by Barbara Ebel
“I understand. A potential carcinogenic warning is better than nothing.”
“Yes, but we both know most people tend to ignore warnings, particularly when it comes to ingesting something they like … which brings me to point number two.”
Danny didn’t like that Grant was numbering points. Maybe the worst was yet to come. “That being?”
“Damn if this stuff isn’t habit-forming! In my researchers’ infinite wisdom, they have this data down pat, like a Hollywood handprint in cement. There’s a high concentration of caffeine swimming around in this slop and what makes it worse is it also reacts with the carb molecules making the taste buds have an insatiable desire for more.”
“Great,” Danny said as he scribbled on a notepad before him: 1. True or possible carcinogen 2. Addictive!”
“We are sure about this so, again, maybe an appropriate warning on the can is warranted.”
Grant cleared his throat and Danny wondered if it was too soon to really tell if Blue Bridge played a role in the strange blood flow in human brains or was it indeed just a coincidence?
“So here comes my third point but it comes without saying that you must be a magnet for ground-breaking medical understanding, discoveries, and treatments. Do you have some kind of medical guardian angel lurking over your shoulders?”
Danny was taken aback. He felt a tinge of awareness about above average situations that had occurred in his professional life and with his own health when he had escaped death’s door. Was there such a thing as a guardian angel? He’d like to believe so. Perhaps he was blessed by Saint Cosmas, the patron saint of surgeons, but he answered Grant without that conviction. “I doubt if I’m that special.”
“Get it through your thick neurosurgical skull that you are. Anyway, here’s the crème de la crème about Blue Bridge. Although I knew a little bit about this protein, my main product researcher who works with it gave me a mini-crash course. You must know about VEGF or vascular endothelial growth factor?”
Danny wrapped his thoughts around VEGF and had an illuminating realization. VEGF may be at the core of the issue.
“Grant, this protein kicks off vasculogenesis or the embryonic formation of a baby’s circulatory system. It is also responsible for growing blood vessels from pre-existing blood vessels; it’s called angiogenesis.” He glanced at his notepad.
“I’m having an epiphany,” he said while scribbling, 3. VEGF. “And I can glean what your researchers have discovered so far.”
“A synthetic form of this protein is in these cans, Danny! But whether it’s there due to a reaction between some of the sinister components already present or if it’s an original ingredient of the drink, we can’t be sure.”
“That explains it. And since it’s our body’s function to use VEGF when circulation is inadequate, thereby supplying a better oxygen supply to tissues, then what we have here is a normal protein which has run amok … because it’s being supplied in a relatively exponential quantity. However, it’s target seems to be solely the vasculature in the brain.”
“They can’t explain that fully, yet they said the protein has been known to be more highly concentrated in certain areas of the body under different circumstances,” Grant said.
Danny jumped out of his chair and selected the largest internal medicine textbook in his bookcase. “I’m checking on that,” he said, thumbing through to diabetes mellitus. “I don’t see what I’m after, but I believe diabetics who develop poor circulation have a higher concentration of VEGF.”
All of a sudden Danny remembered Paula Branson. “Oh, and above-normal VEGF can affect the retina!”
“In essence,” Grant said softly “what we possibly have here is a product or an ingredient which can revolutionize the human race. We could all become Einsteins or tightrope walkers … or have bionic eyes, or whatever else. We can only imagine.”
“You’ve substantiated my theory,” Danny also said in a hushed tone. “But here’s the thing. VEGF can contribute to disease. If it’s over-expressed, it can cause cancer to grow and metastasize. By supplying a continuous rich vasculature and oxygen, a cancer can thrive. We just don’t know its downside.”
“Exactly. Which is why this potential miraculous product or potential problem has to be investigated further. So far the rats being experimented on show remarkable collateral circulation in their brains and are displaying superb mental tricks. We’ve nicknamed them Aristotle’s rats.”
