Bobby read about, studied, made drawings of microtubules, lysosomes, Golgi, ribosomes. He meditated on cell membranes—walls that actively discriminated, selectively regulated the immigration and expulsion of living and dead materials; on mitochondria, the power companies of the cells; on the endoplasmic reticulum; and the headquarters, the tactical operations centers, the Pentagon complex, the nucleus itself with its double helix structure and its fifty to sixty thousand separate dioxyribonucleic acid (DNA) offices each with its own nucleotidal foreman, plans sets, and fax machines transmitting or capable of transmitting via intra- and intercellular chemical communication lines, pools, RNA messages—do this, don’t do that, link these amino acids together like Lego blocks in this exact sequence, multiply and/or divide, or cease multiplying, dividing, or commence until this exact condition is encountered at which moment your present mission is complete, and get back to me, chemically, for debriefing so I too can rest. Genes! Construction drawings. Much more. Executives, decision makers. Still more. Stimulators, movers and shakers, motivators, prime movers, holders of the life force. Inside each gene a desire to be alive! An intimate and inseparable relationship of life forces, of strong, weak, love and ...
Bobby could not yet grasp, conceive, conceptualize, the primary forces within atoms, the subparticles, quarks, muons, and their relationship to atomic structure, to molecular structure, to genetic desire, to cellular communication, to the production and reproduction of cells, to the reproduction of aberrant cells.
He studied, searched, analyzed, pondered.
Hemoglobin is constructed—actively and purposefully assembled—of four porphyrin molecules “glued” to a molecule of iron. Herbicide poisoning has a destructive, though indirect, effect upon this bonding that can be measured in urine samples by testing for coproporphyrins. Reaching backward: TCDD has been shown to be stored in the fatty tissues of those exposed to Agent Orange. Reaching forward: Is there a way to flush the toxins from human fatty tissues without endangering other, more active tissues such as blood-producing bone marrow, or egg/ sperm-producing sex organs? Maybe an in-home purge? Fast and deluge the organism with endless quantities of pure Endless Mountain water, enough to cause diarrhea? Chelation: The process of chelating, or combining, with a metallic ion to form a chelate; or to form a ring with one or more hydrogen bonds ... Hydrogen bombs! Vaporize me!
The attempt to formulate a workable design exhausted him yet he pressed on. Chelation therapy introduces a chemical agent—how he abhorred that tag—that will combine, chelate, with a specific toxic element producing a precipitate that can be flushed from the organism.... Backward: to a conceptualization of the 2,4,5-T molecule, of the 2,3,7,8-TCDD molecule, to an analyzation of their surface topographies, to the reverse, inverse topographies, to picturing and constructing molecules with those reverse topographies—nature does it all the time, antibodies to antigens—which can key into the toxin, lock on, together fall to the “bottom” like a child’s suspension of backyard dirt in a water-filled beach bucket.
He attempted to enter the mind, to be the mind of an experimental pathologist, toxicologist. “TCDD induces malignant tumors”—he addressed a conference within his mind—“in exposures as low as five parts per trillion ... causes carcinomas of the liver, lungs, palate ... testicular cancer, lymphomas and leukemias ... delayed effects ... more toxic than the most lethal nerve gas in the military arsenal ... causing failure of all elements of the blood-forming system, causing victims to hemorrhage, to be defenseless to infections, essentially to deteriorate, literally to fall to pieces ...
“Yet ... But ... However ... TCDD is eliminated from human tissue via bile fluid from which, by which, it is transported to the intestines to be defecated ... Yet ... However ... here it is reabsorbed, the enterohepatic cycle, recirculated to liver, lungs, bone marrow, the body constantly discarding and inadvertently recycling unwanted trash like pissing into the wind ... Yet ... if it could be chelated, combined, as if the wind ceased, combined perhaps with cholestyramine used as a salt binder in patients with high cholesterol, used as a chelation agent in kepone toxicity ... then not reabsorbed but indeed deposited, the mark being left, the throne room’s excreta whisked away by the simple act of depressing the lever.”
