Silent Fear, a Medical Mystery

by Barbara Ebel

  Casey nodded. “Me, too. Every time Mark and I make a run, we worry if it’s going to be someone infected.”

  Danny reached for his cell phone on the coffee table and lowered the volume on the TV. “I’m going to call Joelle real quick.” Danny hit her number and she answered on the second ring.

  “Hi Danny. You watching our media recap?” She had a curled up position with Bell on a recliner.

  “I am. I couldn’t go to bed without putting all my faith in your lab work for tomorrow. Will you call me immediately the next few days if you get any breakthroughs?”

  “You bet. Especially since all our present hope rests on your dog. Or what his DNA can do.”

  Danny smiled at Dakota who rumbled in his sleep. “Thanks Joelle. They say there is a greater thrust these days towards intertwining human and veterinarian medicine.”

  “For sure. And Rhonda has been a big help.”

  “Okay, good night,” Danny said.

  Casey flicked the television off since the news conference coverage ended. Danny picked Julia up, but she didn’t stir too much. Both men turned off the lights and headed upstairs where Mary was already asleep.

  ----------

  Joelle helped the young medical student assistant with the spectrometer samples and results he worked on. The sun beamed into that area of the lab as she showed him how she wanted the outcomes recorded. He asked her questions about the ongoing medical epidemic. “I want to be a medical researcher some day,” he said. “I don’t think I can handle listening to people complaining about what aches them here or there.”

  “You may make a fine researcher then,” she responded. “Especially if you like detail.”

  He gleamed and pushed back his long hair. “Plus, I’m good with numbers.”

  Joelle finished with him, turned the radio up a bit, and went to the other side of the lab. He was probably another student filling his resume, covering all the basics, and then would come to her in a few years to write a recommendation. That’s the way it usually worked.

  She couldn’t wait to prepare her slides from the seventh saliva sample and needed to start without Rhonda, who had told Joelle she’d get over in the afternoon if a small window of opportunity came along.

  Joelle moved the base of the light miscroscope over and sat on the bench. She had several slides of the same thing and slipped the first one under the stage clips and worked the knobs to adjust the image. Before looking, she tapped her fingers on the scope in time to the music, praying for an optimistic finding.

  Under the scope, what she peered at was a trophozoite whose outer membrane had been breached like what the Newfoundland’s saliva had done. But in addition, the inside, the cell nucleus, had been decimated, like what Joelle had caused to happen with the Labrador retriever’s saliva. One dog, or possibly one breed, had done both.

  “Eureka!” she exclaimed. She stood up, switched to another slide and it showed the same thing. Tears came to her eyes. She sat down again. The tears accumulated and flowed. She reached for a tissue, sobbed, and pumped her fists when she stopped whimpering with joy.

  ----------

  Ten minutes later and with much more composure, Joelle called Danny. When Danny saw her number, he excused himself from speaking with a patient in the pre-op area and went to the desk. “Joelle?” he said.

  Joelle choked up again. “Guess what?” she sputtered.

  Danny closed his eyes. “I’m taking your tone to mean we’ve got a positive result.”

  “Yes. Your dog’s saliva both penetrates and destroys the inside of this amoeba. In vitro, of course.”

  Danny felt his hair stand on end. The implications were staggering. “Joelle, nice work. This is incredible.” He spun the stool around to face the wall, away from staff and patients.

  “Nice team work for all of us,” she said.

  “You know this will go somewhere. It has to. The implication is that Dakota’s saliva probably kept me from getting PAM, or killed the amoeba once I picked it up.”

  “I hear you. Let’s see what results we get from Rhonda’s samples she brought me yesterday, although we have a beginning substrate for a cure. But … there’s always the FDA to contend with.”

  “However, lives are at stake,” Danny said. “What can I do for you now?”

  “I have to call Rhonda right away. Can you call Ralph at the CDC and give him a heads up, too?”

  “You’ve got it. I’ll talk to the southern humorist doc any time.”

  ----------

  When Joelle called her veterinarian friend with the news, Rhonda confessed, “I’ve never been this happy about results to do with humans ever!”

