by Angela Hunt
Looping the damp towel around his neck, he carried another bottle of water through an adjoining corridor that led to a courtyard. Though the sun beat mercilessly upon the garishly painted concrete slab that passed for decorative pavement, the area was at least fifteen degrees cooler than his oven of an operating room. His operating theater, if one could call it that, was a windowless room with an operating table at the center, a single light overhead, and not even a fan to move the stultifying air. Michael had perspired profusely during the entire procedure, soaking his scrub suit, surgical gown, and cap.
He had scrubbed up under conditions that would horrify his colleagues in Britain (a bucket of water served as a sink because no water flowed into the hospital after 7 A.M.) and operated in a sauna that would compel less demanding surgeons to resign in protest. He had been assisted by one unsuperstitious orderly, two surgical nurses, and one anesthesiologist. He had cut with a scalpel that had obviously seen sharper days, and he was certain the cloth covering the operating table had not been changed since the previous procedure that morning.
Most surprising had been the conclusion he’d reached after opening the wound—his patient’s abdomen had been pierced by some type of spear, most likely a sharpened stone, for Michael had pulled flakes of chipped rock from the peritoneal cavity.
The presence of rock fragments made him lift a brow. There was no rock in this part of the Amazon. The stones used by the Indians for cultivating crops, sharpening machetes, and grinding food were purchased from a “stone man” who gathered his stones near his home in the foothills of the Andes, then traveled downriver selling his wares. So this man had either been injured by a weapon carved of relatively rare rock . . . or he had come from some part of the jungle far away from Iquitos.
He’d wager a decent shepherd’s pie that none of his mates at St. George’s Hospital in London would treat a stone-spear wound in the entire length of the coming year.
Michael pulled off his cap, then shook his head and ran his fingers through his wet hair. A medical practice at the jungle’s edge kept life interesting . . . and kept his thoughts occupied. Which was the entire point of his being in this godforsaken place.
He flinched when Fortuna interrupted his reverie by slamming the exit door against the concrete wall. “El doctor! The patient is awake.”
Michael glanced at his watch. The man had recovered from the anesthetic rather quickly, but the anesthesiologist might not have administered the proper dosage.
He stood and walked toward his nurse. “Is he in pain?”
“No se, Doctor. He is talking, but I cannot understand him.”
Michael frowned. “He does not speak Spanish?”
“I believe he is speaking an Indian dialect. I do not recognize it.”
Michael exhaled as he led the way to the postoperative ward. The man could be babbling nonsense in his pain, but if he could communicate at all, they needed to ask for his name and the name of his nearest relative. As the anesthesia wore off, perhaps one of the hospital staff could find a way to communicate with the unlucky fellow.
The patient lay on a gurney in the postoperative ward, his hands loosely bound by restraints to prevent him from disturbing the dressing. Michael leaned over the man and checked his breathing, then noted the blood pressure on the chart. An IV next to the bed dripped cefoxitin— the strongest antibiotic available in this place—into his veins.
Michael leaned over his patient when the man’s eyelids fluttered. “ ¿Senor? ¿Está usted en dolor?”
The man’s lids opened to reveal hazel eyes, a color Michael had never seen among the native peoples. For an instant the patient’s body tensed in an atavistic flee-or-fight reflex, then he closed his eyes, relaxed against the restraints, and began to mumble in a low monotone.
Michael listened a moment, then turned to Fortuna. “Is he speaking Yagua?”
She shook her head. “I do not think so.”
“Is anyone around here fluent in the native dialects? If this man has relatives, we’ll need to find them as soon as possible.”
“Un momento, el doctor. I will ask.”
Fortuna spun on the sole of her sneakers, then disappeared behind the curtained divider. While she searched, Michael checked the man’s vital signs and his urine output, then leaned over the bed railings to listen to the native’s mumbling. Three years in Peru had improved Michael’s Spanish to the point where he could usually follow the thread of a conversation, but these words bore no resemblance to the Spanish spoken in every Peruvian city and most of the Indian villages. This could be Yagua, Witotoan, or one of three hundred other Indian tongues, but those languages had nearly died out except in the native villages.
