The brain loathes uncertainty. In laboratory experiments, humans actually fear uncertainty more than physical pain. We are simply wired this way. When we encounter uncertainty, the first thing we do is try to beat it back. The problem is, uncertainty may not be the biggest threat. It may be a distraction the kind we have to cope with while we do the actual work of keeping ourselves alive.
Hayden Henshaw, 18, got sick on a Tuesday in late April. He was at his high school in Cibolo, Texas, just outside San Antonio, when he came down with a fever of 103°F (39°C) and felt nauseated. Three days later, his doctor confirmed he had a mysterious new strain of swine flu that had just hit the U.S. a virus that would eventually be labeled H1N1 of 2009.
As word spread that three students at Hayden's school had the new flu, people in his town began trying to stamp out the uncertainty. It was an unsatisfying endeavor. Health officials came to Hayden's house and asked him dozens of questions. Had he been to Mexico lately? (No.) Had he had contact with any pigs? (No.) That weekend, Texas health officials closed all 14 schools in Hayden's district, sending 11,000 children home. Workers wiped down the school district's 100-plus buses. At Cibolo city hall, employees posted signs asking residents to pay their utility bills at a drop box instead of coming inside. Garbage collectors donned face masks. At the time, no one knew how deadly the virus was or how many people had it.
Hayden and his family handled this storm of ambiguity with relative grace. Hayden complained only about being stuck inside. "After a while, TV got boring, and then games got boring, and then there was nothing to do," he says. His parents were worried but also grateful that health officials were taking the matter seriously. "Nobody knew how bad anything was going to get," his father Patrick remembers, "but at least we were together."
Other people, however, seemed to want more drama out of the story. Early on, the family agreed to do a local TV-news interview to show that they were "just a normal family with a virus," as Patrick puts it. Then the national shows started calling. "What was it like when you found out you had swine flu?" a CNN anchor asked Hayden. He replied, in a teenager's deadpan, "I mean, it's just the flu. I just went through it normally." Producers asked the family to wear face masks on camera, even though health officials had told them that wasn't necessary. Meanwhile, regular people, some of them friends, started acting strangely toward the Henshaws. Their immediate neighbors and their friends from church were generous and helpful. But other neighbors crossed the street before walking in front of the Henshaw house. When Hayden's prom got postponed, disappointed classmates accused his family of exploiting the situation, making money off TV interviews. "Hayden was beaten up pretty bad on the Internet," his dad says. "He asked me, 'What did I do wrong?' "
To make sense of the situation, some people needed a villain. Bloggers accused pharmaceutical companies of intentionally concocting the virus in order to sell vaccines. On one website, conspiracy theorists researched public records about the Henshaws and deduced that they were actually victims of radiation poisoning possibly from a dirty bomb smuggled in through Mexico. As things turned out, Hayden's school reopened about a week later. To make up for the lost time, school officials canceled final exams. With that, Hayden's classmates found it in their hearts to forgive him. The summer brought a new consensus about H1N1 flu to Cibolo. "Now people say, 'Ah, it's no big deal. They blew everything out of proportion,' " says Patrick, who's still a bit mystified by the whiplash of reactions from paranoia to complacency in a fortnight.
It would all be a surreal memory for Cibolo and the rest of America, if only it were over. Instead, Hayden's case is a flare in the darkness, a warning that as the nation begins its second big battle with a strange flu virus, we are up against a threat that we are not particularly skilled at overcoming, one that provokes an extreme range of emotions from fear to indifference none of which are all that helpful. The battle ahead is psychological as much as it is medical. And although we have heard a great deal about the importance of washing our hands, the real challenge may be in how to live with what we don't know.
Today, Americans are being told to brace themselves for explosions of flu, shuttered schools, mass vaccinations and tens of thousands of deaths or perhaps not. Are the media to blame for the confusion? Absolutely. But no more than usual. What about the government? So far, officials have done a relatively decent job of explaining what they know and what they don't and planning for the worst. "It's going to be a unique flu season. The only thing certain is uncertainty," says Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC). "Even with the best efforts, influenza will cause severe illness and, tragically, some death."
Pandemic diseases have a way of revealing our vulnerabilities in quick order. Already we have been humbled by the virus's exploitation of our fragmented health-care system, as families without insurance overwhelm emergency rooms, schools flounder without nurses, and people without a sick-leave option choose between going to work with a raging fever or getting fired. At the University of Washington, some 2,000 students have reported having H1N1 symptoms. At Emory University in Atlanta, sick kids are relocated to a dorm dubbed Club Swine. But H1N1 has also homed in on the weaknesses in our heads hovering in the blind spots where our risk analyses break down, just beyond the view of our mind's eye. What is the defense for the mind games of a virus?