Dying to Remember
Page 30
He had nearly reached the bathroom mirror when he looked back at the bed and, for the first time, realized Elizabeth was gone. Her work schedule was usually lighter than his, but she sometimes got up early and left for the hospital before he did, almost always without waking him. Apparently today was one of those days.
He wondered when she would be back.
Epilogue
The November 1987 outbreak of domoic acid in mussels killed three people and left a dozen with permanent memory impairment. As a result, officials in Canada took measures to reduce the risk of a recurrence of poisoning by shellfish contaminated with domoic acid. Batches of mussels are labeled with their location of origin, and before commercial distribution they are spot-checked by laboratory tests for the presence of domoic acid. The last reported case of poisoning by domoic acid in Canada was December 1987.
In September 1991 the first reported marine outbreak of domoic acid in the United States occurred in Monterey Bay, California. Hundreds of cormorants and brown pelicans were found dead or dying, and analyses of their stomach contents revealed anchovies containing domoic acid. Analyses of mussels from Monterey Bay also revealed domoic acid.
Within two months another outbreak traced to razor clams afflicted twenty-one people in Washington State, and shortly thereafter, domoic acid appeared in Dungeness crabs along the coast of Oregon and Washington and in other edible marine species in the Gulf of Mexico.
Despite these events, the United States government did not institute federal regulations mandating routine testing of shellfish or other seafood for domoic acid.
To date, there is no antidote.
Bibliography
Anonymous. “Domoic acid intoxication.” Canada Communicable Disease Report 18, 15 (1992): 118–20.
Department of Fisheries and Oceans, Canada. “Fish inspection regulations—amendment.” Canada Gazette. Part I. Ottawa, Ont.: Government of Canada, April 29, 1989: 2145–8.
Dickey R. W., Fryxell G. A., Granade H. R., and Roelke D. “Detection of the marine toxins okadaic acid and domoic acid in shellfish and phytoplankton in the Gulf of Mexico.” Toxicon 30, 3 (1992): 355–9.
Gjedde A. and Evans A. C. “PET studies of domoic acid poisoning in humans: excitotoxic destruction of brain glutamatergic pathways, revealed in measurements of glucose metabolism by positron emission tomography.” Canada Diseases Weekly Report 16, S1E (1990): 105–9.
Kizer K. W. “Domoic acid poisoning.” Western Journal of Medicine 161, 1 (1994): 59–60.
Perl T. M., Bédard L., Kosatsky T., Hockin J. C., Todd E. C. D., and Remis R. S. “An outbreak of toxic encephalopathy caused by eating mussels contaminated with domoic acid.” New England Journal of Medicine 322, 25 (1990): 1775–80.
Squire L. R. Memory and Brain. Oxford University Press: New York, 1987.
Teitelbaum J. S., Zatorre R. J., Carpenter S., Gendron D., Evans A. C., Gjedde A., and Cashman N. R. “Neurologic sequelae of domoic acid intoxication due to the ingestion of contaminated mussels.” New England Journal of Medicine 322, 25 (1990): 1781–7.
Todd E. C. D. “Domoic acid and amnesic shellfish poisoning—A review.” Journal of Food Protection 56, 1 (1993): 69–83.
Wekell J. C., Gauglitz E. J. Jr., Barnett H. J., Hatfield C. L., Simons D., and Ayres D. “Occurrence of domoic acid in Washington state razor clams (Siliqua patula) during 1991–1993.” Natural Toxins 2, 4 (1994): 197–205.
Wright J. L., Bird C. J., de Freitas A. S., Hampson D., McDonald J., and Quilliam M. A. “Chemistry, biology, and toxicology of domoic acid and its isomers.” Canada Diseases Weekly Report 16, S1E (1990): 21–6.
About the Author
Glen Apseloff won first place at the international SEAK medical fiction competition for his novel Dying to Remember. He is also the author of the medical thrillers Overdose and Lethal Cure. A medical doctor with expertise in drugs and toxins, he draws on his clinical experiences and training to generate ideas for his novels. He is also a nature photographer who has published numerous calendars and two books: Backyard Birds—Looking Through the Glass and The Chipmunk Book. He lives in Ohio with his wife, Lucia.
If you liked Dying to Remember, please check out these other medical thrillers by Glen Apseloff
Overdose
Dr. Emily Morrison undertakes a controversial drug study over protests from fringe groups and even some colleagues. Soon she’s facing death threats and a letter bomb that maims her secretary. Then a young coed suddenly dies after taking the experimental medication. Emily figures out what killed the girl—not the study drug but DIFP, a toxic chemical from her lab. A diabetic, Emily discovers the same toxin in her insulin. But when the police find a bottle of DIFP in Emily’s office, she suddenly changes from victim to suspect.
Then a professional killer comes after her, eliminating anyone who gets in the way. Emily knows she must confront this stalker on her terms, but she’ll have to do it without help, using only the element of surprise. And that’s just her first step in uncovering the truth—she needs to find out who hired the killer before someone else tries to finish what he started.
Lethal Cure
On his last shift in the emergency room, medical resident Jake Warner is looking forward to a change of pace. But then a teenage girl hobbles in on the stump of an amputated leg, collapses in his arms, and dies. She leaves behind a handbag with a barely legible diary of dreams. Haunted by his inability to save the girl, he photocopies the diary, hoping to discover why their lives intersected.
The more Warner learns about the diary, the more he realizes that nothing is a coincidence. Even as he moves on to a psychiatry rotation—where a patient dies unexpectedly and where he somehow forgets the events of an entire day—thoughts of the girl, and her diary, linger. In need of a break, he pools his vacation time and travels to Italy. There, he falls in love. He figures out the connections among the deaths, the diary, and his forgotten day, but too late—everything he has learned is erased. His last hope is to reconnect with the woman he loves across a void of lost memories. Only then can he reveal the true cause of his patients’ deaths, and save himself.