“But how do you know me?” Sylvia asked.
The doctor grinned. “I overheard you asking for her at the desk, and I took a guess based on the resemblance.”
“Do you know what’s wrong with my daughter?”
“Actually, I’m one of her attending physicians, so if you follow me, I will take you to her room, and we can talk there.” The elevator doors opened again, and they both stepped out.
“A car accident, you said?” Sylvia followed the doctor, now taking big steps, all the way to the other side of the floor.
“You sound surprised. She didn’t tell you?”
Sylvia shook her head. “No, nothing.”
“It wasn’t too serious. She had a slight concussion, nothing else. I believe she was with friends from Yale, doing research.”
Sylvia shook her head. A few years ago, her husband, Jennifer’s father, had died under strange conditions. Though it always had seemed Jennifer knew more about the circumstances, her daughter had never told her much about what had happened. The only thing that she’d told her was that despite suspicions they might have had, he died of natural causes. Sylvia had always felt there was more to it than that, but she had let it go. Her husband had been very sick in his final months, so his death had been for the best, or so she told herself.
They stopped outside Jennifer’s room.
“Now, before we go in,” the doctor said, “she will be asleep. But that’s nothing to worry about. We kept her sedated to give the brain rest. But she can come to any moment now. Please come in.”
The room was a typical sterile hospital room with a single bed and two comfortable looking chairs next to it, on a colorful laminate floor. Behind the bed was an empty corkboard and a lightbox with what looked like an X-ray of a head, on the otherwise spotless white wall.
Next to the bed, a tube from an infusion device ran drops of liquid to the needle attached to Jennifer’s wrist. On her head, a white net spread with electrodes covering her long blonde hair was wired to an EEG machine next to the bed. On an attached monitor, a pattern of lines represented the young woman’s brainwaves.
Sylvia stepped up to the bed and took Jennifer’s hand. “What’s wrong with here? Is she going to be okay?”
“Please sit down.” The doctor moved one of the chairs next to the bed for her. Then he took the other chair, moved it next to it, and sat down. “I’m afraid I have some good news and some bad news.”
“Tell me.” Sylvia didn’t take her eyes from her daughter.
“I’m sorry to say that we diagnosed your daughter with Naegleria, a rare and unusual brain infection. Now, in 95 percent of the cases, the infection is fatal. The good news is that your daughter falls in the other 5 percent category.”
Now Sylvia turned and stared the doctor in the eyes. “What does that mean?”
“It means Jennifer will survive the infection.”
“But is she going to be okay?”
The doctor paused for a short moment. “Well, to be honest, that’s hard to say at this point. The infection is caused by the Naegleria Fowleri amoeba. A bug that causes a disease called primary amebic meningoencephalitis, resulting in brain inflammation and destruction of brain tissue.”
From the bed came a soft grunt.
“She’s waking up.” Sylvia took her daughter’s hand in both of hers and squeezed.
“Ouch,” Jennifer uttered softly.
Sylvia quickly released her daughter's hand a bit. “Oh, I’m so sorry, dear.”
“Here.” The doctor handed Sylvia a glass of water with a straw. “She’ll be thirsty.”
Holding the glass, Sylvia put the straw to her daughter’s mouth, who took small sips. “That’s good,” she spoke comfortingly.
“Where am I? What are you doing here, Mom?” Jennifer looked around the room. “A hospital? What happened?” Then she looked at the doctor and frowned. “I know you. Don’t I know you?” Her voice sounded panicky. Waking up, realizing she was hospitalized, in an instant, reminded her of her father in his last moments when she was with him at the hospital. What is this? Why am I here? Will this be my end?
“It’s okay, honey. It’s going to be okay.” Sylvia tried to calm her down. “Can she talk this much, doctor?”
“That’s not a problem,” the doctor reassured her. “We gave her something that will clear her mind quickly now. Hello, Jennifer. It’s Dr. David Elder.” He moved his head closer to hers. “I treated you briefly in Hebron. You remember?”