Again he reached back, reached forward. What causes cancer? No! What caused my cancer? No! No! When I was wounded, light shrapnel in the legs, I did not say, “Corpsman, take my shrapnel out.” Nay! I said, “Medic, get this fucking shrapnel outta me!” I said, “Take this out. It’s not mine. It belongs to the NVA.” So take this cancer. Take this aplastic anemia. I didn’t ask for it. I don’t want it. It’s not mine. It’s somebody else’s. Give it back to Dow. Give it back to Daddy Dow. What has caused this cancer that has attacked me? Is it the Agent Orange? Sara is certain. She is leading the technical information search, the search for new treatments. She is the advocate. She is addressing civic groups in my name. She is the leading advocate for veterans, for humans. Certainly TCDD is a trigger. But what pulled that trigger?! Is it something in me? Something deeper in me than the strict biomechanical process, the reaction to a toxicant that has cleaved the genetic lines of chromosome ∆ allowing for translocation of gene x on arm q of the heavy chain to relocate to chromosome A where it lodged next to gene y which enables it, chromosome ∆, to evade the mechanism that controls its expression? Why was it set off in me, in this manner, and not in others who were equally exposed? Why in my bone marrow? Why my blood? Why, in affected others, did it trigger brain tumors, or liver ... or testicular ...? And what, if it is something innate in me, beyond the biomechanical, is it? What is the triggering and the site selection determinant? And if it is beyond the physical, is it something I can reverse? Is this something, if I can determine the trigger, I can psychologically or spiritually untrigger? And if untriggerable, if chelated and flushed, what happens to the chromosomal damage previously done?
Bobby searched into himself for hours on end, day after day, week after week. He sent messages, explored hidden regions, sought information, gave orders. “Headquarters, free the infiltrators, expel the double agents, arrest the saboteurs.” Can the damage be repaired? Can the war be won though major battles have been lost and the nation is on its knees? Will a win at Xuan Loc keep Saigon from falling?
Daily Bobby studied, contemplated, ruminated. Daily he unfocused, disciplined nonfocused meditation. He lay still, on his back, on the floor of Grandpa’s office, alone, wrapped in a blanket, a bedroll, warm yet not aware of the warmth, secure though without cognition of that security. Over his eyes he laid the old OD jungle sweater that reduced the dimmed room to utter darkness, to the void in which the search could be continued. He looked in. He traveled to sites of unrestrained growth, of mutant self-destructive platelets. He attempted to spy on the man-made environmental toxins triggering the aberrant cellular mutations. He tried to infiltrate the mutants’ base camp to discover their need for suicide. Why have you allowed these substances to enter the walled city of the cell? Why have you not expelled them? Why have you let them come to headquarters? Or have they simply gained control of the commo center, altered the messages and production orders, to their choosing? And why have you not recognized the abnormalities of the new structures? Why have you allowed them to replicate endlessly their chimeric clones? Or do they, themselves, or do you ...? Surely there is not and never has been a TCDD alien for each and every cell. Then why are all new cells aberrant? Surely the answer to this, like a change in the cultural norms of a society, explains the delayed onset of the disease, and like a society the aberration began with a tiny pocket of radical ...
So what?!
Re-unfocus and flow. He is a microscopic entity, not matter, not energy, but thought represented within his unformation by a blue glow flowing within his own arteries, veins, capillaries, a pinball ball ricocheting from concave disks but 0.0003 inch in diameter, inspecting each; a blinking cursor in the three-dimensional holographic computer screen of his body, leaping through t
issues, randomly interviewing a sample of the one hundred trillion cells of his being, checking that each contains an identical headquarters with identical blueprints—though with different assignments, tasks to perform, different rooms to construct, different systems to maintain—checking randomly, then comparing blueprints, finding that hair cells and skin cells and toe cells all know the proper way to make blood cells so how come the bone marrow that makes those blood cells is fucking up?!!! Fire the CEO! Chastise the nucleotidal foreman! Send in a ... a what? A messenger with proper prints! “Ah, hey look, Buddy. You spilled coffee on yours and you’re building the wrong stuff, Man. See? Here’s a good set. I borrowed it from your patella.”
“I’ll make what the hell I want. Leave me alone.”
“What? Man, you keep makin that shit, you’ll kill us all.”
“Says who? You follow your prints, I’ll follow mine.”
“Man ... see, you spilled that TCDD coffee right there and the cell lysosome isn’t complete and it’s leaking its enzymes into the cytoplasm and causing quick self-destruction.”
