The Anthrax Letters: The Attacks That Shocked America by Leonard A. Cole
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Authors: Leonard A. Cole
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At 3 a.m. on Friday, October 12, a telephone call jolted Marcelle Layton out of her sleep. David Ashford was on the line from the Centers for Disease Control and Prevention in Atlanta. “Marci, I’m calling to give you a chance to wake up. I’ll be phoning back in 5 minutes. Jeff Koplan wants to talk to you and some others on a conference call.” Dr. Layton, New York City’s assistant health commissioner for communicable diseases, had gone to bed an hour earlier “with a smile on my face,” she recalled. She had left her office after midnight following a good-news phone call from the CDC. The PCR (polymerase chain reaction) results for a skin biopsy of an NBC employee were negative for anthrax. Happily, the CDC had confirmed the city’s own negative findings. But the Atlanta-based agency was still performing capsular and cell wall testing on the specimen—the same kind of tests Phil Lee had done in Florida a week earlier on Bob Stevens’s sample. Still, Layton felt optimistic.
Then came Ashford’s ominous middle-of-the-night call. When the phone rang again, Jeffrey Koplan, CDC’s director, came on to say that the immunohistochemical staining for the specimen was positive. (Capsular and cell wall tests both involve immunological and chemical staining, thus the shorthand term “immunohistochemical” testing.)
When Phil Lee had conducted these tests on Stevens’s sample, he had come away from his microscope knowing he had seen something momentous. Now, in Atlanta, Koplan and two other CDC officials—Sherif Zaki, the lead pathologist for the agency, and James Hughes, director of its infectious diseases center—looked through the microscope and experienced the same sense of gravity. Zaki, who had devised these anthrax-specific tests a few years earlier, told Koplan he was 90 percent certain that the results were positive. The anthrax outbreak, evidently, had not been confined to Florida. Still, Koplan seemed reluctant to make a definitive pronouncement. Later that morning he was on the phone with New York’s Mayor Rudy Giuliani, who asked, “Are you sure it’s anthrax?” “Well, we have a high degree of probability,” Koplan replied. Hughes recalls that moment vividly. A year later he told me: “We were reluctant to say ‘absolutely’ because there is always the chance of error. If we say ‘yes,’ and it turns out not to be anthrax, the consequences would be huge.”
“No, no, no, don’t give me that stuff,” the mayor responded to Koplan. Giuliani, whose decisive leadership in the wake of September 11 had become legendary, would not settle for probability. “Is it anthrax or is it not?” he insisted.
“Yes,” Dr. Koplan said.
“Fine, that’s all I need to hear.”
Months later Dr. Layton reflected on that day and the weeks leading to it. Her third-floor office on Worth Street in lower Manhattan is nine blocks north of the abyss where the Twin Towers had stood. Behind her desk are shelves of volumes that befit her specialty in epidemiology—texts on infectious diseases, vaccines, AIDS, a folder of CDC reports. The sound of classical music, the single feature in her office not directly related to her professional charge, is faintly audible. “I never met anyone who works as hard,” Tim Holtz, a staff physician, observed when Layton was out of earshot. “She is always here.”
Layton evinced a shy smile as she mentioned that her responsibilities include “disaster planning” for bioterrorism. But on September 11 everyone in the department was consumed with overseeing the city’s health response to the morning’s horror. The office phones were down, so communications went out erratically by cell phone, computer, and hand delivery. “I’m the chair of the surveillance committee,” Layton said. That day, from her small corner office, she directed the citywide surveillance of hospital emergency room activities, injuries, staff responses, and availability of equipment. By
At 3 a.m. on Friday, October 12, a telephone call jolted Marcelle Layton out of her sleep. David Ashford was on the line from the Centers for Disease Control and Prevention in Atlanta. “Marci, I’m calling to give you a chance to wake up. I’ll be phoning back in 5 minutes. Jeff Koplan wants to talk to you and some others on a conference call.” Dr. Layton, New York City’s assistant health commissioner for communicable diseases, had gone to bed an hour earlier “with a smile on my face,” she recalled. She had left her office after midnight following a good-news phone call from the CDC. The PCR (polymerase chain reaction) results for a skin biopsy of an NBC employee were negative for anthrax. Happily, the CDC had confirmed the city’s own negative findings. But the Atlanta-based agency was still performing capsular and cell wall testing on the specimen—the same kind of tests Phil Lee had done in Florida a week earlier on Bob Stevens’s sample. Still, Layton felt optimistic.
Then came Ashford’s ominous middle-of-the-night call. When the phone rang again, Jeffrey Koplan, CDC’s director, came on to say that the immunohistochemical staining for the specimen was positive. (Capsular and cell wall tests both involve immunological and chemical staining, thus the shorthand term “immunohistochemical” testing.)
When Phil Lee had conducted these tests on Stevens’s sample, he had come away from his microscope knowing he had seen something momentous. Now, in Atlanta, Koplan and two other CDC officials—Sherif Zaki, the lead pathologist for the agency, and James Hughes, director of its infectious diseases center—looked through the microscope and experienced the same sense of gravity. Zaki, who had devised these anthrax-specific tests a few years earlier, told Koplan he was 90 percent certain that the results were positive. The anthrax outbreak, evidently, had not been confined to Florida. Still, Koplan seemed reluctant to make a definitive pronouncement. Later that morning he was on the phone with New York’s Mayor Rudy Giuliani, who asked, “Are you sure it’s anthrax?” “Well, we have a high degree of probability,” Koplan replied. Hughes recalls that moment vividly. A year later he told me: “We were reluctant to say ‘absolutely’ because there is always the chance of error. If we say ‘yes,’ and it turns out not to be anthrax, the consequences would be huge.”
“No, no, no, don’t give me that stuff,” the mayor responded to Koplan. Giuliani, whose decisive leadership in the wake of September 11 had become legendary, would not settle for probability. “Is it anthrax or is it not?” he insisted.
“Yes,” Dr. Koplan said.
“Fine, that’s all I need to hear.”
Months later Dr. Layton reflected on that day and the weeks leading to it. Her third-floor office on Worth Street in lower Manhattan is nine blocks north of the abyss where the Twin Towers had stood. Behind her desk are shelves of volumes that befit her specialty in epidemiology—texts on infectious diseases, vaccines, AIDS, a folder of CDC reports. The sound of classical music, the single feature in her office not directly related to her professional charge, is faintly audible. “I never met anyone who works as hard,” Tim Holtz, a staff physician, observed when Layton was out of earshot. “She is always here.”
Layton evinced a shy smile as she mentioned that her responsibilities include “disaster planning” for bioterrorism. But on September 11 everyone in the department was consumed with overseeing the city’s health response to the morning’s horror. The office phones were down, so communications went out erratically by cell phone, computer, and hand delivery. “I’m the chair of the surveillance committee,” Layton said. That day, from her small corner office, she directed the citywide surveillance of hospital emergency room activities, injuries, staff responses, and availability of equipment. By
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