The Anthrax Letters: The Attacks That Shocked America (12 page)

The aide winced as she recalled that the door to Daschle’s office “kept opening and closing all afternoon with people going in and out.” The following week Senator Daschle announced that more than 6,000 people had undergone nasal swabs and that 28 had tested positive for anthrax. A breakdown of the swab results provided by the CDC indicated that 20 members of Daschle’s staff had been exposed, two members of Feingold’s staff, and six “responders” from the Capitol Hill Police. Some staffers accepted the offer to take anthrax vaccinations and others refused, but all remained on antibiotics for 90 days or longer. None became infected.

Meanwhile, Capitol Hill had become unnerved. A day after the discovery of the letter preliminary tests showed that spores had been found in the Senate mailroom. Attorney General John Ashcroft announced that the strain of anthrax found was “virulent, strong, very serious.” The Capitol was shut down, and all six House and Senate office buildings were closed for screening. In subsequent weeks, suspicions of anthrax, many of them false alarms, prompted closings throughout the Washington area, including parts of the Federal Reserve Building, the State Department, and the Pentagon. A letter containing white powder prompted evacuation of the Supreme Court.

According to Feingold’s aide, the senator’s staff remained “anxious and edgy” for months. Only after the Hart Building was decontaminated and people returned in January 2002 did they seem more relaxed about the ordeal.

In 1986 a new mail-processing center opened in Washington, D.C., on Brentwood Road, 2 miles northeast of the Capitol off Rhode Island Avenue. Mail delivered to the Washington area, including Capitol Hill, was sorted at the center. During the week that the Daschle anthrax letter was discovered, four of Brentwood’s 2,000 employees became linked by a common fate. The four men were black, as were most Brentwood workers, and were of similar ages: Leroy Richmond was 56 and Qieth McQue was 53. Thomas Morris was 55 and Joseph Curseen 47. All were bright and articulate: McQue was a graduate of the University of Maryland, Curseen of Marquette University. Susan Richmond, Leroy’s wife, herself a postal worker at Brentwood, spoke of them all as “well-mannered guys.” Jim Harper, who had operated a mail-sorting machine with Curseen, says that his friend Joe “would do anything for anybody at any time.” He described all four as kind, good men.

They knew each other. “Rich” and “Mo,” as Richmond and Morris were called, had been pinochle partners. During the 4 a.m. break in the night shift, Curseen led a Bible-study group. A half dozen men attended. “We’d read scripture and psalms and discuss what they meant to us,” said Rich. Rich worked under McQue, who supervised the crew that picked up and sorted express mail from Baltimore-Washington International Airport. But the ultimate commonality of the four men began to surface on Tuesday, October 16, the day after the Daschle letter was opened. On that day each had begun to feel mildly ill.

Leroy Richmond, nearly 6 feet tall, is bone thin. His narrow face breaks into an easy smile even as he ponders that stressful week. By Friday he was feeling so achy that he did something he rarely does—“because I’m never sick.” He called a doctor. That afternoon he went to the office of Dr. Michael Nguyen, an internist with Kaiser Permanente in Woodbridge, Virginia. Soft spoken and conscientious, Nguyen examined Richmond and found nothing exceptional. Like people everywhere by then, he knew about the Daschle anthrax letter, though he doubted it had anything to do with Richmond’s illness. Still, he “had this feeling in the back of my neck,” he told me, that prompted him to send Richmond to the hospital for further assessment.

After driving her husband north for 20 minutes from Nguyen’s office, Susan Richmond turned off Route 495 onto Gallows Road in Falls Church. There, at about 5 p.m., she parked near the entrance to Inova Fairfax Hospital and helped her husband to the emergency room. Leroy Richmond’s case was not deemed critical, and he had to wait until people with heart attacks and other clearly urgent problems had been seen. After 4 hours, a doctor appeared.

