At the very beginning of this book, 28-year-old Erin Connelly, a physician only one year past her residency, was working in the Congo with Dr. Jacob Kohl, helping him with his medical research. They were there on a special World Health Organization project, testing a possible treatment for monkey pox. The two of them also had a personal relationship. But things ended very badly there. Erin found out that Jacob was infecting villagers with a strain of monkey pox that had been altered to infect humans, in order to test their new drug. He was doing this without the consent or even knowledge of the villagers. Worse, a woman with whom Erin had become close died due to being deliberately infected with the altered monkey pox. As she was dying, she gave birth to an HIV-infected baby. Furious with Jacob, Erin destroyed his data and went back to the United States. She adopts the deceased woman’s baby.
The rest of the book takes place eight years later. Erin’s adopted daughter, Esperance (French for “hope”), is very ill with AIDS. Erin, who is still a research doctor, thinks she can save Esperance’s life. If she can get a smallpox culture, she can make a mutated form of it called Enigma. Through her research, she believes that there is a link between HIV and smallpox.
But of course, smallpox cultures aren’t so easy to come by. And the man in charge of the U.S. supply of smallpox cultures, at the Centers for Disease Control, is none other than Jacob Kohl (she never turned him in for his ethical violations in the Congo eight years ago).
Jacob has come around to Erin’s way of thinking about what he did eight years ago. He realizes that they were lucky that the virus hadn’t spread. And he is not happy when Erin contacts him about possibly getting a smallpox sample. He knows firsthand how deadly the virus can be, having lost his entire family to smallpox when he was a small child in Nepal, only a few years before it was eradicated from the earth. (So why was he willing to infect an entire village with a similar pox virus eight years previously? I didn’t get that.) Anyway, Jacob is determined that Erin will not get a smallpox culture. He is determined to destroy all of the world’s smallpox samples before Erin can get her hands on any of them.
Both Erin and Jacob come across as extreme and desperate. I remember thinking several times while reading this that they were both nuts. Of course, I could understand Erin’s doing anything she could possibly do to save her child’s life. I imagine that could make a person seem a little desperate and nuts. Jacob’s angst I could understand as well, at least to a point. He had lost his entire family at age five. I can’t even begin to truly know how awful that would be. But I still found some of his actions (without giving too much away) pretty hard to justify. In any case, though, the book was very compelling reading.