“Amazing,” Danny said. “But hasten the experimentation. The sellers of Blue Bridge are relentless at their sales tactics.”
Danny got off the phone. Soon he had to tackle a reporter.
-----
Kathleen Fairbanks dropped a copy of U.S. Nation newspaper, The Tennessean, and a magazine called Weekly Review at the head of the table in the meeting room. After their greetings, she said, “Someone called me about this drink, these ads, and your name being spotted. Otherwise, I think this story was slipping right by me.”
Danny waved her to sit down and glanced at the Weekly Review. He never looked at that magazine so the Blue Bridge ad was news to him but, more than that, it was apparent Rachel had not stopped advertising and these ads were probably just a piece of the iceberg. He slipped into a chair as well while letting out a little laugh.
“What is it?” asked the reporter.
He shook his head so as to not divulge the realization that had just hit him … like he’d discovered he held the winning hand in a poker game. Rachel and Varg promised they wouldn’t do any more advertising but Rachel meant in U.S. Nation. She hadn’t said ‘all advertising.’ Kathleen looked at him with a blank expression.
“It’s nothing,” Danny said. “Except that I’ve been duped.”
Kathleen tapped the advertisements with her long, slender fingers. “Will you share with me the medical jargon about what’s going on? And I will give you my first-born son if you provide any patient’s name that has experienced the effects claimed here.”
“I dislike being interviewed about this drink but, whether or not I talk to you, Blue Bridge is going to sell. But perhaps I can illuminate your readers from a cautionary perspective.”
“Go ahead, Dr. Tilson.”
“At present, there does seem to be a beneficial blood flow in some people’s brain causing them to have enhanced attributes. But the drink is only implicated. So a lot of research is needed before folks start using this product, or more of it. The FDA is looking at it; already there is a quality in it that is distressful to us and associated with the possibility of cancer.”
“But, Dr. Tilson, your own words seem to sing praises of Blue Bridge.” She tapped her fingers again on the literature atop the table.
“That statement was taken out of context and without my knowledge. Please, Miss Fairbanks, let me count on you to report that the FDA does not condone this drink. Nor do I. Any new potential drug or medical device goes through proper investigative screening before it’s released to the public. It’s all about safety. Since this drink may have a profound effect on human brains, don’t you think using it should be dealt with caution?”
With a noncommittal facial expression, she asked, “You’re not telling me you wouldn’t drink it, are you?”
“You bet I wouldn’t … and neither should you.”
-----
As everyone at the Tilson house came and went over the next week with their own schedules, Danny made a point of explaining to each of them the story behind the energy drink that had become a sensation. Teachers and parents of youngsters at school asked Sara about it, customers and gallery owners asked Mary about it, and Casey was queried at the gym. Even Annabel and Nancy were asked about it by students who knew the infamous neurosurgeon was their father. It had been discovered at colleges and high schools and its popularity was on a steep incline; students wanted their brain cells to pop and sizzle with smartness so they could ace their exams.
But Danny made it clear to his loved ones not to drink it because all
the data wasn’t in. Besides, its ingredients - even without causing any brain changes - were scary enough for their health and they shouldn’t touch it.
Casey took it upon himself to talk about Blue Bridge among other paramedics and staff in area hospitals after he’d bring patients into emergency rooms. His coffee room chat was always welcomed by female nurses … no matter what he talked about. “Dr. Danny Tilson, my best friend, does not stand behind the claims made in those advertisements you see all over the place,” he said at different locations several times a day.
But, today, Casey had a different announcement. Something he wanted to ponder over with his best friend. It wasn’t newsworthy like the things Danny got involved with but, to him, it could perhaps change the normalcy and enjoyment of going to work every day.
He hurried to Danny’s office after his seven-to-three shift. Ever since they had been kids, his best friend was always the person Casey shared significant events with first.