The man was definitely speaking something, though, and it didn’t sound like gibberish. He seemed to be chanting, perhaps even singing . . .
Fortuna came around the curtain, followed by a dark-haired woman Michael had seen in the administrator’s office. “This is Esma,” Fortuna explained offhandedly. “She speaks Yagua and English.”
The tip of Esma’s nose went pink as she looked at the tattooed man in the bed. “I did speak Yagua,” she said, meeting Michael’s gaze. “When I lived with my parents. But that was a long time ago.”
“Please.” Michael gripped the side rails of the bed. “He came from out of the jungle, and his prognosis is not good. See if you can discover anything that will lead us to his family.” Straightening, he turned to Fortuna and lowered his voice. “We’ll need to watch him carefully for the next twelve hours.”
Esma moved toward the head of the bed, then leaned on the railing and whispered a greeting in a tongue Michael had never heard. At the sound of her voice the patient’s eyes flew open, bewilderment creasing his lined face.
Glancing up at Michael, Esma asked a question—presumably about his family. The patient stared at Esma a moment, shifted his eyes to Michael and Fortuna, then began to speak in abrupt, hoarse tones, his voice cracking with every word. When he paused to cough, frothy, bloodtinged sputum tinged his lips—a sign of adult respiratory distress syndrome. A patient who developed ARDS would not likely last the night.
“Has he a name?” Michael raised his voice to be heard above the man’s coughing. “A wife? Someone we can call?”
Esma cut Michael off with an uplifted hand, then repeated the question. Confusion filled the patient’s eyes, then he released a stream of flowing words that did not slow even when Esma turned to Michael.
“The language is not Yagua, but it may be related. I do not know all of the words, but I think I may be able to understand some of what he is saying.”
Michael crossed his arms. “Has he family nearby? That is the crucial thing.”
The translator showed her teeth in a humorless smile. “Patience, Doctor. He seems intent on telling me a story. Every time you interrupt, he begins again.”
“That’s lovely,” Michael answered, his voice coagulating with sarcasm, “but I need to know about his next of kin now. We may have to send someone downriver.”
Esma gave him the pointed look he always received when he inadvertently committed a cultural blunder. “He did not answer me, Doctor, and I think I know the reason why. You will not need to send for anyone.”
Michael closed his fist around the bed railing. “And how, exactly, would you know this, seeing that he has not spoken a word that makes any sense?”
Lifting her chin, Esma spoke with quiet firmness. “He will not give me names, Doctor, because the jungle tribes consider it evil to speak the names of their loved ones . . . particularly those who are dead.”
1 APRIL 2003
2:20 P.M.
Aheadache had begun to hammer on Alex’s optic nerves by the time the sun stood directly overhead. Not wanting to be the first to suggest it was time they descended, she sipped from her water bottle, ate the oily peanut butter sandwich in her backpack, and sweated away her sunblock. The wide-brimmed straw hat she wore provided some shade, but already she could feel her shou
lders and arms burning.
Two more hours passed before Kenneth Carlton announced that it might be time to descend. Olsson, who had been hanging by a rope from the platform edge, climbed back onto the raft and seemed surprised to discover that his teammates had wilted in the blistering heat.
“We are ready to call it a day?” he asked, looking around.
“More than ready,” Baklanov called, winking at Alex. “You have been in the shade for the last hour. We have been sizzling like—how do you say it?—eggs, sunnyside up.”
“The lodge is supposed to send someone to pick us up,” Carlton added. “I expect the man is down there waiting.”
“All right, then.” The Swede pulled a handkerchief from his pocket and wiped his neck. “Shall we let the ladies go first?”
