“Did her brain function return as well?” Joanna asked.
“It was unbelievable,” Green answered. “All of her motor and sensory functions were completely restored. And perhaps most remarkable of all, she had been suffering from a progressive form of dementia, like Alzheimer’s. That, too, was reversed.”
“Like magic,” Lori commented.
“Like black magic,” Green went on. “Because right in the middle of this woman’s brain was an astrocytoma, which is just about the nastiest tumor you can find.”
Joanna sighed deeply. “And we still don’t know why.”
“It could be happenstance,” Lori suggested. “That’s a possibility here. Remember, we’re dealing with only two patients.”
“No way.” Green shook his head at Lori. “We’ve got two very rare tumors occurring in a group of thirty patients. That’s not a coincidence. I’d bet it’s somehow related to that lipolytic enzyme they received.”
He turned in his swivel chair to Joanna. “Did you find out anything at Bio-Med?”
“Everything looked fine,” Joanna told him. “They have very good quality control. In one lab they even had a—” She interrupted herself, thinking back to the lab with the technician wearing a space suit. And plain latex gloves. That’s what had bothered Joanna. The plain latex gloves wouldn’t protect the wearer in a supposed hot zone laboratory. “Excuse me for a moment.”
Joanna went to a wall phone, spoke briefly, and returned.
“What was that all about?” Green asked.
“A virus was contaminating one of the labs at Bio-Med,” Joanna replied.
“So?”
“So the technician in that lab was wearing a space suit.”
Green looked at Joanna strangely. “A space suit?”
“We’ll talk about it in a little while,” Joanna said. “I just spoke with Mack Brown down in virology research. He’s on his way up. Maybe he can explain it to us.”
“A space suit?” Green asked again.
“Let’s wait for Mack.”
Joanna reached in her white laboratory coat for a chocolate bar. She unwrapped it slowly, her thoughts now going back to the rare cancers. “Let’s focus in on the enzyme made by Bio-Med. They had plenty of quality control in place. Their enzyme preparations should have been pure. But we’ll check them out ourselves to make sure.”
Green asked, “You think there may be a contaminant in the preparation?”
“It’s possible,” Joanna said. “I think we all remember the L-tryptophan story.”
Green and Lori nodded at the memory of the medical disaster.
L-tryptophan, a naturally occurring amino acid, was found to be helpful in inducing sleep and relaxing muscles. It was eventually produced by a Japanese pharmaceutical company using a gene-splicing technique and sold in large quantities at health food stores all over America. Soon some of the patients taking L-tryptophan showed signs of a progressive, devastating neurologic disorder. A number of them died as a result. The disease was caused by a contaminant that was present in the L-tryptophan preparations. The pharmaceutical company was sued for hundreds of millions of dollars. L-tryptophan was pulled from the shelves.
“So,” Joanna said as she nibbled on the candy bar, “a contaminant in the Bio-Med preparation remains high on the list of possibilities. But the enzyme itself could still be the causative agent.”
Green waved off the idea. “There’s never been an enzyme shown to induce cancer. Not one.”
“Right,” Joanna agreed. “Except this enzyme was produced by a genetically altered bacteria. This may not be your run-of-the-mill enzyme.”
“You’ve got a point,” Green conceded.
Joanna licked the chocolate from her fingers. “But this doesn’t bring us any closer to the answer, does it?”
“Well, whatever it is,” Green said, “I think we can all agree that the causative agent is in that enzyme preparation.”
Joanna nodded firmly. “You can bet your house on that.”
“Two patients already dead from cancer,” Green said, more to himself than to the others. “And more sure to come.”
Lori asked thoughtfully, “Can you imagine how those other twenty-eight patients will feel once they find out what’s going on? They’ll just be sitting there, waiting for a cancer to pop up and kill them. And there’s not a damn thing anybody can do about it. Our study is not going to help them.”
