At last he spoke. “Humans can’t contract thirty slash eighty-seven. But that leaves us with this puzzling question: What is Lucy doing with a disease that occurs only in pigs, mice, rats, rabbits, and nonhuman primates? It makes me wonder if the disease has jumped from animals to humans as diseases sometimes do. In which case it could present quite a threat to the public health. You see where I’m going with this …?”
The silence seemed to go on and on as Jenny stood there trying to think clearly. Amanda bit her nails, looking from one to the other in anticipation. Jenny kept telling herself that Dr. Syropolous couldn’t prove anything yet. He had only hunches, and so far they were the wrong hunches. He was looking for an abnormality in the virus, not in Lucy.
“Wait a minute. So are we supposed to worry or not supposed to worry?”
“That’s the thing. I don’t think this is a case of the disease jumping from one species to another. Because when a disease does that it has to make certain adjustments in its genetic makeup. We did some genetic workups overnight and …” Here Dr. Syropolous paused again, as if he had an extremely delicate matter to discuss. Jenny felt her heart sinking. It’s over, she thought. All we can do now is delay.
“And what? Can I get it or not?”
“I think I can assure you that you will not get this disease, Amanda. It’s the exact same form of the virus that animals get. It hasn’t picked up the extra genetic material it would need to be contagious to humans.”
“Wait, so how did Lucy get it then?”
“That’s what I was asking myself.”
“You know what? Lucy was scratched by a rabbit when we were in the woods.”
“You didn’t tell me that,” Jenny said.
“It was just a little scratch. She said it was nothing.” Amanda turned to Dr. Syropolous. “But even so, you said it could never infect a human.”
“That’s correct. But a rabbit carrying it could infect other animals.”
“I’m confused. What does it mean?”
“I think it means that you won’t get sick. Tell your mother not to worry.” He turned to Jenny. “But that still doesn’t explain how Lucy could have contracted it from a rabbit, if that’s what happened. We’re doing a complete genetic workup on Lucy right now, and that may shed some light on this rather mysterious development. You don’t have any idea why—”
“No. None.”
“Okay. Well, in the meantime, you and Amanda can stay with her if you like, or you can go and get some rest. The front desk can give you a list of nearby motels. Lucy’s being well cared for, and I gave her something to help her sleep. She’ll recover just fine. Any questions?”
Jenny could tell that the truth had not yet entered his mind. It probably wouldn’t until he saw the actual genetic profile. It was simply too far-fetched. “No. Thank you, Doctor.”
As she led Amanda out and down the hall, Jenny tried to imagine some way to stop them from doing a genetic workup on Lucy. But she knew that as a responsible physician, Dr. Syropolous would have to do it. In desperation, Jenny imagined snatching Lucy from the hospital and vanishing, but they already had her blood. And Lucy still needed treatment.
Jenny and Amanda returned to Lucy’s room and sat on opposite sides of the bed to watch her breathe. The IV infusion pump made a whirring noise every minute or so as it pushed fluid into Lucy’s vein. The hospital made all sorts of strange and urgent sounds. Jenny knew what Lucy would say: This is a place where it is impossible to tell when you’re safe and when you’re in danger.
Jenny told Amanda, “You should get some rest.”
“No, I’ll stay. I want to be here when she wakes up.”
For a long time after that they said nothing. Jenny was thinking, Now they’ll know. Genes don’t lie. On the trail of an explanation for the EMCV infection in a human, Syropolous would have to take this all the way to the Centers for Disease Control in Atlanta. It was a matter of public health now. Within weeks, perhaps only days, the world was going to know the truth about Lucy. Jenny would have to rest and gather strength for what was coming. She had already gone to talk to Donna in Milwaukee. Donna had agreed to help if it ever became necessary. But that would be a last resort. What Jenny didn’t know yet was how the world would greet Lucy in the meantime.
“Jenny.”
“Yes, honey?”
“When we went camping?” Amanda began as if asking a question.
“Yes.”
“Do you think I’ll get sick, too?”
“No. Why?”