“Vaguely,” Jennifer answered, slowly regaining her calmness. “What am I doing here?” She squinted her eyes.
“This better?” The doctor dimmed the lights above her bed. Jennifer nodded slowly.
“Do you know your name?” the doctor asked.
“Sure. Jennifer Porter,” she reacted promptly.
“Do you know where you live?”
“Orange Street, East Rock, New Haven.”
“Date of birth?”
“None of your business.”
Her mother gave a tiny grin.
“Good, very good.” He smiled. “Do you remember getting unwell?” he asked while testing her pupil response with a small flashlight.
“I’m not sure.” She paused for a moment. “I remember giving a presentation at the university, but from there, nothing, I think. How long have I been here, and where is here?”
“You fainted during your presentation almost three days ago. You are now at the Tropical Medicine Practice at Mass General. You were brought here from Yale hospital because of the nature of your illness. You’ve been in and out consciousness the past forty-eight hours, and we’ve been able to keep a good eye on you and perform some tests.”
“How are you feeling, honey?” Sylvia asked scowling.
Jennifer moved her shoulders, arms, legs and head. “I think I feel okay. What happened? Am I okay, doctor?”
Dr. Elder took a deep breath. “As I was explaining your mother, you were infected by the microscopic Naegleria Fowleri amoeba.”
“I’ve heard of it,” Jennifer interrupted. “The brain-eating bug. But isn’t that always fatal?”
“She’s okay, isn’t she?” Sylvia spoke fast. “Oh, what are you always doing in those godforsaken faraway countries?”
“Please let me explain,” the doctor said. “First of all, it’s a misunderstanding that Naegleria fowleri Amoeba is indigenous to third world countries. Actually, in the U.S. alone, millions of people are exposed to the amoeba each year, but only a handful of them ever get sick from it. What we know is that the amoeba is commonly found in freshwater lakes, rivers and hot springs. So, the greatest chance to get infected is while swimming or doing other watersports. Once exposed, the amoeba travels up the nose and to the brain, but we don’t know why some develop naegleria, and others don’t. In your case, we were lucky to identify the cause soon enough to treat you with an antifungal drug called amphotericin B, which, let’s say, kills the bug in about 5 percent of the cases.”
“And the other 95 percent?” Jennifer asked.
“I’m afraid they die.”
“How do we know the bug is dead?” Sylvia asked.
“Jennifer?” the doctor asked. “Have you been ill in the past few days? Any headaches, fever, vomiting or a stiff neck?”
Jennifer thought for a moment. “I am. I was. I thought I had a bit of the flu or something.”
“And how long have you been feeling unwell?”
“Three, four days, perhaps.”
The doctor took his stethoscope and pointed at Jennifer’s chest. “Do you mind?”
Jennifer shook her head.
For a few moments, he listened to her chest. “That sounds fine.”
“So, you asked how we know the bug is dead.”
Sylvia nodded.
“Well, that’s as crude as it is simple. Your symptoms started at least three days before passing out, add three days hospitalized, and that makes six. At six days, everyone infected who doesn’t survive is at least
in a coma. Ninety-nine percent of them are dead in six days. I think it’s safe to say you’re fine.”
“So, she’s going to be okay?” Sylvia asked.
“I’m sorry,” the doctor corrected. “What I meant to say was that we can safely assume that the amoeba is dead. I’m afraid that still leaves us with the damage done.”
Sylvia grabbed Jennifer’s hand again and squeezed it tight. The doctor’s tone of voice immediately reminded her of her husband’s doctor, when he gave her the message that there was nothing left to be done for her husband.
“You’ll live,” the doctor responded hastily when he saw the impact of his remark. “But we observed your brain activity through the sensors on your head and on this monitor. Now, during your sleep the past few days, we saw a normal brain pattern most of the time. We even noticed some dreams from time to time. Unfortunately, we noticed abnormalities that caused epileptic seizures. Now, these happened when you were asleep, but you likely had one of those same seizures when you passed out during your presentation.”
