The Cobra Event by Richard Preston

From Barnes & Noble

The Barnes & Noble Review
December 1997

The Cobra Event is a petrifying, fictional account of a very real threat: biological terrorism.

Seventeen-year-old Kate Moran wakes one morning to the beginnings of a head cold but shrugs it off and goes to school anyway. By her midmorning art class, Kate's runny nose gives way to violent seizures and a hideous scene of self-cannibalization. She dies soon after. When a homeless man meets a similarly gruesome — and mystifying — fate, the Centers for Disease Control in Atlanta sends pathologist Alice Austen to investigate. What she uncovers is the work of a killer, a man who calls himself Archimedes and is intent on spreading his deadly Cobra virus throughout New York City. A silent crisis erupts, with Austen and a secret FBI forensic team rushing to expose the terrorist.

Even more frightening than Preston's story about the fictitious Cobra virus, however, is the truth that lies beneath it. As the author writes in his introduction, "The nonfiction roots of this book run deep.... My sources include eyewitnesses who have seen a variety of biological-weapons installations in different countries, and people who have developed and tested strategic bioweapons." In fact, the only reason The Cobra Event was not written as nonfiction is that none of Preston's sources would go on record.

Woven throughout the novel are sections of straight nonfiction reporting that reveal the terrifying truth about the development of biological weapons and the clandestine operations of Russia and Iraq. Three years of research and more than 100 interviewswithhigh-level sources in the FBI, the U.S. military, and the scientific community went into The Cobra Event. The result is sure to shock you.

From the Publisher

"A PAGE-TURNER . . . THOROUGHLY FRIGHTENING."
—Newsweek

"ENORMOUSLY ENTERTAINING."
—The New York Times Book Review

"THIS BOOK SCARED THE LIVING DAYLIGHTS OUT OF ME. . . . Manages to grab you with the authenticity of its scientific detective work and haunt you with its sheer plausibility."
—Entertainment Weekly

Five days ago, a homeless man on a subway platform died in agony as startled commuters looked on. Yesterday, a teenager started having violent, uncontrollable spasms in art class. Within minutes, she too was dead.

Dr. Alice Austen is a medical pathologist at the Centers for Disease Control in Atlanta. What she knows is that the two deaths are connected. What she fears is that they are only the beginning. . . .

NY Times Book Review

Enormously entertaining.

Entertainment Weekly

This book scared the living daylights out of me. [It] manages to grab you with the sheer authenticity of its scientific detective work and haunt you with its sheer plausibility.

Newsweek

A new hybrid of fact and faction. . .utterly terrifying. . .wonderfully readable.

New York Times Book Review

Enormously entertaining.

Katherine Whittamore

Confession time: I couldn't make it through pages 59 to 76 in Richard Preston's The Cobra Event. The chapter is innocuously titled "Kate," but it's no personality profile -- it's "Kate" as dead person, dead person whose autopsy is laid out in infinite detail. If you've read The Hot Zone, which covers an Ebola virus outbreak, you know that Preston is not squeamish. And in The Cobra Event (I might as well get this over with), we are treated to descriptions of self-cannibalism (the victims of the deadly virus eat off their lips and more), plus the effects of decay on a corpse and, yes, how it smells. Be thankful there's no scent strip.

Disgust aside, this is a pretty good corker. Sometimes it's easy to ignore the clumsy writing, sometimes not. Grafting fiction onto extensive, fact-laden passages doesn't really work. And must we carry the science metaphors so far? Traffic, for instance, "moved on the avenue like blood swishing through an artery." Some marble lobby walls "reminded her of a cancerous liver, sliced open for inspection." "Her" is our Centers for Disease Control heroine, whose name is Alice Austen. But we'll call her Jodie Foster for short. Indeed, The Cobra Event is so hilariously bent on Hollywood, it reads more like a novelization than a novel. There's plenty of "Men in Black" FBI types, every chase scene leads to a cinematic tunnel and there's a hint of romance between Alice/Jodie and forensics hotshot Will Hopkins/Kevin Costner/Bill Paxton. The kickass government type has Tommy Lee Jones written all over him. Bioweapons inspector Dr. Mark Littleberry is "a tall handsome African-American with a crewcut."