Cecele Murphy is a tall, ebullient blonde. A former flight attendant, she later became a professor of communications at Purdue University. Then in 1988, at age 37, she began another dramatic career change: she entered medical school. After her residency in emergency medicine at George Washington University, she started working at Inova Fairfax in 1996. That Friday afternoon, while tending to dozens of emergency room cases, she received a briefing about the patient in Cubicle 8. She had seen his chest X ray—mild pulmonary effusion—and heard he had some breathing difficulties. Dr. Murphy drew the curtain behind her as she entered the 7-foot-wide space. She smiled at Susan Richmond, who had not left her husband’s side since their arrival at the hospital and turned to Mr. Richmond.

“Hi, how are you? I’m Dr. Murphy. The physician’s assistant tells me you’re not feeling well.”

“I really know my body, and there’s something wrong,” he answered.

Susan chimed in: “He is never sick. I mean, if he says he’s sick, he really is.”

Murphy thought to herself, “He’s not pale because he’s dark skinned, but he looks and sounds very weak.” Midway through the interview Richmond said, “I work at Brentwood.”

“What’s Brentwood?” Murphy asked. “It’s the post office that handles mail for the Senate.”

She thought about whether this revelation had meaning: “None of us knew anything about Brentwood at that point. We knew all about the Daschle letter and the Senate because we were getting reports from the CDC and the Washington Health Department about what to do with patients who come in and say they were on the fifth floor in the Hart Building. But about Brentwood, nothing.”

She doubted that Richmond’s illness was connected to the Daschle letter, but she felt she could not ignore the possibility. His chest X ray showed no mediastinal widening—a tell-tale sign of inhalation anthrax. But she wanted a more refined view, so she ordered a CT scan of his chest. “CT,” or “CAT,” stands for computerized axial tomography. It is an x-ray technique that produces multiple images of a part of the body taken from different angles. A computer reconstructs the images into vertical cross sections that can be viewed layer by layer, like slices of salami.

Meanwhile, Richmond’s condition seemed to worsen as he lay in the emergency room. He had developed a fever and showed blood in his urine. Murphy drew blood samples for testing and then ordered him on multiple antibiotics, including intravenous Cipro. When the radiologist saw Richmond’s CT results that night, he called Murphy: “What were you thinking you might find in this CT?” he asked. She mentioned pneumonia, cancer, maybe anthrax. He replied, “Well, he’s got significant mediastinal lymphadenopathy. It looks like there’s blood in his lymph nodes.” Even though Murphy had thought of anthrax as a possibility, hearing that the lymph nodes were swollen and bloody stunned her. “Are you playing with me?” she asked. “No,” the radiologist responded. She did a quick mental inventory: Brentwood, rapidly failing health, now the nodes. “My God, then he really does have it.” She returned immediately to Cubicle 8. “Mr. Richmond, your CT shows swollen lymph nodes in your chest. That could mean anthrax.” Richmond remembers hearing Dr. Murphy say “anthrax” but decided she must be wrong. It had to be pneumonia, he believed.

At 1 a.m Richmond was admitted to the intensive care unit. Around that time Dr. Susan Matcha received a phone call at home from the emergency room. “We have a patient here who could have anthrax.” Matcha was the Kaiser plan infectious disease doctor covering three hospitals that weekend. She was told the patient’s blood was being cultured, that he had a chest X ray, and that he was on Cipro. She answered: “Okay, it sounds like the appropriate things are being done. I’ll see him in the morning.”

The next morning, as she was driving to Inova Fairfax, her cell phone rang. It was from another physician at the hospital. “You better get over here right now. It’s really looking like the patient has anthrax.” Leroy Richmond’s blood culture had grown organisms consistent with anthrax. She rushed to the hospital and examined Richmond. After phone consultations with the CDC, Matcha added rifampin and clindamycin to the Cipro, hoping that the additional antibiotics might help fight the organism and its toxin.