Amanda hesitated, her finger to her lips. Jenny looked at the girl, so beautiful, so innocent, so intelligent. “What is it, honey? You can tell me.”
“I kissed her. In the woods.”
Jenny felt her heart ache for them. She thought, The rest of the world will know soon enough. Amanda should be the first to know. Tell her, she thought. So that she knows why she won’t get sick. But not here. Not now.
Jenny reached over and took Amanda’s hand. She put her finger to her lips, looking around to make sure that no nurses were nearby. She knew that they could be overheard through the device that the patients used to call the nurse.
“We’ll talk about this later,” Jenny whispered. “But you won’t get sick. Trust me. It’s okay. I’ll explain later.”
“Okay.” Amanda still looked worried. Then she said, “I’m so selfish. I should be thinking about Lucy.”
“Shh. She’s going to be fine. You, too. I promise.”
19
LUCY HAD BEEN SHIVERING VIOLENTLY, she remembered that. She had just wanted to sleep. Then Amanda was in bed with her. Her body was warm, and Lucy wanted to reach for her, to hold her, but then Amanda was gone. The next thing Lucy knew, she opened her eyes and saw Jenny sleeping in a green reclining chair. Amanda was curled up on the floor in her sleeping bag and sunlight was coming in. Lucy felt hungry. Then she saw that she was in a strange room with odd machines and unfamiliar noises. A tube ran into her arm. Lucy began to shriek in fear. She saw Jenny vault across the room, saying, “Honey, it’s okay. I’m here. It’s okay. Shhh … You mustn’t scream. You were sick. You’re in the hospital. I’ll be taking you home soon.”
A nurse was at the door with an annoyed look on her face. “What’s going on in here?”
“Sorry,” Jenny said. “She was having a nightmare.”
Amanda was sitting on the floor looking around. “What happened?” she asked.
“I screamed,” Lucy said. “I’m sorry.”
“I’ll tell Dr. Syropolous she’s awake,” the nurse said, and left.
“What happened?” Lucy asked.
“You had convulsions and a high fever,” Jenny began. “I had no choice, I’m sorry. They’ve given you medicine, and you’re getting better now.”
Lucy sensed a disturbance in The Stream. But she was groggy and unsure of what she was perceiving. Jenny leaned in close to her. She pointed to a device on the bed with a cord running out of it. It said “Call Nurse” in red letters. Jenny put her finger to her lips. Then she picked up a pad of paper and wrote, “They can hear us.” She wrote again, then held the page so that Lucy could read it. It said, “They have your DNA.”
“Oh, no,” Lucy said.
“What? What is it?” Amanda asked.
Jenny looked from one girl to the other and shook her head. “Be calm,” she said. “Be very calm. Just wait until we’re home.”
Jenny sat on the bed in the smelly motel room with her head pounding, her mind racing through all the possibilities. She took ibuprofen and stood under the shower for half an hour until her headache went away. Then she put on clean clothes and returned to the hospital. She gave Amanda the key to the room and stayed with Lucy while Amanda went to shower. Jenny didn’t want to risk leaving Lucy alone. While Lucy slept, Jenny thought about how their lives were about to change. She began to list in her mind all the passionate groups that were going to try to get in on the circus once it began. The true believers. She tried to imagine a
happy ending, but she could not.
When Amanda returned, Jenny said, “Honey, I have to sleep. I have to think, and I can’t think until I sleep.”
“I’ll take care of her. You go ahead. We’ll be fine.”
“Call me if you need to. I have my phone.”
At the motel Jenny fell into profound sleep and woke at dawn. She couldn’t remember what day it was. She dressed and hurried to the hospital. Amanda and Lucy were playing chess on a set that one of the nurses had bought them. They both smiled when she entered the room.
“I’m so sorry, Amanda. I slept all night. I didn’t mean to. You must be exhausted.”
“It’s okay. I slept some.”
Dr. Syropolous arrived at about seven o’clock. Just seeing him in the doorway made Jenny’s heart jump. He asked if they could talk in his office, and Jenny left Amanda with Lucy.
