October 27, 2014 Issue

Richard Preston hasn’t been on my radar for years. The last piece by him that I remember reading is “Climbing the Redwoods” (The New Yorker, February 14, 2005). But now here he is, in this week’s issue, with “The Ebola Wars.” It’s extraordinary! To say that it’s about how genomics research can help contain Ebola fairly describes its gist, but hardly does justice to the riveting life-and-death drama at its core, a drama that hinges on access to the experimental drug ZMapp, described by Preston as “a cocktail of three antibodies that seemed especially potent in killing Ebola.” The piece reads like a streak. Preston has a gift for figuration that turns complex phenomena into vivid images, e.g., on the size of one Ebola particle, he says, “If it were the size of a piece of spaghetti, then a human hair would be about twelve feet in a diameter and would resemble the trunk of a giant redwood tree.” He describes the look of an Ebola-infected cell as having the appearance of “a ball of tangled yarn.” Regarding microtubes of human blood serum, he says, “Each microtube was the size of the sharpened end of a pencil and contained a droplet of human blood serum, golden in color and no bigger than a lemon seed.” His description of how a DNA-sequencing machine works is amazing:

Using a pipette, a technician sucked up about a tenth of Gire’s Ebola droplet—an amount like a fleck of moisture on a wet day—and placed it on a glass slide known as a flow cell. The fleck of liquid contained the full library of code from the blood of the fourteen Ebola patients. The bit of water spread into channels on the flow cell, which sat in the mouth of an Illumina HiSeq 2500 machine, one of the fastest DNA sequencers in the world.

For the next twenty-four hours, the sequencer worked automatically, pulsing liquids across the flow cell, while lasers shone on it. On the surface of the flow cell, hundreds of millions of fragments of DNA had gathered into hundreds of millions of microscopic colored spots. The colors of the individual spots were changing as the process went on, and a camera took pictures of the changing field of spots and stored the data. Twenty-four hours later, the machine had finished reading Gire’s library of bar-coded fragments of DNA. The data were sent to the Broad Institute’s computer arrays, which assembled all the fragments into finished genetic code—it organized the vast pile of books in the library and placed the letters of all the books in their proper order on shelves. On Sunday, June 15th, Gire and Sabeti got word that the computers had finished their job. The result was twelve full genomes of Ebola virus—the Ebolas that had lived in twelve of the fourteen people.

Then Preston cuts from the Genomics Platform to the Ebola ward at Kenema hospital in Sierra Leone, and we are suddenly in hell:

Khan was inside the plastic Ebola ward, and the place was a mess. There were thirty or more Ebola patients in the ward, lying on cholera beds, and the floor was splashed with everything that can come out of the human body. Khan was making rounds, with one nurse, both of them wearing P.P.E.

The contrast between the two realities – the cerebral, stainless steel, high-tech Genomics Platform, on the one hand, and the ghastly, chaotic, plastic-walled Ebola ward at Kenoma hospital, on the other – is transfixing. The person who knits the two worlds together, who coolly moves between them is the research scientist Stephen Gire. Preston says that Gire is “tall and quiet, and there is an air of precision about him.” Preston’s prose enacts that precision. “The Ebola Wars” is astonishingly achieved.