Snideness aside, I'll admit that Richard Preston is a fine teacher. In the notes to the book, we learn that he spoke to hundreds of inside sources about "black biology." It shows. We discover that weapons inspectors need only a cotton swab to get the goods (they take samples of goo in suspect buildings, then feed the data to a biosensor). FBI snipers are taught to shoot terrorists in the eyes, because that shuts the brain down fastest, which means the reflex instinct that prompts a dying man to pull a trigger/detonator switch is shorted out. Viruses, Preston explains, are vampirish; they need blood to survive but often can be killed off by sunlight.

Even though I couldn't bear those 17 pages, I admit the science is riveting in The Cobra Event. The story, however, is only fair. Recommendation? Stick to nonfiction, Mr. Preston. Hollywood will still sniff you out. -- Salon

Library Journal

Preston, who scared us to death with his account of the Ebola virus in The Hot Zone, fictionalizes real events that could spiral into something far worse than Ebola.

School Library Journal

What happens when one crazed scientist takes it upon himself to develop and release a new biological weapon that will '"thin out' the human race? A doctor working for the Centers for Disease Control first notices some strange evidence in a young girl's death. Soon other bodies are arriving at the morgue in similar condition. The police, the FBI, and national medical and science personnel become involved in trying to get to the bottom of the deadly disease that is attacking New York City. Though the details in this novel are fictional, they are based on the history of biological weapons and the advanced genetic engineering and biotechnology that is available today. Despite the use of potentially confusing technical terms, the story line is easy to follow and fast paced. Sections of the narrative that sideline into history and worldwide political events are not crucial to the plot and may be skipped over. Realistically rendered characters hold center stage. The symptoms described in this story are frightening, and often presented in morbidly graphic detail. Fans of the horror genre are bound to enjoy this one. -- Anita Short, W. T. Woodson High School, Fairfax, Virginia

Entertainment Weekly

This book scared the living daylights out of me. [It] manages to grab you with the sheer authenticity of its scientific detective work and haunt you with its sheer plausibility.

Newsweek

A new hybrid of fact and faction. . .utterly terrifying. . .wonderfully readable.

NY Times Book Review

Enormously entertaining.

Product Details

• ISBN: 0345409973
  
• ISBN-13: 9780345409973
• Format: Mass Market Paperback, 432pp
• Publisher: Random House Publishing Group
• Pub. Date: September 1998
• Edition Description: Reprint
• Sales Rank: 16,814

• Interviews & Essays
• Read an Excerpt

Interviews & Essays

On Monday, December 8th, barnesandnoble.com welcomed Richard Preston, author of THE COBRA EVENT.

Richard Preston: Hi. I'm fine. No runny nose or anything.

Richard Preston: There are dedicated public health doctors. A lonely profession. My brother David Preston, a doctor in China, Maine, is one of my heroes.

Richard Preston: RashawnA bioweapon is a powdered material, say freeze-dried Ebola virus particles or smallpox, released into the air through various means. The particles are absorbed into the human lung. One single particle can cause a fatal infection. The particles of an aerosol bioweapon can drift for 50 miles downwind.

Richard Preston: Two nonfiction books FIRST LIGHT and AMERICAN STEEL. Now my first novel, THE COBRA EVENT, a suspense thriller about bioterror in New York City.

Richard Preston: Status of Ebola virus it's still out there. Various smoldering outbreaks of Ebola have occurred in central Africa, in Ivory Coast, Congo, and Gabon. The hidden host of Ebola virus remains unknown. There have been at least two expeditions to the Central African rain forest to look, and the origin of Ebola has not been found yet.

Richard Preston: Hi, Steve. My background Pomona College (CA), then Ph.D. in English lit. from Princeton University. Then I decided I didn't want to be a professor, so I became a freelance writer. I studied with John McPhee while at Princeton. He is a mentor and a friend. Also a master of nonfiction writing.

