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There are times when fatigue is the great aphrodisiac, annihilating all other thoughts, granting sensuous slow motion to heavy limbs, urging generosity, acceptance, infinite abandonment. We tumbled out of our respective days like creatures shaken from a net. (56)
People often remark on how quickly the extraordinary becomes commonplace. I think that every time I'm on a motorway at night, or on a plane as it rises through cloud cover into sunlight. We are highly adaptive creatures. The predictable becomes, by definition, background, leaving the attention uncluttered, the better to deal with the random or unexpected. (151)
I loved the telescopic nature of this next bit. McEwan takes us from pondering visible critters in the soil, down to the perspective of the most microscopic of mycelia and then suddenly we are sucked back up from such revery and thrown straight into the dangers of this world -- shooting down the road and into the immediate future. It's the perfect spell, this suspension of suspense, when our minds are sidetracked momentarily from what has been the obsessive driving force of this book. It's genius: In the rich black crumbly mulch I saw two black ants, a springtail, and a dark red wormlike creature with a score of pale brown legs. These were the rumbling giants of this lower world, for not far below the threshold of visibility was the seething world of the roundworms, the scavengers and the predators who fed on them; and even these were giants relative to the inhabitants of the microscopic realm, the parasitic fungi and the bacteria - perhaps ten million of them in this handful of soil. The blind compulsion of these organisms to consume and excrete made possible the richness of the soil and therefore the plants, the trees, and the creatures that lived among them, whose number had once included ourselves. What I thought might calm me was the reminder that for all our concerns, we were still part of this natural dependency, for the animals that we ate grazed the plants which, like our vegetables and fruits, were nourished by the soil formed by these organisms. But even as I squatted to enrich the forest floor, I could not believe in the primary significance of these grand cycles. Just beyond the oxygen-exhaling trees stood my poison-exuding vehicle, inside which was my gun, and thirty-five miles down teeming roads was the enormous city on whose northern side was my apartment, where a madman was waiting, a de Clerambault, my de Clerambault, and my threatened loved one. (224-225)
(1997. New York: Anchor Books, 1999)
It's really frightening to think that the entire human population is vulnerable to a disease that spreads quickly through tiny droplets in the air and kills at the very least 30% of all who become infected. Even the older folks like our parents who may have been vaccinated against it are no longer immune -- the vaccine is only good for about 7 years. And as ex-bioweaponeers in this book say: we are naive if we think that smallpox is reposited in only two places on earth. This description of the different forms is especially gruesome (so of course I have to quote it):Smallpox virus interacts with the victims' immune systems in different ways, and so it triggers different forms of disease in the human body. There is a mild type of smallpox called a varioloid rash. There is classical ordinary smallpox, which comes in two basic forms: the discrete type and the confluent type. In discrete ordinary smallpox, the pustules stand out in the skin as separate blisters, and the patient has a better chance of survival. In confluent-type ordinary smallpox, which Los had, the blisters merge into sheets, and it is typically fatal. Finally, there is haemorrhagic smallpox, in which bleeding occurs in the skin. Haemorrhagic smallpox is virtually one hundred per cent fatal. The most extreme type is flat haemorrhagic smallpox, in which the skin does not blister but remains smooth. It darkens until it can look charred, and it can slip off the body in sheets. Doctors in the old days used to call it black pox. Haemorrhagic smallpox seems to occur in about three to twenty-five per cent of the fatal cases, depending on how hot or virulent the strain of smallpox is. For some reason black pox is more common in teenagers.
The rims of Barbara Birke's eyelides became wet with blood, while the whites of her eyes turned ruby red and swelled out in rings around the corneas. Dr William Osler, in a study of black-pox cases he saw at the Montreal General Hospital in 1875, noted that 'the corneas appear sunk in dark red pits, giving to the patient a frightful appearance'. The blood in the eyes of a smallpox patient deteriorates over time, and if the patient lives long enough the whites of the eyes will turn solid black.
With flat haemorrhagic smallpox, the immune system goes into shock and cannot produce pus, while the virus amplifies with incredible speed and appears to sweep through the major organs of the body. Barbara Birke went into a condition known as disseminated intravascular coagulation (DIC), in which the blood begins to clot inside small vessels that leak blood at the same time. As the girl went into DIC, the membranes inside her mouth disintegrated. (50-51)
As the end approaches, the smallpox victim can remain conscious, in a kind of frozen awareness - 'a peculiar state of apprehension and mental alertness that were said to be unlike the manifestations of any other disease' (52)
The IL-4 gene holds the recipe for a common immune-system compound called interleukin-4, a cytokine that in the right amounts normally helps a person or a mouse fight off an infection by stimulating the production of antibodies. If the gene for IL-4 is added to a poxvirus, it will cause the virus to make IL-4. It starts signalling the immune system of the host, which becomes confused and starts making more antibodies. But, paradoxically, if too many antibodies are made, another type of immunity goes down -- cellular immunity. Cellular immunity is provided by numerous kinds of white blood cells. When a person dies of AIDS, it is because a key part of his or her cellular immunity (the population of CD4 cells) has been destroyed by HIV infection. The engineered mousepox seems to create a kind of instant AIDS-like immune suppression in a mouse right at the moment when the mouse needs this type of immunity the most to fight off an exploding pox infection. An engineered smallpox that triggered an AIDS-like immune suppression in people would be no joke (280-281)
(London: Headline, 2003)