Chapter 30
To err on the side of caution, Danny had made another follow-up appointment with Garret Archer months after his surgery and seizures - his first post-op doctor’s visit and after he had been seen by the neurologist, Penny Banks. He stood in the hallway and refreshed his memory by going over his chart notes.
Danny had clipped Archer’s anterior cerebral artery aneurysm and had found that the man lacked further arterial distribution to his frontal lobe. He mused that, in a new context - especially in light of everything that had transpired since that time - Archer had a brain picture similar to the increased collateral circulation of his energy drink patients, one that terminated in an aneurysm. But when seen by Danny, he had ended up with the opposite problem; a decreased or non-existent blood flow after having an area of too much.
He skimmed over Penny’s thorough report and went into the exam room. “Mr. Archer, it looks like you’ve had a birthday since I last saw you.” Danny shook his hand and scooted up close. “Did you ever get back on your motorcycle or to the gym?”
“Nah. I didn’t th’ink it wise.” He had the same broken-up voice as before, Danny noted, as he tried to judge the spontaneity of his words.
“I went to rehab like you and Dr. Banks had me do but they finally kicked me out of th’ere.” He scratched his bald head. “I didn’t make any more progress.”
“I see. Have you had any more seizures and does Dr. Banks have you on an anticonvulsant?”
“Yup. It’s the one with the long name. Pheno something.”
“Phenobarbital.”
“I tell you what else, doc. I read that sign you have about praying with your patients. That’s a damn nice thing to put up there. I wish I’d taken ‘ya up on that after the surgery you did for me. You know, I still get those headaches and I don’t get to the gym as much because, inside my head, it feels like someone’s playing the drums.”
“And the sticks are beating on more than one drum, aren’t they?”
Garret nodded and flashed a painful expression, feeling grateful for having such an understanding physician.
When Danny finished his exam and after making entries into his laptop’s new medical software, he rolled his chair back over. “I know you want to be done with me, but I want to get another MRI and angiogram just to make sure we’re not missing something this far out.”
Garret finally smiled. As he got off the table and headed for the door, Danny said, “I hope you don’t mind, but today I’m going to say my own prayer for you.”
Archer’s hand quickly grabbed Danny’s and pressed it with gusto. “That would mean a lot to me.”
-----
Casey stood at the front counter of Danny’s office and gave the women a broad smile. “Will you let me have access to the chief? I brought you all a bribe.” He slid a box of warm donuts over to them.
“You didn’t need to do that,” one of them said. “Your smile is your pass so go ahead back. If you don’t see him, Cheryl will get him between patients. And, Casey, please put the box in the kitchen so at least we have to walk to get one.”
Casey allowed a man to pass through the doorway first; a bald, early-fifties man who looked familiar. After delivering the box to the kitchen, he peered into the x-ray room and found Danny and Jeffrey.
“Hey.” Danny patted Casey on the arm and nodded to the view box. “Jeffrey and I are catching up on one of his Blue Bridge patients.”
The shorter doctor with the deep voice said hello. “The neurologists,” Jeffrey said, “are seeing more of these patients than we are and, frankly, they are scared to death at what they are finding.”
The three men just looked at each other, then Jeffrey took down the films and left.
“You have a minute?” Casey asked.
“You rarely pay me the honor of a visit so I have more than a minute.”
Casey tailed Danny out of the room. “Remember I told you Mark was studying for the MCAT?”
“Yeah. How did he do?”
“Quite nicely. So he applied for early med school admissions.” Casey raised his eyebrows and said, “He got in.”
“Big news. Do you regret not copy-catting his course of action?”
“No. He’s younger than me. I wouldn’t consider studying like what you went through in medical school. I like what I do; there’s a challenge and daily mental stimulation. I’m fine. However, he starts next August and he’ll take time off beforehand.”
“Hmm.” Danny evaluated the diaphragm of his stethoscope and cleaned it off with an alcohol wipe. “So you’ll be in need of a new partner. Someone you spend the entire day with.”