Jennifer now sat up straight in the bed. “You mean I now have epilepsy?”
“Something like that,” the doctor responded. “Epilepsy is factually a collective term for a group of neurological disorders that we know very little about. However, in your case, we are sure it’s related to the naegleria.” He flipped on the switch to the lightbox next to the bed. “Early this morning, we did a brain CT scan. This is your brain. And here, you see these spots?” He pointed to the image. “That’s where the amoeba did its damage. Those are parts where your brain is missing small pieces of tissue.”
Jennifer shook her head. “But I feel fine.”
“We’ll do some more tests, but from what I see, you are fine for the moment and probably will be most of the time. The problem is that we monitored the seizures happening every four hours or so. But I’m afraid that will not be something you can count on like clockwork. The other problem is that we don’t know if your condition is stable. What I mean to say is that we don’t know if your condition is progressive.”
“You mean getting worse over time?” Sylvia asked.
“I’m afraid that’s exactly what I mean. What we do know for sure is those pieces of missing brain will not grow back by themselves. Unfortunately, the brain is not very good at repairing itself.”
“By themselves?” Jennifer remarked.
“Sharp, very sharp,” the doctor complimented. “This morning, we had a staff meeting where we talked about your case. Now, it’s not my field of expertise, but there is a highly experimental stem cell treatment that might be useful in your case. You know about stem cells?”
“A little,” Jennifer answered.
“That’s about what I know,” the doctor joked. “Stem cells are basically blank cells without a function that are present everywhere in our bodies. These blank cells can develop into blood, bones, all of the body’s organs and, potentially, brain. Theoretically, they can repair, replace, restore and regenerate cells and can be used to treat many medical conditions and diseases. But we’re still at the beginning of understanding how to manipulate these blank cells. A few years ago, researchers found a new type of quiescent stem cell.”
Jennifer frowned.
“Sorry, sleeping stem cell. They called it the ‘G2 quiescent stem cell.’ This stem cell has a much higher regenerative potential than any other sleeping stem cells previously identified. It took a while to find out how to activate the G2 cell, but researchers identified a gene known as Tribbles that could selectively regulate G2 quiescent stem cells. Long story short, there might be a possibility to inject modified stem cells directly into your brain and hope they will repair the damage caused by the naegleria.”
“And this will cure my daughter?” Sylvia asked.
The doctor turned to Sylvia. “Truth be told. For now, it’s just theory, and if we do this, you will be the first to undergo such treatment for this type of damage. We did, however, see some really hopeful results in patients with minor stroke damage.”
A tear rolled down Sylvia’s cheek.
“Mom, please,” Jennifer begged. “What are the risks of such treatment?” she asked the doctor.
“I really couldn’t say. We first need to perform a series of tests to see if you are indeed a viable candidate, and then the experts can probably tell you about the possible risks. For now, I only need to know if it’s something you would consider. If so, I will send the real experts by tomorrow who can talk you through all the specifics.”
“Are there any alternatives?” Jennifer asked.
“There are medicines that are known to give epileptic patients relief, but like I said, there are countless reasons for epileptic seizures, and everyone reacts differently to the medications at hand.”
“Does she need to decide now?” Sylvia asked.
“Only if it’s something you would consider. If this is a possible way to go, it’s time-sensitive to start the treatment as soon as possible.”
“Of course, I’ll consider it,” Jennifer replied, “if the alternative is having seizures for the rest of my life, every other moment. What do you think?”
Another tear rolled down Sylvia’s cheek.
“I’ll be fine, Mom.”
Chapter 8 – The 12 Races
Reserva Indígena Mashco-Piro, Peru, The Present
“Finally, the last one,” Lindsey said.
Bishop looked at the piece of paper, on which he had tried to draw the route they’d walked through the caves. The cave’s construction was simple. From the central room, where they had found Kajaq, Lucy and the baby, there were a total of six corridors with rooms left and right of it.
