
Sitting at his usual table was one of the boardwalk’s
best-known and strangest-looking residents. His entire
face and shaved head were covered with intricate designs,
as well as rings, studs, and small chains protruding from
his earlobes, nose, and lips. Stanton often wondered where
a man like Monster came from. What had happened to
him in early life that led to the decision to cover his body
entirely with art? For some reason, whenever Stanton
imagined Monster’s origins, he saw a split-level home near
a military base – exactly the type of houses in which he
himself had spent his childhood.
‘How’s the world out there doing?’ Stanton asked.
Monster looked up from his computer. He was an
obsessive news junkie, and when he wasn’t working at his
tattoo shop or entertaining tourists as part of the Venice
Beach Freak Show, he was here posting comments on
political blogs.
‘Other than there being only two weeks before the
galactic alignment makes the magnetic poles reverse and
we all die?’ he asked.
‘Other than that.’
‘Hell of a nice day out there.’
‘How’s your lady?’
‘Electrifying, thanks.’
Stanton headed for the door. ‘If we’re still here, I’ll see
you tomorrow, Monster.’
After Stanton downed his Black Gold outside, he and
Dogma continued south. A century ago, miles of canals
snaked through the streets of Venice, tobacco magnate
Abbot Kinney’s re-creation of the famed Italian city. Now
virtually all of the waterways where gondoliers once ferried
residents were paved over and covered with steroid-fueled
gyms, greasy-food stands, and novelty T-shirt shops.
Stanton had ruefully watched a rash of ‘Mayan apocalypse’ graffiti and trinkets pop up all over Venice in recent
weeks, vendors taking advantage of all the hype. He’d
been raised Catholic but hadn’t been in a church in years.
If people wanted to seek their destiny or believe in some
ancient clock, they could go right ahead; he’d stick to testable hypotheses and the scientific method.
Fortunately, it seemed not everyone in Venice believed
December 21 would bring the end of the world; red and
green lights also decorated the boardwalk, just in case the
crackpots had it wrong. Yuletide was a strange time in LA.
Few transplants understood how to celebrate the holidays
at seventy degrees, but Stanton loved the contrast – Santa
hats on rollerbladers, suntan lotion in stockings, surfboards
festooned with antlers. A ride along the beach on Christmas was as spiritual as he got these days.
Ten minutes later, he and the dog reached the northern
tip of Marina del Rey. They made their way past the old
lighthouse and the sailboats and souped-up fishing vessels
bobbing quietly in the harbor. Stanton let Dogma off his
leash, and the dog bounded ahead while Stanton trotted
behind, listening for music. The woman they were here to
see surrounded herself with jazz at all times, and when
you heard Bill Evans’s piano or Miles’s trumpet over the
other noises of the waterfront, she wasn’t far. For most
of the last decade, Nina Countner had been the woman in
Stanton’s life. While there had been a few others in the
three years since they’d split, none had been more than a
substitute for her.
Stanton trailed Dogma onto the dock of the marina
and caught the mournful sound of a saxophone in the
distance. The dog had arrived at the tip of the south jetty
above Nina’s massive dual-engine McGray, twenty-two
pristine feet of metal and wood, squeezed into the last
slip at the end of the dock.
Nina crouched beside Dogma, already rubbing his
belly. ‘You guys found me.’
‘In an actual marina for a change,’ said Stanton.
He kissed her on the cheek and breathed her in. Despite
spending most of her time at sea, Nina always managed
to smell like rose-water. Stanton stepped back to look at
her. She had a dimpled chin and striking green eyes, but
her nose was a little crooked, and her mouth was small. To
Stanton, it was all just right.
‘You ever going to let me get you a real slip?’ he asked.
Nina gave him a look. He’d offered to rent her a permanent boat slip so many times, hoping it would lure her
back to shore more often, but she’d never accepted, and he
knew she probably never would. Her freelance magazine
assignments hardly provided a steady income, so she’d
mastered the art of finding open slips, out-of-sight beaches,
and off-the-radar docks that few others knew about.