  “Why don’t you come see for yourself at the end of the day,” Joelle suggested. “I think we can prepare the next six samples you brought over by then ... the other Chesapeakes. I am so curious if it’s just Danny’s dog or indicative of the whole breed.”

  “I have my theories about that,” Rhonda said. She stood at an open classroom door monitoring students taking a test.

  “Are you going to tell me what they are?”

  “I’ll explain later.”

  ----------

  At four o’clock Danny and Joelle met with Timothy and Peter at the hospital to round on all present patients with PAM. Joelle explained to Timothy and Peter how her lab work showed promise and how they had gone down the route they had. They visited Bill Patogue, barely alive, in a deep coma. They each silently said their good-byes. Death would come during the night.

  They sat down in a small room for families, which was empty. Timothy propped his cane in the corner and sat with a heavy heart. “I’m retiring soon, all of you. It is very sad to be leaving under these conditions.”

  “Maybe we’ll break ground before we throw you a retirement party,” Joelle said, forcing a smile.

  “I’ll second that,” Danny said. “Even so, Timothy, I know you’ve had a stellar career. You and I have sent patients back and forth for each other’s expertise for years and I can attest to your neurology skills.”

  Timothy grinned, his crow’s feet giving testimony to his seventy-one years. “Thanks, Danny.”

  A half hour later they broke up their discussions and Joelle and Danny walked over to the lab. A cool, pleasant breeze blew through the wind-tunnel between the medical buildings, hinting of an advancing change in the weather.

  Chapter 27

  As Danny and Joelle passed the fountain and towards their own reflections on the glassed ground floor, Joelle pulled out her cell and called Rhonda. “Danny and I will be in the lab in two minutes. Is it a good time for you?”

  “I’ll be there in five,” she said and hung up.

  After gearing up, Joelle and Danny took a spot at her lab table. “Let me show you what your dog did.” She opened a slide box nearby. “By the way, what’s his name?”

  “Dakota.”

  “Good name. How did you come up with it?” She set up a scope with the morning slides.

  “I didn’t. My baby girl’s mother dumped him on me. Her loss. She then wanted him back after she blew town and got settled.”

  Joelle fiddled with her earring. “Well, I can say two things about her. She has good taste in men and dogs.”

  “Well, thank you. I think what you mean to say is that she had good taste to figure out a sucker.”

  Joelle laughed. “We all make mistakes, Danny. Now you’ll never make that one again.”

  “I make a better surgeon than a womanizer,” he said with a smile.

  She signaled for him to look under the microscope. “I have a sneaky suspicion it’s your ex-wife that’s your soul mate.”

  “Me, too.” Danny stared at the brain eating amoeba whose inside had been churned to goop. He whistled. “Hallelujah,” he said.

  “What did I tell you? I think either Dakota or you are going to have a medical cure named after you.”

  “I’ll second that,” Rhonda said,
planting herself behind them. Her painted fingernails did an imaginary writing in the air. “The Dakota or Tilson antibiotic, or DakTilmycin.”

  “Oops, I better get the new samples ready,” Joelle said. She’d forgotten to turn on the radio, however, so she did that first. “I work better with music in the background,” she said as they watched her zip back and forth doing her scientific steps using the six dog saliva samples left.

  “So what’s you’re thinking about these samples?” Joelle asked Rhonda. “What was it you wouldn’t tell me before?”

  Danny swung to the side of the stool. Rhonda grinned. “Okay, here’s what I’m thinking. It’s all about DNA.”

  “It always is,” Joelle agreed.

  “I believe these samples will show the same results as Danny’s dog, his Chesapeake Bay retriever. It’s the breed’s DNA that’s the key, slightly different than all the other dogs, each of them with their own slight differences.” She paused, but realized they knew their genetics, too. “The only positive results we’ve had were from three breeds. The Newfoundland and Labrador retriever each did something different. But the Chessie is accomplishing what they both did. It is felt that Chesapeakes are bred from Newfoundlands and Labradors. So they inherited the positive features we’re looking for from both those breeds.”

