by Barbara Ebel
----------
After routine catch up with her ongoing research work, Joelle examined the previous PAM work she had started before the canine contributions. She made notes and went over twice to the young student by the window, who assisted her for the day. Results so far, except for the ray of hope with the dog saliva or enzyme penetrating the organism’s outer wall, proved to be futile. When would the incidence of PAM breakouts stop? When would its morbidity and mortality be put to an end by medical miracles stemming from a lab?
Rhonda showed up at noon, sacrificing her own lunch time to evaluate Joelle’s plates and slides and offer any suggestions. She popped to the lab door with all the enthusiasm of a fifth grader and began donning a mask. Joelle turned around. “You changed your nose ring, I see.” She frowned. “Less conspicuous. I like it better.”
“That’s what everyone says,” Rhonda said. “Hardly anyone comments about a woman’s bracelet, or necklaces, or earrings, but everyone notices nose rings. I think I’ll start a company to market and sell them.”
Joelle grinned. “If pet rocks were a big thing, you may have something there.”
“Yeah, think of the cool possibilities. Nose jewelry mimicking cat whiskers and elephant tusks. The more bizarre, the better.”
Joelle’s eyebrows rose. “Will you stay in veterinarian medicine and research?”
“Hell, yeah. You have to have a real day job.”
“Good, glad to hear it. You had me worried for a minute.”
Rhonda started glancing at Joelle’s table for slides. “I’m about ready to put them on the scopes,” Joelle said. “I have in order here sample four, five, and six. The beagle, Labrador retriever, and greyhound.”
“I thought you were also doing Dr. Tilson’s dog that dunked his tongue into his wound?”
“I did, but I didn’t get it until a day later, so it’s not ready yet.”
“And why do you have two sets of each sample again?” Rhonda asked.
“This first row is the new dog’s saliva simply put with the organism. So we’ll see if the saliva’s contents wormed its way through the wall, like the Newfoundland’s did. The second set is where I have injected the saliva into the organism, to see what it does then.”
“Obviously you’re hopeful one of them will destroy the amoeba from inside,” Rhonda said.
“Precisely.”
Joelle put the first set under the stage clips on each microscope to hold the slides in place. She then peered through the scopes from left to right with Rhonda following her lead. “Wow,” Joelle said, standing straight and speaking fast. “None of these dogs’ saliva penetrated the amoeba like the Newfoundland’s.” She tightened her lips, wishing she could change the results.
“”This isn’t good,” Rhonda said. “But at least we’ve had one that did.”
Joelle took the slides off and clipped on the next three, where the samples had been microscopically inserted into their killer creature. She went around Rhonda and again started on the left. Joelle focused with both the coarse and fine adjustment knobs. All she stared at was an intact trophozoite amoeba – inside and out.
“I guess a beagle is no good to us,” she said. Rhonda also looked and nodded in agreement. Their theories were going out the window.
Joelle went to number five, the Labrador retriever. The exterior of the eyepiece had a fleck of dust so she reached for a lens cleaner and smoothed the cloth over the glass. The two ladies frowned at their dismal attempts to get results.
Leaning over again, Joelle peered down at a hazy slide, so she fine-tuned the knobs. Finally, her picture looked crystal clear. She held her breath, stood up and rubbed her eyes, and looked again.
Joelle let out a gasp. “Another mother of pearl,” she said.
Chapter 25
Joelle’s arms broke out in goose bumps. She stood tall, squared her shoulders and smacked Rhonda’s upper arm. “Look at this!”
Rhonda viewed the slide. “Damn, Joelle, that saliva has decimated the cytoplasm. And it’s made mince meat of the nucleus.” Taking her eyes off their work, she looked at Joelle with wide eyes. “This is fantastic!”
Joelle bit her lip. “Wow. In vitro we’ve killed this brain-eating amoeba. Now we have to combine what the Newfoundland’s saliva did by getting into the cell with what the Labrador retriever’s saliva did once it was inside.”
