Brisling received his complimentary snack from the flight attendant and promptly stuffed it into the seatback pocket. He did not have much of an appetite. Raising the window shade, he blinked in the brilliant sunlight. A cobalt sky arced above, cold and thin. Far below, the earth was creeping along, withered and cracked beneath its shroud of haze.

What a bastard he had been.

Anna Jankowsky had come to him that morning in tears, terrified she had some deadly disease, the same disease, in fact, that took John Lundquist's life. Brisling managed not to laugh at her, although he remembered rolling his eyes. Because hers was a neurosis as old as Socrates himself: medical students fretting over their own little aches and pains, ascribing them to the horrific illnesses in their textbooks. They even had a name for it, Second-Year Syndrome. And apart from the fact that Anna Jankowsky was a third-year student, her case was classic.

Instead of listening, Brisling regaled Jankowsky with his own story of Second-Year Syndrome. As a young student, he had convinced himself that he had contracted tertiary syphilis, even though he and everyone knew he was still a virgin. His professors dubbed it the Immaculate Infection and he never quite lived it down. He might spare Jankowsky the same humiliation.

But when Brisling finally let the girl speak, let her say what she was actually experiencing—the mood swings, the memory loss, the seizures—he jumped up and marched her straight to the MRI machine. He stood there in the control room as the images came through.

Sweet Jesus, she was right.

No wonder she was struggling. No wonder she teared up on rounds. No wonder she dropped the bone saw and ran out of the autopsy suite. Jankowsky knew. Somehow, she knew.

What a bastard he had been.

On his way to the airport, Brisling called in a prescription for a powerful anti-seizure medicine. Then he arranged for a next-day appointment with a neurologist. It was the least he could do.

What a royal bastard.

Somewhere inside a nameless brick building near the Capitol in Washington, DC, plainclothes security guards ushered Brisling into a boardroom lined with dark wood paneling. A dozen men and women wearing somber business attire milled about a long polished table, chatting, texting, tweeting.

Brisling recognized a few of them. There was big Tad Chalmers, Republican senator from Texas, patting his famously round belly and laughing with a dark-haired woman. At the end of the table sat a stocky, dour-faced man recognizable to any American with a television, Frank Alonzo, current Senate Minority Leader, nemesis of President Jack Almerson.

And there was Senator Joe Flaherty, the Massachusetts Messiah, his lean and handsome figure cutting a swath through the room. "R.K.," he said with an exuberant handshake. "It's good to see you." The years in Washington had burnished smooth his New England accent, but he still sounded like a Kennedy. And that golden-gray hair, so lush and thick, combed straight back like a lion's mane. "Sorry about the cold call yesterday. But I'm glad you could make it."

"Just like old times," Brisling said mirthlessly.

The two had met back in Flaherty's premessianic days, at a congressional subcommittee hearing about an outbreak of rare infections and cancer among gay men in San Francisco. Only later would they call it AIDS. But before they even had a name, Brisling knew what was causing it: a blood-borne pathogen, a virus. The subcommittee scoffed at his hypothesis. Only one man, Joe Flaherty, seemed to recognize its prescience. Hindsight is twenty-twenty, he had said the time, but foresight is one in a million. A clumsy metaphor at best, but it stumbled near enough the truth. Foresight was a rare gift. Rarer still was the man willing to stake his reputation on it.

Flaherty laid his hand on Brisling's shoulder. "How was your flight?"

"Long."

"The next leg will be more comfortable, I promise."

"The next leg?"

He removed his hand. "I'll explain later."

Brisling knew better than to press. "I can't believe he's dead. The vice president, for God's sake."

"We're all in shock. Al Stone and I were pretty close."

"I'm sorry, I didn't realize."

"There'll be time for that later. Right now we need facts."

"OK, but I thought you said this was just a small subcommittee meeting. What's Frank Alonzo doing here?"

"He's a subcommittee member, and he's sure as hell not going to pass up an opportunity to make me eat crow over Al Stone's health."

"You never gave me his medical chart."

"And I'm not going to. What I need you to do right now is deal out cold, hard facts about the virus that killed him."

"I still think you could have found someone better for the job. I haven't published anything in years."

"Perhaps not, but I need someone like you from outside the Beltway, someone with no political ties, someone who's not afraid to tell it like it is, even to the likes of Frank Alonzo over there. Or me."

"You mean someone with nothing to lose."

The senator led Brisling around the table to a battered overhead projector. "I had a hell of time finding this thing," he said, voice straining above the rising chatter. "Don't you people in Seattle use computers? I thought you invented the damn things."

"Like I said, I might not be the best person for the job."

"Too late now." Flaherty called the subcommittee to order. Then he introduced a man Brisling did not quite recognize, former "hot zone" scientist with the CDC . . . codiscoverer of HIV . . . world authority on polyomaviruses. "I've asked him here to today to brief us on the virus that took Albert Stone's life." He flipped on the overhead projector and whispered into Brisling's ear. "You're on, R.K." Then he exited stage left, out of view.

Brisling fidgeted with the keys in his pants pocket. Before him, darkened faces waited, silent. A knot of pressure lodged behind his breastbone—angina pectoris, ischemic heart pain. It came now every time he spoke in public, so predictably in fact, that he had developed a magician's sleight of hand when popping a nitroglycerin tablet. He took a swig of water, slipping in the tiny pill as he wiped his mouth. It zinged reassuringly beneath his tongue.

As the pressure subsided, he loosened his tie a notch. Then he cleared his throat and began. "Thank you, Senator Flaherty, for inviting me here, and for your kind introduction. However, I would like to point out that HIV was discovered by Montagnier, Barré-Sinoussi, and Gallo in 1983. I had nothing to do with it."