Richard Preston: Alex, your long question centers on the mystery at the heart of THE COBRA EVENT. How to trace a bioweapon once it's released into a human population, in a city. Thus the need for a "Reachdeep" bioterror operations unit, as in COBRA EVENT. Is nuclear response appropriate? I don't know. First you have to identify who did the release. Then the political leadership has to decide whether to respond with nuclear counterattack. I would not personally want to have make that decision. The more likely scenario may be the lone terrorist (I don't want to give away ending of CE).

Richard Preston: Amanda, every interview yields surprises, some incredible. One older man stunned me when he described how the U.S. military had conducted huge strategic tests of bioweapons in the Pacific Ocean. Another top source, a guy in the FBI, wanted to meet me in Union Station in Wash DC. He said, "Meet me by the McDonald's. You'll know me because I'll be wearing a black trench coat." (!) He was leader of the bioterror ops unit at Quantico. It was really fun.

Richard Preston: Sam, I won't do the screenplay, thank heavens. Because if the movie is a disaster (as happens sometimes in Hollywood), they'll always try to blame the screenwriter! So I stand back and watch Hollywood do its thing. Hollywood is a parallel universe.

Richard Preston: One of more important incidents was the Siege of Jaffa, around 1346. The besiegers catapulted dead humans over the city walls -- humans who'd died of plague. It is suspected that this warfare started the Black Death, the huge outbreak of plague in Mediterranean and N. Europe in summer of 1348. It killed off one third of the population, fast. Another important incident was deliberate use of smallpox-infected blankets given to Indians during French and Indian war. It killed off many populations of Native Americans. Bioweapons really work, and have been used in history.

Richard Preston: Elvis1. Whitewater canoeing. 2. Mountain biking (I'm not very good at it). 3. Hanging out with my kids, telling them stories and stuff. 4. Reading. Last good book A WRINKLE IN TIME, by Madeleine L'Engle.

Richard Preston: No model for Alice Austen. I made her up. Except I spent days and weeks hanging out with CDC officers, learning how they think and work, and those patterns wove into Alice's character. Yes, there are FBI forensic operations groups. the real one, the one that I call "reachdeep" in COBRA EVENT, is stationed at Quantico and is called the HMRU, which means Hazardous Materials Response Unit. They deal with bioterror.

Richard Preston: Ebola virus is a Level 4 virus. It causes a biological meltdown in the human body. You die in 3-7 days after infection, the virus melts your organs, causes hemorrhage, bruising, eyes fill up with blood, and the linings of the intestines can come off and are expelled. The victim "crashes and bleeds out," with blood running from any or all of the openings of the body. Ebola virus has been made into weapons. It can be freeze-dried, and it can drift in the air. This research was done in the old Soviet Union. Maybe in Russia today also.

Richard Preston: Brian -- that's the idea of the Cobra Event. A bioterror event might be invisible, not obvious. The disease is unknown (genetically engineered virus) and it's worming its way around NY City like a common cold, hitting one person here, one there. Bioterror might be hard to identify. Then ... how do you stop it?

Richard Preston: Manolo, the most convincing evidence was listening to my eyewitness sources describing what they'd seen and done in the Russian biowarfare facilities, especially in Obolensk and Koltsovo. Those places are truly scary, and my sources were really scared. Genetic engineering has clearly been a major focus of bioweapons research in Russia -- and in Iraq.

Richard Preston: THE HOT ZONE is actually nonfiction true factual story. THE COBRA EVENT is a fictional suspense novel, but is based on a ton of facts and research. I like writing both kinds of book, for different reasons. With a novel, I love being able to spin a huge yarn, create scenes and characters. I also loved doing the field research for COBRA EVENT, exploring tunnels in NYC (I won't tell the ending).

Richard Preston: I didn't write CE as nonfiction for the following reasons--I couldn't get my top sources to go on record by name. --Thankfully no major bioterror event has yet occurred. So there was nothing to report on, no story. Initially there was a lot of skepticism. But the experts have weighed in and have been saying, "Hey, Preston's telling the truth. It's real. Bioweapons are here and they are very dangerous, and Preston got it right." That's been the reaction of the expert community.