Rhonda’s hair along her arms stood on end. She pushed her blonde bangs away from her preppy glasses, walked a few steps and turned abruptly. “So we don’t have Dr. Tilson’s dog done yet?” she asked absentmindedly.
“No, we’ll check on it by tomorrow.”
“And what breed did you say it was?”
“I didn’t.”
A smile crept over Rhonda’s face. “Pray, do tell me.”
“A Chesapeake Bay retriever.”
“Hot dog.” Rhonda said. “I have a crazy idea. But I just don’t know.”
“Rhonda, you know what Albert Einstein said, don’t you?”
Rhonda stared at Joelle, a blank expression on her face.
“If at first the idea is not absurd, then there is not hope for it.”
Rhonda nodded. “Thanks,” she said. She turned and started towards the door.
“Where are you going?”
“To get you more saliva from Chessie’s other than Dr. Tilson’s.” She turned with a huge smile. “If my suspicions are correct, I’ll pierce your nose if you want.”
“No thanks,” Joelle said. But Rhonda had already disappeared into the hallway.
----------
Late in the day, the conference room came alive on the upper administrative floor outside Robert Madden’s office. All the major physician and nurse players broke from their other duties and patient care. Everyone made sure their beepers were set correctly so any nursing calls about meningoencephalitis patients would come through during their absence. They wanted the most up to date information before heading into the news conference to follow. Joelle came in last, scurrying in her flat sandals and lugging her brief case. She had received six pure breed samples from Rhonda before leaving the lab and had quickly gotten them processed. Rhonda had procured them from both the vet school and a dog breeder she knew who bred several large pedigrees on the outskirts of Nashville.
Ralph looked like a tired, jet-jumping business man, not like a non-clinical physician from the CDC. His receding hairline had taken the next row of seats. “All right, y’all,” he said standing in front of Robert Madden at the head of the table, “we’ve got to push on downstairs where the national news media wants information to make ‘em stuffed as a hog. Since we’re standing in the hospital where the outbreak started, our info has to be right off the press.” He looked back at Robert Madden, the poor CEO who’d been standing up to a stiff board of directors, news media, and patients’ families since the whole mess started. Robert grinned back at Ralph, jammed his hands into his pockets, and prayed there would be no major surprises.
As if his fingers were too heavy, Ralph rested them in his suspenders. “I have today’s numbers,” he said with utter annoyance. “This damn amoeba is running rampant faster than a scalded dog.”
Joelle elbowed Danny, who was sitting beside her. “Funny he should mention a dog,” she said. “I’ve made some progress with in vitro experimentation, but need to bring the two parts to work together.”
Danny nodded. “Sounds hopeful?”
“Perhaps. But then even if we get somewhere…”
Danny nodded again. “I know. Then there’s the problem of applying it to humans.”
“Precisely.”
They kept their voices low as Robert took the floor and announced their admission stats on meningoencephalitis patients.
----------
On the ground floor, Robert Madden, Ralph Halbrow, Pamela Albrink from nursing, and the team of doctors single filed between the rush of reporters outside the meeting room. A stream of questio
ns bombarded them as well as flashes from cameras.
At the front of the room, two young technical men helped their CEO with a microphone. Robert cleared his throat. “Thank you all for coming. Today I have assembled everyone from this hospital who has been directly involved with our cases of PAM - either patient care or research to find a cure. We also have Ralph Halbrow from the CDC in Atlanta. First, for those of you who don’t know him, Dr. Danny Tilson is one of our neurosurgeons. He was responsible for our source case and involved with the initial diagnosis. He has a recent development which we didn’t break yesterday since the family situation was a bit precarious.” Robert handed Danny the microphone and stepped aside.
“As previously reported, the first case which sprouted this outbreak came from a fourteen year old named Michael Johnson. Michael came in on a Sunday, seventeen days ago. It is with great sadness that we are reporting Michael’s death yesterday.”
