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caught natu- rally.” The Palm Beach Health Department said the case was isolated, but was “very likely” to be fatal.
    Later the same day, Florida Department of Health and CDC epidemiologists and lab workers arrived in Palm Beach County to assist. That night, Dr. Brad Perkins, chief of men- ingitis and special pathogens at the Atlanta-based CDC, re- ceived an urgent call at his daughter’s piano recital. Over
    his cell phone Dr. Perkins got the bare facts—that Bob Ste- vens was hospitalized with inhalational anthrax and had been a worker at AMI. Fourteen hours later Dr. Perkins was in Florida leading a CDC unit in an effort to determine how Stevens had been infected with a “remarkably rare” microbe. The next morning, Friday, October 5, Dr. Perkins was at Stevens’s bedside. The critically ill patient remained fever- ish and was still “intubated,” on ventilation support. His condition had progressively deteriorated: abnormally low blood pressure, internal ulceration, bleeding, altered mental state, and massive shock. Severe respiratory distress had continued for almost thirty-five hours. Despite antibiotic therapy, Bob Stevens’s clinical condition deteriorated rap- idly. The toxin was killing its host by producing secondary shock. Stevens slipped into a coma. He coughed up a yel-
    low, bubbly mess marbled with red.
    Around 3:30 p.m., Dr. Perkins took his team to AMI and met with the editors who knew Stevens. He hoped he could get a clue from them since Stevens had been unable to speak. “That was a fairly dramatic meeting,” Perkins re- ported later, “because we were sitting in a room with people who had known him. This was a universally loved guy.” Just then Dr. Perkins’s cell phone beeped—Bob Stevens had died at 4:00 p.m., dead from inhaling thousands of dangerous spores, the first known anthrax fatality in the United States since 1976.
    “Everyone was just in utter disbelief,” said Perkins. Death usually follows severe respiratory symptoms within thirty-six hours and that timing indicated he might have been infected earlier than thought, before his trip to North Car- olina.
    And what of Ernie Blanco, the man who may have de- livered a contaminated letter? He may have gotten the pow- der in his lungs too. In his case nothing yet had been confirmed. Though clinical anthrax was suspected once they learned of Stevens’s death, Blanco showed no signs of clin- ical infection. Why? Doctors took a nasal swab from him and began to incubate it in a petri dish to see if it grew anthrax spores. They believed they would. In the meanwhile,
    the hospital informed Blanco’s family he too might have been exposed to anthrax.
    Late that afternoon, the world media, state and federal agencies, even the White House began speculating and won- dering if the anthrax was connected in some way with the recent terrorist attacks. The White House had expected a biological attack would be next. Dr. Perkins remained fo- cused on “leading a solid, scientific investigation.”
    Early the following day, Saturday, October 6, medical examiner Dr. Sherif Zaki and his CDC team arrived by char- tered jet and went immediately to the West Palm Beach medical examiner’s office to perform the autopsy. Whenever there is the slightest reason to suspect the possibility of a homicide, an autopsy is always done. The Palm Beach County coroner, Dr. Lisa Flannagan, would make the initial incisions. Under the burning lights, the examiner, dressed like the others in biohazard mask, plastic face shield, and three layers of gloves (one pair Kevlar-reinforced), ap- proached a sloped metal table where the bagged body lay. The table’s upper half had a grated surface. At the other end was a shallow tub that ran beneath a grating flowing with water. After the bag was unzipped, a careful examination of the victim’s skin, scalp, and entire surface of his body would be made. Then the interior of the body would be examined over the next three