Dr. Syropolous closed the door. “I have the results back from the lab, and I’ve been doing a bit of research.” It was what Jenny had expected. She thought, He knows now. He just doesn’t know exactly what he’s dealing with yet. “Does Lucy have any health problems? Any abnormalities? Mental dysfunctions? Behavioral issues? Anything out of the ordinary that you can think of?”
“No. She’s a normal teenager. Why do you ask?” Jenny knew perfectly well why he asked.
“Well, there’s something very unusual in her genetic profile. Some congenital anomaly. I don’t quite understand. It’s out of my field.”
“What congenital anomaly? There’s nothing wrong with her.” Jenny would continue to hold out for time even if it was only a few days. Let him wrestle with it.
“Let me just throw something out to you. It’s going to sound crazy, I know. But bear with me.”
She said nothing.
“Okay. I looked you up after our talk yesterday. And I learned that in addition to your teaching appointment you are a primatologist who studies bonobos in the Democratic Republic of Congo.”
“Yes. That’s correct. How is that relevant?”
“So you must know, Dr. Lowe, that bonobos are genetically more than ninety-eight percent identical to humans. I didn’t even know what a bonobo was until I read up on it.”
Jenny let him have the silence once more.
“But there are notable differences,” Dr. Syropolous continued. “They have, for example, a completely different sequence for amino acid metabolism from the one that humans have. Bonobos probably can’t digest meat very well because of it.”
A pause. Syropolous seemed to want her assent, but she gave none.
“Also there are differences in the alpha-tectorin gene. The hair-keratin-associated protein is different, too.”
“Yes, I know all of that,” she said, as if impatient. “But why are you telling me?”
“Because Lucy has that genetic material. She has what appears to be a genetic sequence that is a combination of human and bonobo genes. Her hair and skin, for example, are not entirely human. Close, but not exactly the same. Her sequence for amino acid metabolism is quite a bit different. I saw it myself in the microarray sequencer or else I wouldn’t have believed it.”
“That sounds crazy.”
“Yes, I know it does.” And after another pause: “Does she eat meat?”
“Of course, she eats meat.”
“Really? She refused the meat that the dietitian offered her. Lucy has some of the genes of a bonobo.”
“That’s impossible.”
“I know, it would seem to be. I’m sorry. I’m just telling you what I saw. It’s utterly baffling. I mean, my first thought was that it must be a contaminated blood sample. But you see, the trouble is that in order for us to have a sample of human blood contaminated with bonobo blood we’d have to have a bonobo. And the nearest ones—I checked on this—are in the county zoo in Milwaukee, which is about a ten-hour drive. Lucy’s blood was taken when she first arrived here. I know the nurse who took it. So you see …” The silence hung in the air for a long moment. Then Dr. Syropolous said, “And then, the fact that you are a primatologist who works with bonobos in the jungle … It seems like a most remarkable coincidence, don’t you think? But you say you know nothing about it.”
“No, I’m afraid not.”
“Because if hers is a natural mutation that allows her to be susceptible to a potentially fatal disease previously found only in animals—and by the way, bonobos are one of the animals that can contract encephalomyocarditis—then it’s worth a paper in one of the scientific journals. And the CDC will certainly want some follow-up research done on Lucy. Then again, if it’s not a natural mutation … Well, I don’t know what to think.”
Jenny remained silent.
“No thoughts at all on this?” Dr. Syropolous asked. “Nothing?”
“No. Sorry. None.” She could see that he was a smart and curious man. He would wake at three in the morning thinking about Lucy. And even if he didn’t do anything about it, the CDC would. Dr. Syropolous was bound by law to tell them.
“Dr. Lowe. I’m trying to help you. I respect patient confidentiality. But I think you’re hiding something. And I do want to know. I mean, you’re a scientist. Put yourself in my position. Wouldn’t you want to know?” He paused. “Dr. Lowe, please. I’m not the police.”
The mention of police sent chills up Jenny’s spine. That would come soon enough. “When do you think she can go home?”