“Says who?! Where do you get off telling me my job?”
“Naw. Naw, Man. You don’t understand. You keep doing that they goina poison your food. Hide somethin in the food that’ll cause your lysosome-stomach to cramp until you’re a goner, Man. Then they’ll replace you. You know, Man, transfer in a bunch a scabs. Chemo followed by bone marrow transplant, Man.”
“They wouldn’t dare!”
... now feeling the warmth of the cocoon about him, then again not feeling it at all but sensing on some level that he is warm, protected, cared for as Sara cares for him, linked eternally, secure in this care, this warmth, this cocoon, liberated to deepen the search, millimeter by millimeter, nanometer by nanometer, searching for the commo line between triggered cells and healthy cells, searching through April, May and June.
The trigger must yet be something more, something else, something different. If the trigger is in me, or of me, what am I? I am more than the sum of my cells, more than a heap of organelles, just as a book is more than the linkage of words, more than a pile of letters. The relationship of the parts, the format, is essential. And the force that organizes the format is essential, is perhaps the life force, the soul, is the essential me. How has that force, how have I, gone awry? How can I right the bias? Trying to understand, trying to construct the parallel universes of mind and body, of corporeal and spiritual, attempting to unite them within a code, to explain them in The Code, in a search for the universal tie.
“Aren’t you getting into the car?” Sara’s words were quick, light. The early morning was delightfully cool.
“Hmm.” Bobby turned, looked out across the pond, let his gaze fall on a pair of mallards by the near bank.
“I told Linda we’d meet them at River Front Park ten minutes ago,” Sara said. “We’re late.” She slid in behind the wheel, turned, checked the children, ensured they’d buckled their seatbelts. Bobby remained motionless, leaning against the car. It was to be their first real family vacation. With the Pisanos they’d rented a cottage on the Jersey Shore. “Bobby?”
“Um.”
“Bobby, are you okay?”
“Yeah. It’s—” his words came slowly, “that I’m just looking ... at the ducks.”
“Come on. Get in. Bobby ... are you feeling okay?”
“I’m a little cold.” He settled into the seat beside her. “And my head’s pounding.”
“Your crit’s low?!”
“I just got a refill.... It’s ... I think it’s because of my eye. It’s like there’s a blob of water over everything.”
“Do you want the patch while we’re moving?”
“No. Maybe. I’m going to just close my eyes awhile.”
He rested his head on the seatback, zippered his jacket. In back Noah and Paul were drawing pictures, Am was munching a bagel, all being “good,” being quiet, not irritating their father. The car rolled. Bobby sat up, took in the drive, the old gate, the orchard and Christmas trees. Then he closed his eyes again. He thought of Josh in Rodney Smith’s care, felt like he was abandoning him. The thought didn’t last. Almost immediately it was replaced by slight vertigo, by nausea, by pains in his joints, arms, butt. Pain, the inner experience, the thought, the word alone can induce it, enable it, allow it to spread. Pain, the process, exactly the opposite of DAARFE-vader, capable of being controlled by DAARFE, capable of destroying DAARFE. And cancer! What caused the ... No. He would not think of it, would not meditate on it. This was vacation time. Time with his kids. And none in diapers! What JOY! Let Tony change little Johnny; Bobby was through that stage. Better to build sand castles ... splash each other, maybe a sand dragon ... maybe an entire sand city at the edge of the rising tide.
“Man, you all right?”
“I’m just kinda hot, Tone.”
“Open your jacket, Bobby. You’re all flushed.”
“Shit! I can barely move my arm.”
Tony pushed his hand through the open passenger window, laid the back of his fingers against Bobby’s forehead. “Man! You’re burning up!”
“No. I can’t be. It’ll be ...”
“Sara?” Tony kept the alarm from his voice. Sara and he were changing places so he could drive with Bobby, Sara with Linda, the girls, and Johnny. “Sara?”
“It’s nothin, Tone.” Bobby leaned forward, smiled weakly. “I musta been leaning on it, put it to sleep.” He raised his arm, began to unzip, leaned forward gasping. Tears welled to his eyes. Beneath his breath he muttered, “This is our vacation!” Then he leaned back, tightened his abdominal wall. More loudly to Tony he said, “Get in. We’re goina have this time.”
