“Made it?” Cohen said.

“It wouldn’t be that hard,” Kilburn said. “Bacteria store resistance in their genes or DNA. There are three common mechanisms for transferring resistance between cells.” He lapsed into the lecture he had given many times before to med students but tried to keep his tone conversational, rather than didactic. “Transformation: where bacteria soak up free-floating DNA in the vicinity. Conjugation: essentially a form of sex between cells where strands of DNA called plasmids are transferred. And transduction: in which a virus acts as the ‘middleman’ passing DNA back and forth between cells. All those mechanisms can be reproduced in a lab. You would have to collect bacteria resistant to each antibiotic, slice up the DNA, and transfer the resistance genes into a waiting group-A strep colony.” He snapped his fingers. “Presto—you have MRGAS.”

Cohen shook his head in disbelief. “It’s that easy?”

“Not quite,” Kilburn said. “But certainly doable for a microbiologist with the right equipment.”

Warmack leaned forward until his elbows touched the desk. “Now you have the how and maybe part of the who. But the one question you haven’t answered is why. Why would anyone go to the trouble of creating a brand-new superbug?”

41 - Seattle, Washington

41

Seattle, Washington

Haley Vallance awoke in the same strange room as before. The tubes and wires still criss-crossed the bed. The machine still whirred by her head. And the same tube was stuck down the back of her throat. She gagged again, which sent her into a spasm of coughs. Her body shook with each cough, but no sound emerged from her lips.

Panicking, she lifted her head off the bed and looked around for Mom or Dad.

Still wearing the funny green pajamas and masks, her parents stood in the same spot by the bed. Mom held her hand; Dad squeezed her arm. The sight of them calmed her. The coughing fit passed. Nothing had changed.

Then Haley realized something was different. Staring up at Mom, she noticed her eyes were dry. Mom was smiling through her mask. She turned to Dad. He was smiling too.

Am I in heaven? she wondered. She tried to ask, but the tube blocked her words.

“Oh, Haley …” her mom began to say, but she dissolved into sobs.

“Haley-Bear, the doctors say you’re getting better.” Dad squeezed her arm gently. “They say you’re going to be okay.” His voice cracked in a way she had never heard from him before.

As soon as he said it, Haley realized she didn’t feel so winded any more. Every time she tried to breathe, the big machine still forced air into her chest, but the choking sensation was gone. And she didn’t feel dizzy either. She squeezed her mom’s hand. She tried to smile at her dad but the tube felt strange between her lips.