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Excerpt of Isolation Ward by Joshua Spanogle
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Chapter 1

St. Raphael's was an old Catholic hospital, struggling to maintain its independence in the face of overtures--friendly and outright aggressive--from Johns Hopkins and the University of Maryland. The hospital sat in the middle of a decayed neighborhood in the southwestern quadrant of the city, surrounded to the north and west by housing projects and to the south and east by a mix of old factories and abandoned row homes. The hospital served the needy in the immediate area, but extended its reach to the working-class neighborhoods of Pigtown and Locust Point. The last I heard, it was hemorrhaging money and talks with Hopkins and Maryland had started up again, this time at St. Raphe's behest. The former belle at the ball, now trying to dance with anyone who'd have her. Rumor had it the powers that be--admin at St. Raphe's, the Catholic archdiocese, the city, Hopkins, U of M--were just going to shutter the old girl. As the dirty pile of bricks, streaked black and dotted with a few forlorn statues of St. Raphael, came into view, I thought a mercy killing might not be the worst thing.

Still, there was a soft spot in my heart for the place. I'd just spent two weeks at St. Raphe's setting up a program to identify exactly the kinds of things that seemed to be happening. Outbreaks. Bioterror attacks. Bad things. St. Raphe's, in other words, needed me. Not like Hopkins, who basically taught my employers, the Epidemic Intelligence Service at CDC, how to play their game. If every employee at CDC were suddenly to die or, worse, to take a job in the private sector, Hopkins probably felt it could rebuild the Centers from scratch. No, St. Raphael's was a third-tier hospital in a city dominated by some of the best medicine in the world. My job was to get this old gal up to snuff.

Okay, my job. I am an officer in the Epidemic Intelligence Service, a branch of the Centers for Disease Control and Prevention. Apropos of my duties--to conduct surveillance for and investigations of outbreaks of disease--the title of officer is a fitting one. The cop jargon has been with us for a long time. Medical detectives was often used to describe officers in the service by those on the outside and on the inside, though the term long ago fell out of use, perhaps because it sounded a little too self-aggrandizing at the same time it sounded a little too trite. Anyway, that's what we do. We look for and hunt down diseases.

As with many things--fashion, say, or diet plans--there is some circularity to the history of the EIS. Originally conceived at the start of the Korean War as an early-warning system for biological attack, the EIS has spent decades searching for things to do. And it's done a pretty good job of finding them. The Service was instrumental in restoring public confidence after a polio vaccine scare in the fifties, it helped erase smallpox from the world, in the late nineties and early '00s it tracked down and set up surveillance for West Nile virus. And now the country is back to freaking out about bioterrorism. Which is why I was in Baltimore, helping to patch a hole in the country's disease-surveillance net. Normally, an old hospital wouldn't merit much attention, but St. Raphe's proximity to the nation's capital scared the public health gods, who wanted to ensure that any outbreak in the area was identified quickly. So, they sent me to set up a surveillance program.

Excerpted from Isolation Ward by Joshua Spanogle Copyright © 2006 by Joshua Spanogle. Excerpted by permission of Delacorte Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.