“I know,” Joanna said softly, thinking how frightened and angry the patients would be. One day they’re feeling great and sitting on top of the world, and the next day they’re without hope and waiting for a deadly cancer to appear.
Joanna pushed the sad thoughts from her mind and focused again on the study to find the causative agent. She pointed to boxes and boxes of slides stacked high on a nearby table. “Those are the slides on the experimental animals who received the enzyme preparation at Bio-Med. We’ve got to review every one of them.”
“Jesus,” Lori groaned. “There must be a hundred boxes on that table. It’s going to take us weeks to go through all of them.”
“More,” Green said miserably.
“Whatever,” Joanna said, ignoring their objections. “Each of us will review a box of slides per day. Don’t just scan them. Look at them carefully and concentrate on the heart and brain.”
“Should we get some pathology fellows to help out?” Lori suggested.
“No,” Joanna said at once. “We can’t afford inexperience here. And remember, subtle changes may be important, particularly if they indicate early malignant transformation.”
The door to the forensic laboratory opened, and J. Mack Brown entered. He was a tall, lanky Texan with a square jaw and tousled brown hair that never stayed in place no matter how often he brushed it. Everybody thought he looked like the Marlboro man. And they weren’t far off. Named after the famous movie cowboy Johnnie Mack Brown, he was born and raised on a ranch near Del Rio, Texas. He was also a renowned virologist and the world’s expert on Lassa fever, an illness caused by one of nature’s deadliest viruses. Mack Brown had spent a lot of time doing research in a space suit.
“How you doing, Joanna?” Mack asked in a soft Texas drawl.
“Just fine.”
“You look real good,” Mack said, scratching his ear. “How do you manage to stay so young?”
“Clean living.” Joanna grinned.
Mack grinned back. “Ha!” He sat in a swivel chair and propped his feet up on a table. His boots were old and worn, but well polished.
“I think you know Dennis and Lori,” Joanna said, sitting on the counter that held the microscopes.
“Sure do.” Mack nodded to them and then looked at Joanna. “What’s all this business about a space suit?”
“What I’m about to tell you has got to be held in strict confidence.”
“Fire away.”
Joanna told him about the lipolytic enzyme and how it appeared to have induced malignant tumors in two patients. She described her visit to the Bio-Med plant, giving Mack all the details of the laboratory where the technician wore a space suit.
Mack squinted an eye at Joanna. “A space suit, with a visor and everything?”
Joanna nodded. “And a tube connected to the helmet to supply oxygen.”
“What the hell were they doing back there?”
“They said that their cell lines were being contaminated with an adenovirus,” Joanna told him. “They thought the virus was being transmitted into the lab by the personnel who worked in there. The space suit was meant to prevent the individual from contaminating the cell lines.”
Mack slowly digested the information and then ran a hand through his hair. “Something is wrong here.”
“Like what?”
“Like you usually wear a space suit to keep nasty viruses away from an individual,” Mack explained to her. “For example, if you were working with the Ebola or Marburg virus, you’d wear the space suit to keep the virus out and not let it get in to
the person. But at Bio-Med it seems they’re using the space suit to prevent a person from transmitting a virus into the lab.” He slowly shook his head. “I’ve never heard of any laboratory doing that. Why spend all the money when you don’t have to?”
“Are you saying they don’t need the space suit to contain the adenovirus?”
“Not in my book,” Mack said. “All that technician needed to wear was a mask, surgical gown, and latex gloves. That keeps out the HIV and hepatitis viruses. It sure as hell would keep in an adenovirus.”
“Maybe that’s why the technician was wearing plain latex gloves rather than the big bulky ones you usually see with the space suit outfit,” Joanna said, thinking aloud. “But it still doesn’t tell us why she wore a space suit.”
Mack tilted back in his chair and rocked gently, considering the various viruses that could contaminate an in vitro cell line. Usually it was the Epstein-Barr virus, not the adenoviruses, that caused the contamination. Then Mack remembered that sometimes strange, modified forms of adenoviruses were used in genetics laboratories. “Did you ask about the type of adenovirus that was causing them trouble?”