He glanced at Flaherty, hunched over his phone in the darkened corner, his chiseled face awash in blue light.

Facing the committee again, Brisling said, "Let me start by saying that although I didn't have the privilege of knowing Vice President Stone, I share your shock and sadness over his death."

He hesitated, suddenly abandoned by all the fitting words he had prepared on the flight out. It was just as well. He had not crossed the continent just to deliver a eulogy for a man he did not even know, let alone vote for. Flaherty had asked him to deal out cold, hard facts, and that was what he was going to do.

"All right. As outlined in your packets, Vice President Stone died from an extremely rare brain disease called progressive multifocal leukoencephalopathy, PML for short. The disease is characterized by rapidly progressive dementia, psychosis, and seizures, followed quickly by death in a matter of days to weeks. The case fatality rate is one hundred percent."

He laid a plastic sheet on the projector's platen glass, and the screen filled with the image of a giant white ball covered with stubby spikes, like a dog's chew toy. "This is an electron micrograph of the virus that causes PML, the JC virus, or JCV. In most people, JCV infection is harmless. In fact, everyone in this room has been exposed to it."

Tad Chalmers slapped his hands on the table and leaned forward. "You're saying I've been exposed to this bug?" His twangy accent was so thick it bordered on factitious.

"It's not a bug. It's a virus. And yes, you've almost certainly been infected." Brisling savored his next words. "What's more, you're still infected with it."

"What?" Chalmers's big belly caught on the underside of the table as he wobbled to his feet.

Brisling gestured for the senator to relax. "Please, there's no need to be alarmed. Many viruses that infect humans remain dormant in our bodies. Chicken pox virus is a perfect example. Most of us were infected as kids, missed a week or two of school, then forgot all about it. But that virus is still in us, just waiting for our immune systems to weaken. When it does, the virus comes roaring back in the form of shingles. I'm sure a few of us in this room have had it."

Chalmers scratched his side and settled back into his chair.

"The same is true for JC virus. It lies dormant in the brain, the kidneys, and lymph nodes. In healthy people, this isn't a problem, but if the immune system weakens, say from AIDS or chemotherapy, the virus can reactivate in the brain. That's what PML is, and this is what it looks like." Brisling swapped the image of the virus with the MRI scan of a brain riddled with dark holes and white streaks. The committee members murmured and gestured to one another. But Senator Alonzo's broad shadow remained perfectly still, arms folded. Brisling could just imagine those big black eyebrows twitching, just like in the presidential debates.

Flaherty cleared his throat and lowered his phone. "Dr. Brisling, can you tell us how JCV spreads?"

"Casual contact. Since JCV resides in the kidneys, it's shed mostly in the urine. That's how it spreads from person to person."

"U-rine?" said Chalmers. "How's that casual contact?"

"Even a micro droplet of urine on the skin, clothing, or any surface is enough to infect."

"Damn good reason for washing your hands after using the outhouse."

The dark-haired woman next to him leaned away. "Did you really need another reason?"

Before the Texan could retort, the woman raised her hand and identified herself as Nicki Lewis, representative from Illinois. "How sure are we that Al Stone actually died from JCV reactivation and PML?"

Flaherty stepped forward and came to Brisling's side. "The diagnosis has been confirmed by two independent groups of neuropathologists, one at Massachusetts General and the other at Yale."

At last, Senator Alonzo stirred, his shadow expanding. "Dr. Brisling," he said his low, cool voice. "Correct me if I'm wrong, but you earlier stated that healthy people don't get PML, and now the good Senator Flaherty confirms that Al Stone died from it. We've all suspected the man's health was poor. Some even think he had cancer. So what I and my constituents would like to know is this: what chronic illness put the vice president at risk for this extremely rare infection?"

Flaherty dismissed the question with a curt chop of his hand. "Dr. Brisling is only here to discuss PML in general. He's not privy to the vice president's medical records."

"Then perhaps you can tell us." Brisling swore he could see Alonzo leaning back with his fingers tented, a sanctimonious smile on his face.

"Frank, we don't have an explanation for why Al Stone got PML. Before the election, he was as healthy as an eighty-three-year-old man could hope to be. His doctors are stumped, plain and simple."

Alonzo shot to his feet and turned to address his colleagues. "Don't get me wrong here. Al Stone's death is a tragedy, for his family, for his friends, for America. But he was never fit enough to serve in office. Jack Almerson only put him on the ticket so he could win the White House. Now we finally have proof of that."

Flaherty sighed audibly. "Frank, this isn't the time."

"The hell it isn't!"

"Please. Al's been gone barely a week."

"That hasn't stopped you from picking out curtains for the White House."

"If I'm nominated and confirmed, I'll be honored to serve as vice president."

"I'm calling for a separate investigation."

"I won't stop you."

"You can't stop me." Alonzo turned and strode for the doors.

Someone flipped on the lights, and the remaining committee members erupted in heated debate.

Flaherty pulled Brisling aside. "Sorry about that. Frank just can't put the election behind him."

"The man's right. PML doesn't affect healthy people."

"I know. I read your articles."

"Then what the hell's going on here, Joe? I just diagnosed two people back in Seattle, and neither of them had a reason to get it, either."

"What would you say if I told you there were a lot more cases just like this?"

Brisling frowned. "I'd say I was intrigued."

"Good, because there's a jet waiting for you at Reagan International. A private jet. No cheap seat this time."

"The CDC?"

"That's right. You're going back to Atlanta."

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