“Check,” Bishop said while—with their headlights—they carefully examined the room, left to right, top to bottom. “All are completely empty,” he added as he put the paper in his jacket pocket. All rooms, except the one with the table in it, had been empty. Bishop looked at his watch. “We should get back if we want some daylight to set up camp.”
“You lead the way.” Lindsey pointed into the corridor. “What do you think Kajaq is, or means?” she asked as they made their way back to the central room.
“That’s a good question. I know that in older, often lower languages, there are words that don’t have one specific meaning. I suspect it’s a bit like ‘yalla’ in Arabic. It can mean ‘come on’ but also ‘hurry,’ ‘follow,’ or even ‘all right.’ I suppose it’s the same with Kajaq. In any way, it always seems to have a positive or confirming meaning.”
They entered the central room again. “Did you have a friendly conversation?” Lindsey asked Ignatowski as they walked in.
Lucy, Kajaq and the baby sat in silence on pieces of fur in the corner of the room.
“Very funny.” Ignatowski rose from the ground. “Did you find anything else?”
Lindsey shook her head. “Nothing. And we need to get out if we’re to make camp with the last bit of daylight left.”
“What do we do with them?” Ignatowski pointed to the three natives.
“We go sleep,” Bishop said and put two hands beneath his tilted head and pointed at the exit of the cave. “Kajaq?” The natives looked up but didn’t respond.
“I’m glad we brought our translator this time,” Lindsey joked. “Let’s go outside, and we’ll see what they do.”
The three picked up their things and walked toward the exit. Bishop looked behind them several times on the way out. Nothing happened, and no one followed them.
“Did you bring the paper from the table?” Bishop asked Lindsey as they walked out of the cave. She waved the roll of paper in the air.
“You want to take a look first?”
Bishop looked up at the last rays of sunlight, casting their light through the treetops. “I think it’s better we set up camp first and make a fire. I don’t want to set up camp in the dark by flashlight. We can look at it later by the fire.”
An hour later, the small contours of three green, small Nemo D
ragonfly tents cast their shadows from the campfire against the cave’s rock wall behind them.
“That wasn’t too bad.” Bishop looked at the empty can in his hand. “Spicy chicken and corn chili,” he read from the label. “I’ve had worse.” He threw the empty can in a plastic bag. “So, finished. Shall we have a look at the drawing?”
“Sure,” Lindsey confirmed.
“It’s about time,” Ignatowski added.
Bishop took a small bottle of hand sanitizer from his jacket pocket, gave it a few pumps and rubbed his hands with it.
“Ah, I see that, uh....” Lindsey pointed at the vial.
“Well, actually, no. I’m good now.” He waved his hands in the air. “I’m ninety-nine percent over my mysophobia. This is just personal hygiene. A few years back, I went to therapy, and most of the time, I’m good.”
Lindsey smiled. “Good for you.”
Bishop took the roll of paper and unrolled it on the ground. He took a few nearby rocks and put them on the corners. “There you are.”
An old-world map revealed itself in the light of the campfire. There were only a few names on the map, and on each, different colored continent, lines were drawn and numbered, like roads that ran all over the world.
“You recognize it?” Lindsey asked.
Bishop nodded. “Sure, I do. It’s the Hypothetical Sketch of the Monophyletic Origin, again by Ernst Haeckel.”
Ignatowski pointed to the lower right side of the drawing. “Amazing. It says so right here, at the bottom.”
“Can’t you boys play nice for a day or two?” Lindsey’s face contorted.
“Thanks for pointing that out.” Bishop narrowed his eyes. “The drawing was made by Haeckel in the late nineteenth century. At that time, he was convinced that the world was inhabited by twelve races like it says here.” He pointed to the lower left on the map. “The Papuans, Hottentots, Kaffirs, Negroes, Australians, Malays, Mongols, Polar, Americans, Dravidas, Nubians and Mediterranean. On this map, he laid out the origin of his human species.”
Ignatowski pointed to the lines and numbers on the map. “What about the numbers?”
Lemuria Page 7