Richard Preston: What to do...1. As citizens, we should demand our government tell us what it knows about bioweapons in countries around the world. Send email to the White House. 2. Demand that the government stockpile medicines, and demand the government give us an emergency response plan. 3. Individually, educate ourselves. This is especially important for doctors and first responders. They should learn the basic symptoms of things like anthrax and smallpox...just in case. The medical people will be on the front line in any bioterror attack.

Richard Preston: Yes, the government is working on biosensor machines. I've seen some stuff. There's a biosensor device used by the U.S. Navy that looks like a pregnancy strip tester. You put a liquid sample on it, and it turns purple in the presence of a bioweapon. This device has actually been used in Iraq. That's why the Iraqis kicked out the UN teams -- they were starting to use biosensor technology, and getting close to finding the fingerprints of real bioweapons in Iraq.

Richard Preston: Dr. Duncan, much of the best research in bioweaponry was done by the U.S. military in the 1960s, and the work is still classified. The Russians have recently published some interesting papers on freeze-dried Ebola and Marburg air tests. Scary. You can find that work in Medline, I believe.

Richard Preston: Nance, the Iraqis are doing advanced research probably involving genetic engineering of viruses. This is a public-health threat to the entire world, because bioweapons can spread through a lethal chain of infection. That's why the UN should keep international pressure on Iraq to cool it.

Richard Preston: Not all my works are morbid. FIRST LIGHT is about galaxies and stars. But I'm drawn to the invisible universe, the microscopic world within, and I'm drawn to the idea of the invisible monsters and predators that inhabit the world of viruses. This is great material for a writer.

Richard Preston: Gregory, natural Lesch-Nyhan is strictly a genetic disease. You have to be born with it. It's caused by damage to a single gene, one called the HPRT gene. It causes the child to gnaw on his extremities and chew off his own face. No one can explain the origin of this bizarre behavior.

Richard Preston: NSD 7 originated in the White House. It's a Presidential Directive, so it comes directly from Bill Clinton. Parts of NSD-7 are classified. That is, the government keeps secret some aspects of a response to bioterror.

Richard Preston: Hollywood paid me $3 million for COBRA EVENT. It has not changed my life yet because we haven't received the check! I hope the heck it doesn't change my life. We're getting a lot of calls from charities!

Richard Preston: Naw, I've gotten used to it. It seems normal to me now.

Richard Preston: I'm trolling for new book ideas. Do you have any? Selling the rights to COBRA EVENT to Hollywood was kind of exciting. However, I am something of a nerd. My hollywood agent called me, very excited, and said that Tom Cruise was dying to play the FBI agent in COBRA EVENT, and Nicole Kidman would be Dr. Alice Austen. I said, "Who's Nicole Kidman." My agent was appalled. "How can anyone NOT KNOW who Nicole Kidman is?" he said. I guess I'd been talking to too many bioweapons scientists or something. I will participate in the production only to the extent that I'll give advice which they probably won't heed. I may do a cameo walk-through, which Stephen King does in his movies. I'd like to play a reporter scribbling notes in a corner while the bioterror operation is going down.

Richard Preston: It's unfortunately terribly real. Bioweapons are real, and genetic engineering has entered the normal process of weapons development in military labs worldwide. There are about 25 countries working on bioweapons. These are the weapons of the future, in my opinion. Bioweapons are probably more likely to be used in terrorism than in warfare, but no one really knows.

Richard Preston: No scientists in the family. My brother Douglas Preston is the bestselling author of THE RELIC (made into the Paramount movie). Doug and I talk about science all the time, and we've been fascinated with it since childhood. We like to talk shop with each other about writing. Also, our youngest brother David is a medical doctor, and he has helped us both with the medical science in our books. The Preston brothers stick together!