On Monday afternoon, 3 days after his admission, Richmond received an unexpected visitor. Dr. Nguyen had come by, not to examine him but to show him something. “These are incense sticks,” he said. Nguyen, a Buddhist, told Richmond that he would be going to his temple, where “I’ll be burning the incense and praying for you.” Richmond nodded and with effort managed a “Thank you.” Nguyen became increasingly emotional. “I am so happy to see you alive and that you went to the emergency room on Friday.” As Dr. Nguyen spoke, Richmond and his wife, Susan, saw tears in his eyes.

Meanwhile, on Saturday night, the day after Richmond went to the hospital, another man was admitted to Inova Fairfax with similar symptoms. Nine months later, Qieth McQue was still insisting on his anonymity, but for the first time agreed to speak about his experience. (In mid-2003 he also gave me permission to cite him by name, McQureerir, or by the short version that he commonly uses: McQue.)

Like Richmond, McQue belongs to the Kaiser health plan, and at 8:30 Saturday morning, October 20, he called to see a doctor. “They had nothing open until 3:30 in the afternoon, so that’s when I went,” he says. According to McQue, the doctor seemed puzzled: “He asked me was I kissing anybody? Was I drinking anything? I said, ‘No,’ Then as soon as I said ‘Brentwood,’ they admitted me.”

When Dr. Susan Matcha, who was already treating Leroy Richmond, heard about McQue’s symptoms and where he worked, she ordered that a blood sample be drawn, and then placed him on intravenous Cipro. She did not tell the patient what her suspicions were, pending the results of his blood test. Fifteen hours later it was clear:
Bacillus anthracis
had been cultured from his blood. Dr. Matcha came to Qieth McQue’s room with a message that overwhelmed him:

McQue thought: “Well, the bad news might be that I have to stay here for 2 or 3 days. The good news would be that I can go home now with some pills.”

“Let me hear the bad news first,” he said.

“You have inhaled anthrax spores. It’s a fatal disease. But we think we got it in time.”

McQue, petrified, responded: “You’ve got to get out of this room, now.” He explained:

Matcha’s recollection differed somewhat. She does not remember being asked to leave the room. “And I’m not really sure I said anything to the effect of ‘I think we can help you,’ because I wasn’t so sure we could help at that point.”

When Matcha visited McQue the next day, Monday, he was better able to talk. “But all I can think is, ‘How can I get out of this hospital?’” McQue said. Matcha was also there to tell McQue and Richmond that she would no longer be treating them. She had been covering at Inova Fairfax over the weekend but would be returning to her base at the Washington Hospital Center, near the Capitol. Two infectious disease specialists at Inova, Jonathan Rosenthal and Naaz Fatteh, would be taking over their cases. From then on, Rosenthal assumed primary care for Richmond and Fatteh for McQue, though each doctor saw both patients and continuously discussed their progress with each other.

After medical school at Columbia University, Rosenthal took a residency at Case Western in Cleveland in the late 1980s. In 1991 he moved to Northern Virginia, outside Washington, D.C., to work at Kaiser Permanente. On Saturday morning Susan Matcha had called to tell him about Richmond’s positive blood culture. “She called me because I’m based at Fairfax and I’m responsible with Dr. Fatteh for Inova Fairfax patients.” Rosenthal had been fully briefed by the time he saw Richmond and Qieth McQue on Monday.

Rosenthal speaks quickly. His manner is direct, no nonsense. How did he feel about taking on the treatment of the two men? “Initially we were terrified that they were just gonna drop dead on us within a few days—because of the impression from the literature that if you get to this stage of the disease, the mortality is just so overwhelmingly high.”

He spoke of the agony Richmond and McQue faced with every breath. “Both patients were rapidly developing bloody pleural effusions.” The poisonous fluids were taking up more and more room in their chest cavities: “I took care of Leroy in particular. He had major lung compression, and he had to be drained repeatedly. You know, two thirds of his pleural cavity was filled with fluid, and his lung was compressed to a third of its previous size.”