‘How’s the experiment coming?’ Nina asked as Stanton
followed her onto the boat. Plan A’s deck was simply
appointed, just two folding seats, a collection of loose
CDs strewn around the skipper’s chair, and bowls for
Dogma’s water and food.
‘More results this morning,’ he told her. ‘Should be
interesting.’
She took the captain’s seat. ‘You look tired.’
He wondered if it was the encroaching tide of age she
was seeing on his face, crow’s-feet beneath his rimless
glasses. But Stanton had slept a full seven hours last night.
Rare for him. ‘I feel fine.’
‘The lawsuit’s all over? For good?’
‘It’s been over for weeks. Let’s celebrate. Got some
champagne in my fridge.’
‘Skipper and I are headed to Catalina,’ Nina said. She
flipped the gauges and switches that Stanton had never
bothered to really master, firing up the boat’s GPS and
electrical system.
The faint outline of Catalina Island was just visible
through the marine layer. ‘What if I came with you?’ he
asked.
‘While you waited patiently for results from the center?
Please, Gabe.’
‘Don’t patronize me.’
Nina walked up, cupped his chin in her hand. ‘I’m not
your ex-wife for nothing.’
The decision had been hers, but Stanton blamed himself, and part of him had never given up on a future for
them together. During the three years they were married,
his work took him out of the country for months at a
time, while she escaped to the ocean, where her heart had
always been. He’d let her drift away, and it seemed like she
was happiest that way – sailing solo.
A container ship sounded its horn in the distance,
sending Dogma into a frenzy. He barked repeatedly at the
noise before proceeding to chase his own tail.
‘I’ll bring him back tomorrow night,’ Nina said.
‘Stay for dinner,’ Stanton told her. ‘I’ll cook whatever
you want.’
Nina eyed him. ‘How will your girlfriend feel about us
having dinner?’
‘I don’t have a girlfriend.’
‘What happened to what’s-her-name? The mathematician.’
‘We went on four dates.’
‘And?’
‘I had to go see a man about a horse.’
‘Come on.’
‘Seriously. I had to check out a horse in England they
thought might have scrapie, and she told me I wasn’t fully
committed to her.’
‘Was she right?’
‘We went on four dates. So, are we on for dinner tomorrow?’
Nina fired up Plan A’s engine as Stanton hopped onto
the dock to collect his bike. ‘Get a decent bottle of wine,’
she called back as she un-moored, leaving him once again
in her wake. ‘Then we’ll see. . . .’
The Centers for Disease Control’s Prion Center in Boyle
Heights had been Stanton’s professional home for nearly
ten years. When he moved west to become its first director, the center had occupied only one small lab in a
mobile trailer at Los Angeles County & USC Medical Center. Now it spanned the entire sixth floor of the LAC &
USC main hospital building, the same building that for
more than three decades had served as the exterior for the
soap opera General Hospital.
Stanton headed through the double doors into what his
postdocs often referred to as his ‘lair’. One of them had
strung Christmas lights around the main area, and Stanton flipped them on along with the halogens, casting
green and red across the microscope benches stretching
across the lab. After dropping his bag in his office, Stanton threw on a mask and gloves and headed for the back.
This was the first morning they’d be able to collect results
in an experiment his team had been working on for weeks,
and he was very eager for them.
The center’s ‘Animal Room’ was nearly the length of a
basketball court and contained computerized inventory
stalls, touch-screen data-recording centers, and electronic
vivisection and autopsy stations. Stanton made his way
toward the first of twelve cages shelved on the south wall
and peered inside. The cage contained two animals: a twofoot-long black-and-orange coral snake and a small gray
mouse. At first glance it looked like the most natural thing
in the world: a snake waiting for the right moment to feed
on its prey. But in reality something unnatural was happening inside this cage.
The mouse was nonchalantly poking the snake’s head
with its nose. Even when the snake hissed, the mouse
continued to nudge it carelessly – it didn’t run to the corner of the cage or try to escape. The mouse was as unafraid
of the snake as it would have been of another mouse.