Richard Preston: My goal is that of most writers, to simply tell an unforgettable story. It's through stories that we learn and remember things about the world, history, and human nature. Stories are ancient and primitive, and can be immensely powerful. My audience is simply the collection of people, whoever they are, who happen to be fascinated with the things that fascinate me.

Richard Preston: I learned about bioweapons while I was writing THE HOT ZONE. I became determined to pursue the subject of bioweapons and learn more. I soon decided that I wanted to try fiction, but I wanted it to be based on a bedrock of convincing fact.

Richard Preston: Happy Holidays to everyone. May the truth prevail. And may that next cold be just a cold.... 'Bye.

Read an Excerpt

Part One

TRIAL

Arc of the Circle

NEW YORK CITY, LATE 1990S

KATE MORAN was an only child. She was seventeen years old and lived with her parents in a loft apartment on the top floor of a handsome old building to the west of Union Square, just on the edge of Greenwich Village. One Wednesday morning in late April, Kate was slow getting up. She had woken in the middle of the night in a sweat, but it went away, and she fell back asleep, into bad dreams that she could not remember. She came awake with a fresh cold, and she could feel her period coming on.

"Kate!" It was Nanette, the housekeeper, calling to her from the kitchen. "Katie!"

"Okay." She didn't like being called Katie. She sat up and found a Kleenex and blew her nose, and went into the bathroom. She brushed her teeth, then went back into the bedroom and dressed in a flowered dress that she had found in a flea market. The mornings could be chilly this time of year, so she put on a sweater. Kate had wavy russet hair, beautiful hair with natural pale highlights, which she wore medium length. Her eyes were grayish blue or bluish gray, depending on the light and the weather and her mood (or so she liked to think); complicated eyes. Her face was changing fast. She could almost see the bones of the woman emerging, yet she had found that the more she stared at her face in a mirror the less she understood it. She thought about this as she brushed her hair, pushing it back so that the two platinum earrings in her left ear were visible.

Kate's mother called her the Packrat, because she accumulated things. The worktable in the corner of her roomwas littered with old cigar boxes covered with their original illustrations, plastic boxes, metal containers, purses, bags, puzzles. Things that opened and closed. There was an old dollhouse that she had found in a junk shop in Brooklyn and had been taking apart, cannibalizing it for a project. She reached into the dollhouse and pulled out a prism made of glass, and the smooth white skull of a vole, with tiny yellow teeth, that she had bought at a bone shop in SoHo. She held the prism up to the light falling through the skylight of her bedroom, and just to see what it would look like, she held the vole's head behind the prism. No colors appeared; you needed direct sunlight. She stuffed the objects into her knapsack. They were going to become part of the Box that she was constructing in Mr. Talides's art room at the Mater School, a private girls' school on the Upper East Side.

"Katie!" Nanette was calling.

"Okay, okay." She sighed and threw her knapsack over her shoulder and went out into the living area—a large open space with polished wood floors and antique furniture and rugs. Her parents had both already left for work. Her father was a partner in a Wall Street investment house, and her mother was an attorney at a midtown law firm. In the kitchen, Nanette had poured orange juice and toasted a bagel. Kate shook her head. She wasn't hungry. She sneezed. Nanette tore off a paper towel and handed it to her. "Do you want to stay home?" "Uh-uh." Kate was already out the door and into the elevator.

It was a glorious morning. She hurried along Fifteenth Street to Union Square, striding on long legs, heading for the subway entrance. The ash trees in the square were threatening to break bud. Puffy white clouds drifted in a blue sky over the city, winds whipping in from the southwest, bringing a warmer day than Kate had expected. The daffodils were mostly gone and the tulips were blown and flopping their petals. Spring was beginning to give way to summer. A homeless man passed Kate going in the other direction, leaning into the warm wind as he pushed a shopping cart piled high with plastic garbage bags full of his possessions. She threaded through the stalls of the farmer's market that filled up the northern and western sides of the square, and at the subway kiosk she ran down the stairs and caught the uptown Lexington Avenue express.