  Joelle and Danny both smiled. “Which would be a blessing for Dakota,” Danny said, “because then we’re not just dependent on the contents of his mouth to experiment with.”

  “That, too,” Rhonda said.

  “Okay, it’s time to say a prayer,” Joelle said, pointing at the six microscopes with slides on them. She looked at the first one. Danny and Rhonda stayed back, letting her do it alone. She stood straight, keeping a straight face. She held out her hand to Rhonda. “Nice work, Dr. Jackson. You were correct and that was a solid working hypothesis.”

  As if Rhonda couldn’t believe it, she asked, “The three of us did it?”

  Danny was already looking at the second slide, a lump in his throat. “Congratulations to all of us,” he said. “This is a huge breakthrough, and as my paramedic best friend would say, the first major medical epidemic and breakthrough for the third millennium.”

  ----------

  Danny, Joelle and Rhonda left the lab and perched themselves at Coffee ‘N More. The place had a quieter atmosphere than the busy daytime hours. The few students there concentrated on books or laptops and staff physicians who wandered in left with Styrofoam sandwich containers and to-go cups. Danny ordered them three hot chocolates and an assorted sample of mini-pastries.

  “Who’s calling Ralph?” Joelle asked.

  “You are,” Danny and Rhonda replied in unison.

  “This will make his day,” Joelle said and used her cell phone. “Ralph, it’s Joelle. Danny and my veterinarian research helper, Rhonda, are with me. We have more progress you want to hear about.” Danny and Rhonda listened to Joelle’s recap of their findings.

  “It’s utterly fantastic what y’all have accomplished up there,” Ralph said. “Do the three of you want a job with the CDC?”

  Joelle smiled and addressed Danny and Rhonda. “Ralph wants to hire us. How much should we ask for?”

  Danny laughed in spurts. “Tell him he can’t pay me enough to leave my loved ones.”

  “And I prefer more animal involvement,” Rhonda said.

  “No takers,” Joelle shot back to Ralph.

  “Can’t have everything,” he said. “It’s just that we’ve also been working with the samples you provided, but you’ve been one step ahead of us. We’ll catch up to you tomorrow and we both better git on the stick to develop a curative antibiotic.”

  “I think this will be the easier part,” Joelle said.

  “I will release CDC funds to your lab if necessary, Joelle. This is a priority. I don’t want the cost for your institution’s involvement to be a burden.”

  “Thanks, Ralph. That will be much appreciated, especially by the higher ups overseeing budgets.”

  Joelle got off the phone. “Ralph promised financial support. I think I’ll be going underground for awhile. We have to isolate the substances and microorganisms in the dog’s saliva which destroyed the amoeba and develop an antibiotic.” She surveyed a chocolate torte and finished it with two bites.

  “Joelle, we won’t abandon you,” Danny said. “We’ll give you all the help you need.”

  “You can buy these pastries any time for us,” Joelle said, “although I’m not running as much as I should these days.”

  Rhonda swiped her blonde bangs away from her glasses. “I’m in, too. And why don’t you take the student in the lab away from whatever he’s working on and put him solely on this project?” She slid a square coffee cake off the center plate onto her own.

  “Yes, I’ll do that,” Joelle said.

  Danny finished his hot drink and got up. “I better get going, but you two finish the goodies. I need to spend some time at home with my baby girl.”

  As Danny approached the door, he thought twice, and backtracked to the table. “If either or both of you are free a week from Saturday, my sister and Casey are getting married at the house. Consider yourself invited. It will be grand.”

  “I love a good wedding,” Joelle said.

  “Me, too,” Rhonda said, “as long as it’s not my own.”

  ----------

  Friday morning Danny cut himself some slack about going to work extra early. He’d checked on Julia but hadn’t disturbed her sleep. He sat on the back patio steps with a coffee mug in hand and Casey sitting an arm’s length away. It had rained overnight and the moisture clinging to the grass and the trees glistened with the 6 a.m. light casting from the east.