“I’ve been fortunate but I guess I’m worried my luck will run out and I’ll end up with some young hot head or someone I won’t get along with.”
“A young hot head, maybe, but in my entire life I’ve never known anyone who didn’t like you or you didn’t get along with.”
Casey cracked a smile. “Except for you, occasionally.”
“I always told you I’m not crazy about paramedics … they just chase down accidents in ambulances.” Danny laughed and Casey shrugged him off.
“I just saw a patient leave who looked really familiar.”
“May have been Garret Archer. I think you were the one who picked him up; he’d had a seizure and I ended up clipping an intracerebral aneurysm.”
“Oh, yeah. Mark and I brought him in. Glad he looks to be doing well.” Casey rose to leave. “See you later at the house.”
“Hey, I’ll say a prayer for you.”
“What for?”
“That your next partner is as fine as Mark.” Casey tipped his hand off his forehead and hustled out of the office.
When he reached the lobby, Casey stumbled straight into pandemonium; a group of people were gathered around a man lying on the floor. An ambulance’s cacophony stopped right outside, the exit doors flew open, and two paramedics rushed in. They separated the onlookers and were alongside the patient in a flash while Casey crouched down. Before he could acknowledge the healthcare workers, he stared at the man as they rolled him over. It was Garret Archer.
“There’s nothing,” said one of the paramedics, his fingers planted on Garret’s neck. Casey felt the carotid artery on the other side and shook his head. As the crowd melted into the background, the men carried on a full resuscitation as they placed Archer on a stretcher and took off for the hospital.
Approaching his car, Casey thought hard about when he’d entered Garret’s residence months ago to pick him up. There was something nagging at him, something he had to recall.
Then he remembered. It was the first time he’d seen Blue Bridge outside of Serious Gyms … a can of it had been sitting on Garret’s kitchen counter.
-----
A handful of patients still sat in the lobby to see Danny and Jeffrey. It was almost five o’clock and Cheryl had already let her hair down when she knocked and poked her head into an exam room.
“Dr. Tilson, Casey’s on line three.”
“
I’ll take it in a moment. Have him hold on.” Danny told his patient he would see him next week before his scheduled surgery and patted him on the shoulder. He slipped into his office.
“Casey?”
“I wasn’t able to call you until now. I’m back at the hospital after following Garret Archer in an ambulance. He’s passed away.”
It didn’t make sense and Danny stared blankly at his Norman Rockwell print.
“I left your office,” Casey said, “and found him on the ground floor, a commotion going on, and EMS arriving. Looks like he had a major stroke. We did full ACLS, brought him in but … nothing. Family has been notified, he wasn’t married. The next-of-kin refuse an autopsy.”
“Jeez,” Danny mumbled. “Fifty-two years old. I feel awful.” Silence embellished the next few seconds. “Let me think this out.” He walked back and forth alongside his desk. “Can you do me a favor on your way home?”
“You bet.”
“Garret had been a health fanatic and said he went to a gym, but we never talked about that. Can you stop by Serious Gyms and find out if he was a member? It’s a long shot but maybe, with his history of the aneurysm and strange decreased blood supply I found after it, he drank Blue Bridge.”
“I was going to tell you that next after the news sank in. I recall Blue Bridge on his kitchen counter when Mark and I picked him up the first time.”
Danny’s knuckle paled as he tightened his grip on the phone. “Okay, then,” he said as if revealing his cards in a poker game. “We have to see about this. Can you stop by anyway and ask Katarina if he was a member there and what his account looked like. If he was buying it there and how much?”
“No problem. I’ll call you back.”
As Danny hung up, a small rap came on the door and Sara poked her head in. He waved her in with a big smile.
“You and Casey rarely come to the office. Today, I’ve had two visits back-to-back.” He laughed and, unbeknownst to Sara, it helped relieve his sorrow about Garret Archer.
Danny took her hand and guided her to the couch. “To what do I owe the honor?”