The train was crowded, and Kate found herself crushed in a corner of the first car by the front window. It was where she had liked to stand when she was a girl riding with her mother and father, back when they had more time to take her places. You could look out the window and see the steel columns marching by under the car's headlights, and the track extending out into seemingly infinite darkness. Switches and branches whirled past, and if you were on an express train that caught up with a local on the adjacent track, there would be a moment when the two trains were locked together in a shuddering rush forward.

She didn't like it. The lights flashing in the tunnel made her feel sick. She turned away. Then she found herself looking at the faces in the subway car. The faces bothered her. If you look at too many faces jammed together, every face begins to look alien. People in the subway can look . . . humanoid.

The Mater School was only a few blocks from the Eighty-sixth Street subway station. Kate was still running a little late, and by the time she got to the stone parish building that housed the school, the younger girls had mostly gone inside, although some of the upper-school girls were hanging around on the steps.

"Kates, I have to tell you something." It was her friend Jennifer Ramosa. They walked in together, with Jennifer talking about something that Kate didn't follow. Kate felt strange, as if a feather had brushed across her face....

A gong rang...and there was the headmistress, Sister Anne Threader, going by.... For a moment Kate had a feeling of vertigo, as if she were staring into a black pit with no bottom, and she dropped her knapsack. It hit the floor with a smack. There was a sound of breaking glass.

"Kate? You moron. What's the matter with you?" Jennifer said.

Kate shook her head. It seemed to clear. She was going to be late for homeroom. "What's going on, Kates?" Jennifer asked. "I'm fine." She picked up her knapsack. It slushed and rattled. "Something broke. Damn, I broke my prism." She headed into class, annoyed with herself.

At about 10 o'clock in the morning, Kate went to the nurse's office and got some Tylenol. It didn't help her cold, which was getting worse and worse. It was a real sinus cold. Her mouth was hurting a lot; it felt bumpy and it stung. She was debating whether or not to go home. She decided to go to art class and leave after that. The art teacher, Peter Talides, was a balding, middle-aged painter, likable and disorganized, and his art room was a satisfying place. Students hung out there during the day and after school hours. Kate settled herself at a table in the corner of the room, near the window, where her assembled Box was taking shape. It was an ambitious construction, a kind of a house, made of pieces of dollhouses and all kinds of found objects. Kate felt dizzy and weak. She tried to work on the house but couldn't remember what she had planned to do with it. She felt as if she had never seen it before and as if some other person had built it.

"I want to go home," she said out loud.

The students looked at her. She started to stand up—she intended to go back to the nurse's office—when suddenly she felt really dizzy. "Oh, no," she said. She got part way to her feet, and found she couldn't stand. She sat down heavily on her work stool.

"What's the matter, Kates?" Jennifer asked.

There was a crash. Kate had slid off the stool and landed on the floor beside her worktable. Peter Talides came hurrying over. "Are you all right?"

"I'm sick," Kate said in a thick voice. She began to tremble. She was sitting on the floor with her legs out straight. "My mouth hurts."

Talides bent over her. "We need to get you to the nurse," he said.

She didn't answer. Her teeth were chattering and her face was flushed and feverish. Peter Talides was frightened. Kate's nose was running with clear mucus that flowed down over her lips. It was gushing out, as if she had a very bad cold. Her eyes flicked over his face without seeming to see him.

"Someone tell the nurse," he said. "Go on! Go!" To Kate he said, "Just sit still, okay?"

Kate said, "I think I'm going to throw up."

"Can you stand up?"

"No. Yes."

He helped her to her feet. "Jennifer. Prasaya. Please take Kate to the bathroom, will you?"

The two girls helped Kate out of the room and into the bathroom, while Peter Talides waited in the hallway. Kate stood in front of the sink, hanging on to it, wondering if she was going to throw up. Something moved inside her mind, as if some being that was not Kate but was Kate was in agony. There was a mirror over the sink. For a moment, she couldn't bring herself to look. Then she opened her mouth. The inside of the mouth reflected in the mirror was dotted with black blood blisters. They looked like shining ticks feeding there.