The first time Stanton saw this behavior, he and his
team at the Prion Center erupted in cheers. Using genetic
engineering, they’d removed a set of tiny proteins called
‘prions’ from the surface membrane of the mouse’s
brain cells. They’d succeded in their strange experiment,
disrupting the natural order in the mouse’s brain and
eradicating its innate fear of the snake. It was a crucial
step toward understanding the deadly proteins that had
been Stanton’s life’s work.
Prions occur in all normal animal brains, including
those of humans, yet after decades of research, neither he
nor anyone else understood why they existed. Some of
Stanton’s colleagues believed prion proteins were involved
in memory or were important in the formation of bone
marrow. No one knew for sure.
Most of the time, these prions sat benignly on neuron
cells in the brain. But in rare cases, these proteins could
become ‘sick’ and multiply. Like Alzheimer’s and Parkinson’s, prion diseases destroyed healthy tissue and replaced
it with useless plaques, squeezing out the normal function
of the brain. But there was one key, terrifying difference:
While Alzheimer’s and Parkinson’s were strictly genetic
diseases, certain prion diseases could be passed through
contaminated meat. In the mid-1980s, mutated prions
from sick cows in England got into the local food supply
through tainted beef, and the entire world became familiar with a prion infection. Mad cow disease killed two
hundred thousand cattle in Europe and then spread to
humans. First patients had difficulty walking and shook
uncontrollably, then they lost their memories and the
ability to identify friends and family. Brain death soon
followed.
Early in his career, Stanton had become one of the
world’s experts on mad cow, and when the CDC founded
the National Prion Center, he was the natural choice to
head it. Back then it had seemed like the opportunity of a
lifetime, and he was thrilled to make the move to California; never before had there been a dedicated research
center for the study of prions and prion diseases in the
United States. With Stanton’s leadership, the center was
created to diagnose, study, and eventually fight the most
mysterious infectious agents on earth.
Only it never happened. By the end of the decade, the
beef industry had launched a successful campaign to
show that just one person living in the United States had
ever been diagnosed with mad cow. Grants for Stanton’s
lab became smaller, and, with fewer cases in England as
well, the public quickly lost interest. The worst part was
they still couldn’t cure a single prion disease; years of testing various drugs and other therapies had produced
one false hope after the next. Yet Stanton had always
been as stubborn as he was optimistic and had never given
up on the possibility that answers were just one experiment away.
Moving on to the next animal cage, he found another
snake and another tiny mouse merely bored by its
predator. Through this experiment, Stanton and his team
were exploring a role for prions in controlling ‘innate
instincts’, including fear. Mice didn’t have to be taught to
be afraid of the rustling of the grass signaling a predator’s
approach – terror was programmed into their genes. But
after their prions were genetically ‘knocked out’ in an
earlier experiment, the mice began acting aggressively and
irrationally. So Stanton and his staff started directly testing
the effects of deleting prions on the animals’ most fundamental fears.
Stanton’s cellphone vibrated in the pocket of his white
coat. ‘Hello?’
‘Is this Dr Stanton?’ It was a female voice he didn’t recognize, but it had to be a doctor or a nurse; only a health
professional wouldn’t apologize first for calling before
eight in the morning.
‘What can I do for you?’
‘My name’s Michaela Thane,’ she said. ‘Third-year
resident at East LA Presbyterian Hospital. CDC gave me
your number. We believe we have a case of prion disease
here.’
Stanton smiled, pushed his glasses up the bridge of his
nose, and said, ‘Okay,’ as he moved on to the third animal
cage. Inside, another mouse pawed its predator’s tail. The
snake seemed almost befuddled by this reversal of nature.
‘ “Okay?” ’ Thane asked. ‘That’s it?’
‘Send over the samples to my office and my team will
look at them,’ he said. ‘A Dr Davies will call you back with
the results.’
‘Which will be when? A week? Maybe I wasn’t being
clear, Doctor. Sometimes I talk too fast for people. We
think we have a case of prion disease here.’
‘I understand that’s what you believe,’ Stanton said.
‘What about the genetic tests? Have they come back?’
‘No, but –’
‘Listen, Dr . . . Thane? We get thousands of calls a
year,’ Stanton interrupted, ‘and only a handful turn out
to be prion disease. If the genetic tests are positive, call
us back.’