20
MEMORANDUM
FROM: M. George Glandon, PhD, Division of Viral Diseases, National Center for Immunization and Respiratory Diseases
TO: Distribution List, Centers for Disease Control and Prevention
CLASSIFICATION: Unclassified
ABSTRACT: A recent human infection with an enterovirus suggests that research is called for in human-to-animal contact with special emphasis on nonhuman primates. EMCV 30/87 is an enterovirus normally found only in pigs, mice, rats, rabbits, and nonhuman primates, such as apes. A case described by P. Syropolous, MD (Dir. Internal Medicine, Mercy Hospital, Duluth, MN), in a letter to the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, describes a fifteen-year-old female patient who presented with severe febrile illness and the potentially fatal condition of infection with encephalomyocarditis 30/87. She was treated with PLL and released in satisfactory condition. A genetic profile of the patient showed abnormalities indicating an increased susceptibility to the enterovirus, suggesting mutation not of the virus (to suit humans) but of the human genome (making the patient more susceptible to the virus). This confusing state of affairs deserves attention, but emphasis must be placed on determining whether Dr. Syropolous’s methods were satisfactory and his conclusions correct. This may simply represent a misreading of the evidence or a contaminated sample.
RECOMMENDATION: CDC will take a clean sample of blood and produce a full genetic profile of both patient and virus to determine the appropriate course of action.
AUTHORITY: 42USC264.
21
JENNY SAT IN THE KITCHEN watching Lucy eat a banana with peanut butter. Lucy saw Jenny watching and gave her an embarrassed look. “I peel them at school,” she said.
“That’s a relief.”
Jenny had considered stopping in Milwaukee on the way home from Duluth, but the fact that Lucy had been sick meant that she could be a danger to the bonobos there. Jenny called Donna, who agreed that the visit would have to wait.
Lucy sheepishly peeled her banana and spread peanut butter on it. She looked up at Jenny and took a bite. Jenny smiled and was about to say something, but the phone rang, and she jumped at the sound. She picked it up.
“Dr. Lowe, this is Dr. Syropolous. I trust you got home safely.”
“Yes.”
“Dr. George Glandon at the Centers for Disease Control asked that I contact you. They want to rule out the possibility that the virus has crossed over to the human species in some way that might pose a threat to the public health. They’d like to take a new sample of Lucy’s
blood for analysis on the off chance that our sample was somehow contaminated.”
Jenny leaned on the counter. She already felt tired from what had not yet happened. They had decided at last how to respond. And Jenny had her backup plan with Donna if the worst happened. But the question before the world would be: What is the appropriate response to Lucy’s existence on this earth?
“Yes, yes,” Jenny heard herself saying. “I think I’d like to delay this until Lucy is feeling a bit stronger.”
“Well, I’m afraid that’s not up to us. The CDC has certain powers under the law to prevent diseases from spreading. They can take Lucy’s blood by force if need be. They’re already a little concerned that she left the hospital. Even though she seems better, the virus is still in her system, and they need to sample it. They’ll be sending someone over today, in fact, a well-trained phlebotomist from Northwestern University. It won’t take five minutes.”
“I see,” Jenny said, thinking, We’d better get Amanda over here. It’s time for the girls to get busy.
“They wanted me to be the one to call since I am, de facto, Lucy’s physician at the moment.”
“Yes, of course.”
“The phlebotomist’s name is Roberta Dyson, I’m told. So I wanted you to be expecting her.”
Jenny hung up. She felt as if she were on speed, her mind racing through what the next weeks and months would bring.
“What?” Lucy asked. She had stopped eating and was staring at Jenny intently. “What is it, Mom? What happened?” But she knew. They had already discussed it all on the way home from the hospital.
The road they traveled from Duluth had stretched out ruler-straight for miles, cutting farm fields in half, as pastures fell away in gentle slopes toward island lakes. Dark clouds had gathered in the western sky as they entered the great expanses of forest in Wisconsin. Lucy caught the scent of deer and fox and even wolf in there. Somewhere around Washburn, Jenny said, “I think you should talk to Amanda now. The whole world is going to know soon enough.”
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