She screamed and hung on to the sink, and screamed again. She lost her balance and crumpled to her knees. Peter Talides ran into the bathroom. He found Kate Moran sitting on the floor, looking at him with glassy eyes. The clear mucus was running out of her nose and mouth, and she was weeping. She said in a thick voice, "I don't know what to do."

Kate's expression went blank. The left side of her face rippled in a series of twitches that moved in a wave. The twitches were marching jacksonian seizures. Suddenly she uttered a fierce, guttural cry. She toppled backward. Her knees straightened out and her body seized and froze hard in a clonic jerk. Her head hit the tiled floor with a crack. The stiffness lasted for a few seconds. Then her arms and legs began to tremble and jerk rhythmically. She lost control of her bladder. A puddle formed under her.

Talides tried to hold her arms still. "My God!" he cried.

Her legs lashed out in a clonus, knocking over a wastebasket, kicking Talides backward. She was very strong. Then her body began to scissor back and forth. Her teeth clicked together repeatedly. Her mouth was working. Her lips moved and rippled. Her tongue stuck out and was withdrawn again. Her eyes were half open. He thought Kate was looking at him and trying to say something to him. She moaned but no language came out.

Then her teeth sank into her lower lip, cutting through the lip, and a run of blood went down her chin and neck. She bit her lip again, hard, with ferocity, and she made a groaning animal sound. This time, the lip detached and hung down. She pulled her lip in, sucked it into her mouth, and swallowed. Now she was chewing again. Eating the inside of her mouth, chewing her lips, the insides of her cheeks. The movement of her teeth was insectile, like the feeding movements of an insect larva chewing on its food: intense, greedy, automatic—a kind of repetitive yanking at the tissues of her mouth. Her tongue suddenly protruded. It was coated with blood and bits of bloody skin. She was eating her mouth from the inside.

"She's biting herself!" he yelled. "Help!"

He got his hands around her head and tried to hold her chin steady, but he couldn't stop her teeth from gnawing. He could see her tongue curling and moving behind her teeth. He was begging for help at the top of his lungs. Jennifer was next to him, weeping, crying for help, too. The bathroom door was open, and students were standing in the hallway, looking in, stunned with fright. Most were crying. Several of them had run to call 911.

The girl's body went into a back-and-forth thrashing movement. Then she began to writhe. It was a type of writhing associated with damage to the base of the brain, the midbrain, a knot of structures at the top of the spinal cord. The movements were what is known as basal writhing.

Kate opened her mouth and a hoarse croak came out. She was lying on her back now. Her spine began to bend backward. Her body arched into the air. Her stomach lifted up higher and higher. Her teeth clacked together in a spasm. Her spine recurved impossibly far, lifting off the floor, until only the back of her head and her heels were touching the floor, her stomach raised up. Her body formed the shape of a C. Her head and heels were supporting her weight.

Her body remained poised in the air, writhing slowly, squirming, as if it were being driven by some force trying to escape from within. Her eyes opened wide. They were pure white. There were no pupils. The pupils had rolled up into the eye sockets. Her lips drew back from her teeth and she smiled, and a dark, bright liquid flowed from her nose. It was a nosebleed, a heavy epistaxis. With each heartbeat, a pulse of blood came from both nostrils. The epistaxis stained Talides's shirt and ran across the floor, where the blood tangled with the urine on the tiles and swirled down a drain in the center. She drew a rasping breath, inhaling blood—the nosebleed was pouring back down her airway now, running into her lungs. Her body was as hard as a piece of timber. Cracking sounds came from her spine.

The nosebleed died down.

The bleeding stopped. It stopped completely.

Her spine relaxed. She sank to the floor. She coughed once, lurching up blood mixed with sputum. Peter Talides was on top of her, his face to her face, crying, "Kate! Kate! Hang on!" He had taken a CPR class with the Red Cross years earlier, but he couldn't remember what to do.

Inside, deep in her mind, Kate came awake, fully aware. She heard Mr. Talides's voice begging her to hang on. There was an absolute peace, no feeling of pain, and she couldn't see anything. It was not possible to hang on. She thought: Oh. She fell away.