“No,” Joanna replied. “Is that important here?”
“It could be,” Mack explained. “Genetic labs often use a modified form of adenovirus to serve as a vector which transfers genetic information from one cell to another.”
He saw the puzzled looks on their faces and went into more detail. “Let me give you an example. Say you wanted to transfer DNA or genes from cell A to cell B. It can be done using a virus as a carrier. First, you take an adenovirus and modify it by removing its disease-producing portion. Next you take a sip of DNA from cell A and attach it to the modified virus; then expose the mixture to cell B. The virus carrying DNA from cell A then penetrates cell B. And voila! You’ve effected the transfer of DNA or genes from cell A to cell B.”
Joanna let the information sink in before saying, “I’m not sure they do that kind of work out at Bio-Med.”
“Every genetics lab is doing it,” Mack said promptly. “They believe it represents the key to the magic kingdom. You see, you can use the same technique to transfer genes from one animal to another animal.”
“Assuming that’s all true,” Joanna said, “why would the Bio-Med people be so concerned with a modified adenovirus that can’t cause disease?”
“Maybe the modified virus turned out to be something they didn’t expect,” Mack theorized. “Maybe it turned out to be something vicious as hell.”
Joanna nodded as the pieces began to fall into place. “So the real reason for the space suit might be to prevent the modified nasty virus from infecting the technician?”
“That’d be my guess,” Mack said carefully. “But keep in mind, it’s only a guess.”
“And there’s no way to prove or disprove it.”
“You might ask them straight out.”
“They’d never admit it.”
“Then question the personnel out there,” Mack advised. “See if some of them have come down with terrible virus infections.”
“Questions and more questions,” Joanna grumbled. “With no answers. And chances are, this virus has nothing to do with the cancers caused by that damn enzyme.”
Mack shrugged. “You never know until you look.”
The door to the forensic laboratory opened, and a secretary stuck her head in. “Dr. Blalock, Dean Murdock would like to see you as soon as possible. He’s in the conference room.”
Joanna turned to Mack. “Thanks for your help. I’ll let you know if anything else turns up.”
“If you want me to go out there and snoop around with you, just give me a call,” Mack offered. “I’m real good at that.”
Joanna hurried out of the laboratory and into the corridor, hoping that Simon Murdock wasn’t bringing more bad news. Which would mean even more work. She was already overloaded to the max, working sixteen-hour days and making absolutely no progress. None. Nada. The only things she was uncovering were more questions she couldn’t answer.
A modified virus! Goddamn it! What did that have to do with anything? Probably nothing. But she’d have to track it down and see where it led. She wondered where she’d find the time to do it.
Joanna entered the conference room. Simon Murdock was pacing around a big oval-shaped table. The blinds in the room were drawn, the phone buttons flashing on hold.
“Lock the door, please,” Murdock said in a somber voice.
Joanna turned the lock and looked over at Murdock. He had a worried expression on his face, the lines deeper than ever. “Bad news?”
“The worst,” Murdock replied. “It seems we have another cancer in the enzyme-treated group.”
“Oh, Lord!” Joanna groaned and sat in a high-backed chair. “Where is the cancer located?”
“Kidney.”
“And he had his renal arteries cleaned out with the lipolytic enzyme. Right?”
“Exactly.”
“It’s a nightmare, Simon,” Joanna said softly. “A medical disaster.”
“There’s still a glimmer of hope,” Murdock told her. “The presence of the cancer hasn’t been proved yet.”
Joanna reached for a pen and a file card. “Give me all the details.”
Murdock continued to pace. “He’s a sixty-year-old patient who had extensive atheromatous plaques blocking his renal arteries. As a result, he was hypertensive and his kidneys were starting to fail. He underwent the arterial cleansing procedure and everything reversed. He was doing wonderfully well until yesterday when he began to urinate blood. X rays show a mass in his right kidney.”