Reporters pushed forward, hands waving in the air, and camera clicking noises competing with each other.
“What about that length of time? Wasn’t that longer than other PAM patient hospitalizations?” a reporter said clearly over the others.
“Yes, Michael’s sixteen days of survival after contracting PAM is the longest so far. Perhaps his age had something to do with it. Michael received the same treatment as other patients. And those antibiotic treatments continue to fail.”
“What were the circumstances under which Michael came to the hospital?” a man asked with a camera crew close by.
“He hit his head on a boat console while boating with his family. I did surgery on him because he had an acute subdural hematoma. However, something else was going on with Michael and he became the source of a rapidly disseminating infection. He acquired the sinister organism from jumping off a cliff into Center Hill Lake. The fresh lake water carrying the amoeba was forced into his nose, which can penetrate the brain by this route.”
“Does this organism only live in that lake?”
“No,” Danny said. “First, it only thrives in fresh water. It is widespread. It is the mode of transmission which is important. Like most of us, little did Michael’s family know this.”
“Why isn’t modern medicine helping us out here?” a tall female with a small name tag asked. “Is there any progress regarding a cure?”
“I’m sure Dr. Ralph Halbrow has an update.”
Ralph leaned over and said, “We continue twenty-four hours a day at the CDC in Atlanta to discover a treatment. So far, I have nothing substantial to report.”
“Dr. Joelle Lewis struck a small ray of optimism today,” Danny said. “I’ll let Joelle say a word about that.”
Joelle stood next to Danny and took the mike. “I have nothing concrete to tell you. Just a researcher’s gut feeling that we’re working on in the lab. We’ve made two small, yet highly significant independent steps at disarming this organism.”
“Dr. Lewis, don’t keep it to yourself,” a burly reporter said. “Tell us anything nonsubstantial as well. Is it a break-through antibiotic or what?”
“No.”
“Then what’s causing your gut feeling,” he said, despite other reporters clamoring with their own questions.
Joelle sneaked a peek at Danny and grinned. “Dog saliva,” she said.
The reporters indistinct mumbles sounded throughout the room and a throng of reporters yelled out their questions. “That’s really all I can tell you right now,” Joelle added.
Ralph took the microphone from Joelle. “Ladies and gentlemen, y’all will have to let Dr. Lewis answer questions at a later time, when she gets more facts.”
Things quieted down and Ralph continued. His tone turned pensive. “I have today’s CDC numbers to report. Nationwide, the total number of cases reported is two hundred and eighty-three and there have been ninety-five deaths.”
The stunned news media took a second of silence to absorb the CDC’s count. “That does include Michael Johnson?” a young woman asked.
Ralph scanned the entire room carefully. “Yes. And please advise your viewers and readers if they have a hint of symptoms or signs of this meningoencephalitis as previously reported, then they should immediately seek medical attention because isolation is required. Patients are continuing to spread this brain-eating organism. I can’t think of anything worse to befall anyone.”
Chapter 26
Rachel pulled her CRV into Maxine’s parking lot, shut off the engine, and peered into the visor mirror. She didn’t need to do a thing to her hair, so she got out and smoothed her knee length skirt and V-neck, long sleeved top. The temperature had turned a little cooler. She enjoyed it when the weather played cat and mouse, teetering between one season and the next.
Rachel looked around at cars and spotted Leo’s two aisles over. Draping her bag over her shoulder, she headed into the restaurant. Her nerves got a bit jumpy. She saw him inside at the bar where they had previously had dinners and the flat screen TV was on. She walked up behind him.
“Hello, Leo.”
“Well, well,” Leo said. “If it isn’t Miss Extortionist.”
Rachel’s heart thumped, like a kickstand on an old bike.
“Nevertheless,” Leo continued, “there’s a lot to be said about her.” He looked her up and down, slowly. He then gazed at her face, scrutinizing it in a clockwise fashion. “She’s just beautiful.” He put down his beer mug. “But even beauty can be a mirage.”