  Danny stretched his neck but Dakota was far down the hill and out of sight.

  “You made excellent coffee,” Casey said. He placed the mug between them. “I drink the ER coffee out of necessity only.”

  “It’s pretty good stuff,” Danny said, “a French roast.”

  “So you know my partner, Mark?” Casey asked. Danny nodded. “He still hasn’t given up on going to med school. He’s been cracking the books again and is retaking the entrance exam.”

  “Well, his background, like yours, is conducive. And it’s never too late, or almost never too late, to change careers.”

  “He’s ten years younger than me.”

  “Medical student ages really vary. A fair number of students in an incoming class are over thirty years old.”

  “Better him than me,” Casey said. “I wouldn’t want to start over with school. Besides, I really like what I do.”

  “You do. It’s a good field.”

  Dakota sprinted between two large trees at the top of the hill. Whatever he smelled didn’t keep his attention and he bounded towards them. Casey grabbed his mug for safeguarding as Dakota rustled in front of their knees. The dog presented his back end to Danny and his head to Casey.

  “I guess it’s time to acknowledge both of your rambunctious ends,” Casey said.

  “I’m on call tomorrow and off on Sunday,” Danny said. “It will be fun for me on Sunday to have Julia around.”

  “I think she’s starting to smile a bit more like a normal baby,” Casey said. He took a sip of coffee and placed the empty mug back down. His hand went behind Dakota’s ears and massaged. “So what weekend coming up does Rachel want her? I hope not next weekend for our wedding.”

  “I haven’t heard from her. I don’t know what to make of it.”

  “The recent legal results must have been a blow to her master plan.”

  “I guess.”

  “It’ll be fun, though. Julia can be in some of the wedding pictures.”

  “Too bad she’s not older. She could have been the ring bearer up the aisle.”

  “Well, not exactly an aisle,” Casey said. “This place is going to be hopping all week. Mary is going to have this yard transformed, then chairs and canopies and a floor an
d food will be set up next Saturday morning.”

  “Oh, I invited Joelle and the veterinarian on the PAM case.”

  “No problem. We’ve got plenty of room.”

  Danny stroked Dakota’s right thigh as the dog leaned against him with more pressure. “Bruce, Matthew and I are getting some relief on Monday. Harold’s replacement is starting. He’s fresh out of residency and trained in Tennessee. His name is Jeffrey Foord. He’s a short, sneakered guy, young for a neurosurgeon. Patients will probably think he looks the Doogie Howser type.”

  “I’ve seen him around during an elective rotation. He’s probably a good choice.”

  “I hope so. I never know when Bruce is going to retire, so our business and professional choices now are more important to me.”

  Danny heard the incoming message noise on his cell phone. He pulled it off his belt to see a text message from Peter Brown. “Bill Patogue died at 4 a.m.”

  Danny passed the phone to Casey and buried his head into Dakota’s sorrel fur. “That’s the last of the initial group of PAM patients to die. And someone who meant a lot. Since I couldn’t just go into all of their skulls and weed this sinister hijacker out of their brains, it hurts even more. I’ve been helpless and I’m supposed to perform astonishing cures inside people’s heads.”

  “Danny, you’re still going to have a part in its cure. Quit beating yourself up.”

  Danny grinned. “Peter and Timothy are still flooded with newer cases.”

  “As is the whole country,” Casey said. “Come on, let’s get to work.”

  ----------

  Saturday proved easily manageable. Danny saw patients and did two elective surgeries and was home by four o’clock. Although he had several phone calls into the evening, he had no neurosurgical emergencies. He had no idea what time it was after going to bed and then hearing his door creak open and a moist nose nuzzle him.

  Danny’s eyes cracked open. “Where have you been, you traitor? What did you do, let me sleep in?” He eyed the time – 9 a.m. “I bet you’ve been with Julia.” Danny rolled out of bed and gave Dakota a heartfelt greeting. He donned a pair of jeans and a tee-shirt from Mary with fish and ‘Alaska’ on it. Julia wasn’t in her room so he hurried downstairs.