‘Doctor, the symptoms are highly consistent with a
diagnosis of –’
‘Let me guess. Your patient is having trouble walking.’
‘No.’
‘Memory loss?’
‘We don’t know.’
Stanton tapped on the glass of one of the cages, curious to see if either of the animals would react. Neither
acknowledged him. ‘Then what’s your presumptive symptom, Doctor?’ he asked Thane.
‘Dementia and hallucinations, erratic behavior, tremor,
and sweating. And a terrible case of insomnia.’
‘Insomnia?’
‘We thought it was alcohol withdrawal when he was
admitted,’ Thane said. ‘But there was no folate deficiency
to indicate alcoholism, so I ran more tests, and I believe it
could be fatal familial insomnia.’
Now she had Stanton’s attention.
‘When was he admitted?’
‘Three days ago.’
FFI was a strange and rapidly progressing condition
that arose because of a mutated gene. Passed down from
parent to child, it was one of the few prion diseases that
was strictly genetic. Stanton had seen half a dozen cases
in his career. Most FFI patients first came in for medical
attention because they were sweating constantly and having trouble falling asleep at night. Within months, their
insomnia was total. Patients became impotent, experienced
panic attacks, had difficulty walking. Caught between a
hallucinatory waking state and panic-inducing alertness,
nearly all FFI patients died after a few weeks of total
sleeplessness, and there was nothing Stanton or any other
doctor could do to help them.
‘Don’t get ahead of yourself,’ he told Thane. ‘Worldwide incidence of FFI is one in thirty-three million.’
‘What else could cause complete insomnia?’ Thane
asked.
‘A misdiagnosed methamphetamine addiction.’
‘This is East L.A. I get the pleasure of smelling methbreath every day. This guy’s tox screen was negative.’
‘FFI affects fewer than forty families in the world,’
Stanton said, moving down the line of cages. ‘And if there
was a family history, you would’ve told me already.’
‘Actually, we haven’t been able to talk to him, because
we can’t understand him. He looks Latino or possibly
indigenous. Central or South American maybe. We’re
working on it with the translator service. ’Course, most
days here, that’s one guy with a GED and a stack of
remaindered dictionaries.’
Stanton peered through the glass of the next cage. This
snake was still, and there was a tiny gray tail hanging out
of its mouth. In the next twenty-four hours, when the
other snakes got hungry, it would happen in every cage in
the room. Even after years in the lab, Stanton didn’t enjoy
dwelling on his role in the death of these mice.
‘Who brought the patient in?’ he asked.
‘Ambulance, according to the admission report, but I
can’t find a record of what service it was.’
This was consistent with everything Stanton knew about
Presbyterian Hospital, one of the most overcrowded and
debt-ridden facilities in East LA. ‘How old is the patient?’
Stanton asked.
‘Early thirties probably. I know that’s unusual, but I
read your paper on age aberrations in prion diseases, and
I thought maybe this could be one.’
Thane was doing her job right, but her diligence didn’t
change the facts. ‘I’m sure when genetics comes back, it
will clear all this up quickly,’ he told her. ‘Feel free to call
Dr Davies later with any further questions.’
‘Wait, Doctor. Hold on. Don’t hang up.’
Stanton had to admire her insistence; he was a pain in
the ass when he was a resident too. ‘Yes?’
‘There was a study last year on amylase levels, how
they’re markers for sleep debt.’
‘I’m aware of the study. And?’
‘With my patient it was three hundred units per milliliter, which suggests he hasn’t slept in more than a week.’
Stanton stood up from the cage. A week without sleep?
‘Have there been seizures?’
‘There’s some evidence on his brain scan,’ Thane said.
‘And what do the patient’s pupils look like?’
‘Pinpricks.’
‘What happens in reaction to light?’
‘Unresponsive.’
A week of insomnia. Sweating. Seizures.
Pinprick pupils.
Of the few conditions that could cause that combination of symptoms, the others were even rarer than FFI.
Stanton peeled off his gloves, his mice forgotten. ‘Don’t
let anyone in the room until I get there.’