“It’s nice to see you, too, Leo.” She slinked onto the bar stool.
“What’ll you have?” the bartender asked. He placed a napkin on the counter.
“Get her a double scotch,” Leo said. “She can handle it.”
“No,” Rachel said, her pulse quickening. “I don’t do scotch. Get me a Bailey’s.”
The young man turned around to his bottles by the back glass wall.
“Nothing hard core tonight,” Leo said, “you’re going smooth and silky.”
“That’s my style.”
“Bull shit,” Leo said.
Rachel tried not to bite her lip. She tried to look peripherally around him. Had he brought her money?
The bartender put down her liqueur as well as two menus. He turned around and focused on the screen. Rachel looked up as well. Live coverage had begun of a news conference in Nashville. The CDC specialist handed over the microphone to the neurosurgeon in charge. Leo’s interest gained momentum when he realized Rachel’s eyes were glued on the news.
“As previously reported,” Danny said, “the first case which sprouted this outbreak came from a fourteen year old named Michael Johnson. Michael came in on a Sunday, seventeen days ago. It is with great sadness that we are reporting Michael’s death yesterday.”
“So,” Leo said, “I gather that must be Julia’s father. The other man you hijacked.”
Rachel kept quiet.
“Okay, then, what’ll you have?” Leo asked, moving the menu towards her.
“I don’t want anything, especially if you’re not going to be civil.”
“Okay, Rachel. We’ll call a truce. I was sorry to see you left me like that. You covered all the bases in your letter, however. Sometimes you just have to do what you have to do.”
Rachel relaxed enough to take a sip. The drink warmed her tongue and slid down like melted chocolate. She took a deep breath. “Did you bring the money?”
Leo cracked a smile. “You must be destitute to ask for such a thing.”
Rachel flinched. The comment struck a nerve.
“Don’t worry. I decided to give you the present with strings, of course. I don’t expect anything else to come of this.” He looked questioningly at her.
Rachel swallowed. She worried over legalities that could arise from Danny. Would he press charges, in which case, she would have to claim her innocence and pin Julia’s abuse on Leo? What if he motioned for change in custody and dragged in the pediatrician’s testimony and she’d again have to
pin it on Leo? She couldn’t think about it now. She needed the payoff, she’d have to stay out of Leo’s way, and hope the custody issues didn’t flare up.
“Leo, unless a court forces it out of me, then no one else is going to know what you did to my baby.”
Leo narrowed his eyes at her. “I’ll hold you to it.”
“No problem,” she said.
“I have your money in two small bags. They’re big bills. They’ll fit fine in that shoulder bag you’ve got on purpose.”
Rachel’s comfort zone returned. She finished her drink.
“If I can’t buy you dinner,” Leo said, “then how about coming back to my place? It would be nice to get my money’s worth.”
Rachel gave him an evil look. She stood and opened her shoulder bag.
“I think I’ll skip. I have a babysitter and I want to get back to Julia,” she lied. There was no way she was going to tell him about the recent turn of events.
Leo slipped his hand into the inside pockets of his sports coat. He dropped two plastic bags into her purse. She sat the purse on the stool, loosened one of the bags, and looked in. Cash was there. She thumbed through it the best she could and felt confident he had made good on her blackmail.
----------
Danny and Casey lounged in the great room watching the 9 p.m. nightly news recap. Danny kicked off his shoes, startling Dakota, and Casey chugged down the last of his soft drink. The small can of mixed nuts they had shared was empty.
The taped evening news conference on the PAM update began. “This is historic, you know,” Casey said. “Here we have the first devastating human illness of the third millennium.”
Danny blinked. He hadn’t thought of it that way.
“You don’t look too bad for a normal guy being on television.” Casey peered over at Danny and patted Julia’s diaper. She lay asleep on the coach between them.
“I guess. But I wouldn’t want to make a habit of it. I’ll be glad when this whole mess is behind us.”