Bobby held out for three days. He built sand castles with Am, waded in the surf with Paul, let Noah bury his legs, winked at some bikinied beauties with Tony, and spent hours watching Sara. Then he could hold out no longer. His legs swelled, he could barely walk, had to ask Noah to help him, Noah so serious, only eight years old, had to ask him to be strong for his father.
On Wednesday 27 July 1983 Bobby returned not to the cottage at the Jersey Shore, not to High Meadow, but to the VA hospital in West Haven. His temperature had risen to 104. They started him on IV antibiotics and IM steroids. Doctors Dachik and Rosenwald prodded, poked, identified a grossly infected hematoma in his right arm. They stuck him, slit him open, sucked pus from his arm—not once, not twice, but over five days seven times. The direct pain and the throbbing pain were tremendous, yet were askew of the deep hematoma site and the first time they’d found only a small pocket, and the second too, and nothing the third and fourth until the ultrasound technician suggested Bobby tell the surgeon to do the next cut down right there in the lab so that the technician could show him the exact location. The fifth and sixth times the surgeons ignored the offer until so frustrated they did the seventh under ultrasound, stuck in the needle, dead center, and withdrew 70 ccs of blood.
“Did you hit it on something?”
“No,” Bobby answered. “I don’t think so.”
“Maybe?” the doctor asked.
“So what if I did?”
“If you didn’t,” Dachik said, “it’s possible that it was spontaneous. Spontaneous bleeds are significant.”
“My condition’s deteriorating, isn’t it?”
“Not necessarily. It may be the low platelet count. We’ve some responses to that.”
More tests. New fever spikes. More blood drawn. Another bone marrow biopsy, another Wednesday at the transfusion clinic. “You’re platelet count is low. And ...”
“And?”
“The tests show an increase in leukemic—”
“Leukemia!”
“There are a number—”
“Leukemia.”
“... chemotherapy ...”
Bobby was barely hearing.
“... treatment has come a long way in the last several years ...” the voice empathetic, matter-of-fact, professional, personal.
�
�I’m a goner. Holy shit!”
“... you’re very early in the leukemic process ... a six-week course of cytotoxic ... and cytosine arabinoside ...”
Then, later, on the phone with Tony, afraid to tell Sara over the phone, “Leukemia.”
“Bummer, Man.”
“Yeah. Ambushed again.”
Meditation: Mid-August—See them, he tells himself. Feel them. The august stem cells of the marrow produce immature or precursor clones that differentiate into specialized cells as they mature. Differentiation and maturation are controlled by specific inducer proteins produced by the stem cells or by other cells in the surrounding support tissues. Immature myeloid (marrow) stem cell clones become macrophages or granulocytes, erythrocytes, megakaryocytes, eosinophils or mast cells, depending on the inducer that binds to the immature cells’ DNA. Picture this, he urges. See this. See the pool, the mixed-inducer ocean, with millions of immature floating rings. When these cells differentiate and mature, growth inhibitors, produced by the mature cells, block these cells from further multiplication. But leukemic cells—immature, undifferentiated—produce their own growth inducer independently of the stem or support tissue and this allows them to steadily, though nondifferentially, multiply immature clones. These immature clones do not produce differentiation inducers that would cause them to mature and stop reproducing. Picture it. See them. How can I turn on the differentiation-factor producers that might stop the uncontrolled growth of leukemic cells? How can I keep the leukemic cells from asynchronously producing their own differentiation factors?
Swimming in meditation, floundering: If all myeloid leukemic clones have abnormal chromosome arrays—that is, the deletion or malarrangement of a chromosome segment—how can that segment be restored or replaced? See it. See it happening. Expect it. What value knowledge if not ... See it being fulfilled.
Bobby remained in the hospital through July and the first twenty-six days of August. On the twentieth he was interviewed by reporters from the New Haven Register, the Hartford Courant; on the twenty-first by a man from UPI. In them, in the media, Bobby found a strange bedfellow—truly interested, sympathetic investigative reporters delving into Agent Orange illnesses and death, exposing personal tragedies in America, Australia, Southeast Asia. They seemed delighted with the new mace, the new battleax with which to bash both the government and corporate America. Yet Bobby found in their seemingly sensational revelations, little ungrounded sensationalism.
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