“It’s cancer,” Joanna said.
“But they haven’t proved it yet,” Murdock argued. “He’ll have surgery next week, and they’ll do a biopsy then.”
Joanna looked up from her file card. “Why the delay?”
“Because he has pneumonia from which he is now recovering.”
Joanna thought through the case again, concentrating on the patient’s renal mass. “Was the mass present in X rays done before the patient received the lipolytic enzyme?”
“They don’t think so.”
“It’s cancer,” Joanna said again. “We may as well face up to it.”
“But it’s only in one kidney,” Murdock said hopefully. “So if we remove that cancerous kidney, perhaps he’ll be cured.”
“Maybe for now,” Joanna told him. “But remember, that enzyme preparation was squirted into both renal arteries. It’s only a matter of time before the other kidney develops a cancer. That patient is sitting on a time bomb.”
“Shit,” Murdock muttered, allowing himself a rare obscenity. “And to make matters worse, this patient also sits on the editorial board of the Los Angeles Times.”
Joanna watched Murdock slump into a chair at the far end of the table. He looked like a very tired, very old man. “There’s no way you can keep this nightmare under wraps any longer. You’ll have to issue some sort of statement.”
“Saying what?”
“The truth,” Joanna advised. “Make it plain and to the point so everybody understands it.”
Murdock sighed sadly. “Another scandal at Memorial. Another black mark against our good name.”
“It would be foolish to try to cover up any of this,” Joanna warned. “That will only make it worse later on. You should tell the public exactly what we know.”
Murdock nodded slowly. “I’d like you to look at the statement before it’s issued.”
“Of course.”
“You’ll be around all day?”
“And all night.”
Joanna left the conference room, for once feeling sorry for Simon Murdock. There was no way to sugar-coat the press release. It was a medical nightmare no matter how you phrased it. Memorial had, in fact, given people cancer. It was more than a scandal. It was a catastrophe that would stain Memorial’s name for years to come.
Joanna entered the forensic reception area, poured coffee into a pl
astic cup, and walked into the laboratory at the rear. Mack and Green were gone. Lori was hanging up the wall phone.
“Guess what?” Lori asked.
“What?” Joanna asked, hoping it wasn’t more bad news.
“They found some peculiar-looking material in Edmond Rabb’s skull fracture,” Lori reported.
Joanna put her cup down, her eyes glued on Lori. “Who found it?”
“The people who did the electron microscopic study,” Lori said. “They discovered some slivers of a foreign material embedded in the fracture site. And they were able to get some of it out.”
Joanna’s mind went back to the Argonaut and the thick bottles of Coca-Cola served aboard the ship. She wondered if there were chips of glass in Edmond Rabb’s skull. “Were they able to identify the foreign matter?”
“That’s the strange part,” Lori said. “They think the material is regular old leather.”
Joanna’s eyes widened. “They zapped him.”
“They what?”
“They zapped him with a blackjack.”
Joanna reached for the phone and dialed Jake’s office number. He wasn’t in. He was attending Billy Cunningham’s funeral.
Lori watched Joanna hang up, not certain what a blackjack was. She had heard the term used but had never really seen one. “Without sounding too stupid, can I ask what a blackjack looks like?”
“It’s a short, leather-covered club,” Joanna said darkly. “It’s the perfect weapon to crack open someone’s skull with.”
16
Sara Ann Moore watched the doctor’s house from her parked car, wondering if the woman who had gone inside an hour earlier was going to spend the night. The woman wasn’t carrying an overnight case and had left her car on the street rather than in the driveway. She was probably visiting.
Bright headlights suddenly appeared in the rearview mirror. Sara quickly slumped down under the steering wheel and stayed there until the car passed by. The residential neighborhood was upper middle class and quiet, with very little traffic. There were no sounds except for an occasional barking dog.
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