Alex had assumed Lauren Hayworth would want to be the first to leave the platform, but that whimpering beauty developed a sudden interest in some odd berries her employer had collected. Deborah Simons probably wouldn’t have minded leading the way, but she was trying to coax a recalcitrant grasshopper into a specimen jar.
Drawing a deep breath, Alex crawled toward the porthole. “I’m ready.” She unsnapped the carabiner that held her to the safety rope. “Hook me up and send me down.”
The descent from the canopy raft was less taxing than the climb, but easily twice as frightening. “Abseiling,” Olsson had told them, “is as easy as falling out of a tree.”
Battling the heat and her headache, Alex scooted to the porthole’s edge and peered into the thicket below. This was not a tree from which she wanted to fall.
Olsson handed Alex a metal piece resembling a figure eight. “Remember how it’s done?”
“Barely.”
The corner of his mouth quirked in a grin. Apparently she wasn’t the first researcher to experience blank-brain on the edge of a leafy precipice.
“Hook this whale’s tail to the carabiner on your safety harness.”
When Alex hesitated, he reached out and attached it for her.
“Hold on to this rope with both hands.” He snapped a rope against her gloved palm. “Ease yourself into the opening, and release the rope slowly. If you let go, you will fall. Do not release the rope too quickly. But do not worry; you will get a feel for the proper pace. Let the rope slide between your fingers, and your body weight will carry you down.” He paused to mop his neck, then gave her a lopsided smile. “You can do this, yes?”
“Of course I can.” Moving with more confidence than she felt, Alex swung her legs into the porthole and gratefully eyed the thick green screen blocking her view of the forest floor. She could almost convince herself she was preparing to travel only a few feet. . .
Olsson wriggled his fingers in a farewell. “Away with you, then. The rest of us are ready for food and drink!”
Alex pushed off from the canvas, then caught her breath as the rope bobbed with her weight. Dangling in the center of the porthole, she moved her right hand below her left, releasing about six inches of rope, and felt her stomach lurch as she slid a corresponding number of inches downward. Yesterday she had glided out of the practice tree, content to know solid ground lay only a few feet away.
“Twinkle, twinkle, little star, how I wonder what you are.”
She would not panic. She had no reason to fear. She would calm her pounding heart with slow, steady breaths and clear thinking.
Besides, what difference did the distance make? She had only to move a few inches at a time. Gathering her confidence, she lowered herself through the canopy, moving through vines, branches, and leaves she had scarcely noticed on the ascent. A group of chattering marmosets scattered at her approach while a toucan watched with interest from only a few feet away. Holding her breath, Alex glided slowly past them.
She traveled by less attractive animal forms as well. A muddy wasp’s nest stretched along one side of the tree’s wide trunk, a monstrous formation over six feet tall and four feet wide. Alex’s pulse quickened as she glided past the mound—one wrong sound or scent could agitate the insects.
“Up above the world so high, like a diamond in the sky. . .”
She heard herself gasping and paused to focus her thoughts. She would not panic. She could not panic, not here. She would think about the tree, about the strangler fig, which, according to Olsson, was a miracle of nature.
She removed her right hand from the rope, placed it below her left, and felt the rope slide beneath her gloves. Again, this time left hand under right.
Good. She was making progress. And her muscles were perfectly obedient.
She kept moving as Olsson’s voice replayed in her brain. Just this morning he had told them they were about to climb one of the most amazing trees in the jungle. Stranglers did not grow from the ground up, but from seeds dropped by birds onto the branches of other trees. A seed that managed to sprout on the branches of a stronger tree would send out tendrils and roots that eventually surrounded the host tree’s trunk and tapped into its water supply. As the host tree struggled to survive the invasion, the strangler kept growing, sending roots down to the earth while new branches and leaves shot toward the canopy and the life-giving sun. Eventually the old tree died, entombed by a parasite that had proven itself more adaptable to the climate.
“Nasty old tree,” Deborah muttered.
“Do not think of the strangler fig as evil,” Olsson had said, laughter in his voice. “It is only doing what it has evolved to do. And it benefits so many other life forms—its tangled roots and trunk offer shelter for an astounding variety of plant and animal life.”
Alex could see several of those life forms now. With the wasp’s nest safely overhead, her gaze fell upon a group of orchids and bromeliads scattered along a branch. Epiphytes flourished in the treetops, absorbing nutrients and water through fingerlike roots that stretched over limbs and sought out resting places in natural crevices. Brilliant blossoms of orange, white, and purple spangled the emerald canopy, and for an instant Alex felt the vague stirring of jealousy. If urgent personal concerns had not propelled her into neurology, she would have enjoyed botany.
Chalk it up as another of life’s cosmic pranks.
Trying to think about anything but the fact that her life depended upon a rope and a safety harness, her mind flittered over other jokes the universe had deigned to play on her. Her genetic heritage, for one. Her fatherless childhood, for another. The orthodontia she’d been forced to wear for four years while all her girlfriends were out of braces within twenty-four months, and her penchant for books, which in high school had repelled every teenage American male within ten miles.
She tightened her grip as her memory drifted toward her college years. Oh, the men had come around then—but they’d only wanted sex and/or information. Could she type a paper . . . and spruce it up a little? Could she do a little extra research while she was at the library? Gee, baby, if you love me, you’ll look up this one little thing . . .
One young man, however, had been quite capable of doing his own work . . . and little else. In medical school she had married teaching assistant Collin Wilt within days of finding out she carried his child and divorced him within weeks of discovering he cared more for his career than for her and the coming baby. She signed the no-fault divorce papers on Caitlyn’s one-month birthday, then kissed her daughter’s downy head and swore they would be okay. She’d reclaimed her maiden name, her room in her mother’s house, and her lifelong dream of going into research, only to find her dream shadowed by a pressing urgency—the doctors had diagnosed her mother with fatal familial insomnia, a genetic and fatal brain disease.
During the eighteen months of her mother’s illness, Alex read and researched and wrote countless letters to scores of other scientists working in the field, but whatever cosmic joker ruled the universe won the race against time. After her mother’s death Alex mourned her loss, tried to care for Caitlyn, and went back to her work, this time for her daughter’s sake.
Now she was convinced the in
fective agent that caused her mother’s disease was like a strangler fig—it had entered her mother’s tissues and begun to grow, slowly and steadily. It had entered Alex’s tissues, too, and probably Caitlyn’s.
With every passing day she became more convinced that FFI was not inherited—at least, not in a genetic sense. Studies of several types of prion-induced diseases had demonstrated that the infective agent could be transmitted orally, surgically, or through other means of ingestion. Surgeons had unknowingly passed it from one patient to another by the use of metal probes in neurosurgery; the agent had also been transmitted by the injection of human growth hormone derived from biological sources. Kuru, a prion disease found in New Guinea, spread through cannibalism, and every scientist in Europe now understood that cattle afflicted with mad cow disease had spread prions to dogs, cats, pigs, sheep, and humans. Prions had probably infected chickens, too, but the birds didn’t live long enough to show signs of the disease.
Prion diseases required time to develop . . . and the length of the incubation period depended upon the strain of disease being transmitted. For years researchers had assumed that fatal familial insomnia was the result of a genetic mutation among family members, but Alex believed the situation was far simpler—the prion that caused FFI passed from mother to child through the placenta in utero. Children did not become symptomatic for thirty, forty, or fifty years because each person’s metabolism functioned differently. Researchers had noted that stress seemed to hasten the onset of FFI, but perhaps the disease gained the upper hand because an individual’s immune system weakened during trying times, allowing the prions greater freedom to multiply. And if stress was an accelerant, she shouldn’t have been surprised a few weeks ago to find herself experiencing tingling limbs, panic attacks, and sleeplessness . . .
No. If Alex could help it, the cosmic joker would not have the last laugh this time.
“Twinkle, twinkle, little star . . .”