Chapter 18 - Charlie's Lab Results
The windows of the big laboratory room in Soufriere stand out against the dark night like cold white rectangles. Dark outlines of growing plants can be seen lining every window. Inside, Baldwin is working late into the night, carrying on his daily battle against human death and suffering, hoping for small victories.
"There's no sign of the microbe, or anything like it, in any of these samples," Baldwin is telling his friend and colleague Zeph. "No spores, nothing. Don't get me wrong, he might be infected with it. We just aren't seeing the evidence. Very likely the evidence is confined to the brain."
"I'd have expected some evidence in the blood, at least," Zeph answers unhappily. "How about if we just send her some doses of the cure anyway? We haven't seen any side effects. Let her try it."
"We can do that, sure. I'm happy to do that for you. But we don't really know it's the same strain. Those kids live way up north, nowhere near the gulf coast where the epidemic is. It might not be the same microbe, Zeph. The cure might not work."
"His mother travels a lot," Zeph responds, "for the political campaign. She could have picked it up. He hangs around with a lot of people who travel. People associated with his mother and the campaign. A lot of them have cats, I'm told."
"Do they take their cats with them on trips?" Baldwin asks.
"I don't know. Some of them might."
"Have there been any other cases of brain malfunctions besides Charlie? It might be misdiagnosed as psychosis or a brain tumor. Maybe as Alzheimer's or a stroke."
"Hunh. Kat did mention an old woman who had a stroke not that long ago. The woman had several cats, as I recall. After she died, the campaign volunteers adopted the cats. You know, one here, one there. Divided them up."
"Was there an autopsy on the woman?"
"No. She was old, and she had high blood pressure. It was ruled a stroke. Nobody thought anymore about it."
"So, there's no chance we can get any brain tissue samples, then?" Baldwin asks, just in case there might be.
"Not unless somebody digs her up," Zeph answers, considering the unlikely idea. "It's out in the country. They don't have any public police forces out there anymore, just the private ones, except for traffic cops. I doubt a rural cemetery maintains any kind of security presence. Maybe a night watchman at most. Somebody like that might be distracted or taken out somehow. I don't know. It might be feasible, but it won't be anybody's first choice."
"Okay, what about her cats then? Any chance we could get one of those? I know your niece will think it's gruesome, but it would help us diagnose her boyfriend, maybe cure him. If she gets one, will Doug bring it down here?"
"I suppose he would. He's a pretty game guy. I suspect he might be sweet on our little Katya too. That's always a driving force."
"If the cat is alive, Doug and Kat both need to take precautions. We'll need to warn them. Warn them to make sure they don't get scratched. Don't clean a cat litter box bare-handed. Don't have a cat box anywhere near food. Don't leave clothes on the floor where the cat might do his business on them. Probably better not to pet the cat too much either, but if they do, they need to wash their hands before eating anything."
"I'll let them know," Zeph says. "You have some paper so I can write it all down? It all seems pretty obvious, but I don't want to forget any of it. Do they need medical masks, those little white face mask filters, like doctors wear?"
"No. There's no airborne transmission. Transmission is purely by ingestion or through an open wound. Touching a cat won't infect you unless you lick your fingers afterwards, or chew your fingernails, eat with your hands, prepare food with your hands, that sort of thing. Being in a room with a cat won't infect you unless food is exposed, and even then, it's only if traces of cat excrement get onto the food. It would be bad to have a cat litter box near the kitchen."
Baldwin hands over a lined yellow writing tablet and a Pilot fine point pen.
Zeph looks at him.
"Don't get scratched," Baldwin repeats, pointing at the paper. Zeph writes it down. They go through the list of precautions one by one as Zeph creates a neatly numbered list.
"The basic idea is, no contact to do with bodily fluids or excrement," Baldwin sums it up. "Don't get scratched or bitten. Keep cat and cat box away from food areas. After contact, wash hands before handling food."
"What if she does get scratched?" Zeph asks.
"Then we better hope it's the same strain we've been looking at, because we've got a cure for that."
Zeph looks down at the floor.
"We'll send her the cure anyway," Baldwin tries to cheer up his friend. "It won't hurt anything. It might not help, but then again it might. And if she's willing, she can try the vaccination on herself. It didn't hurt the kitten any. No reported side effects."
"Kittens aren't known for being careful reporters," Zeph answers. "But it's a good idea. Better than the alternative of doing nothing. When are your actual clinical trials here scheduled to start? You have that lined up now?"
"Already started. This morning, in fact. Local boy. High schooler. An islander whose mother keeps a pet cat. Checked up with a doctor for headaches and mood swings. I know a lot of the doctors around here, and they know what I'm working on, so this one picked up the phone and gave me a heads up, asked for advice. It's a little like the case in Florida. The patient goes to school, gets good grades, doesn't take drugs. And listen to this: The mom gave up the cat for analysis. My hand to heaven."
"Wow. That's a devoted mom," Zeph says, pulling his head back slightly in admiration and amazement. "It'd be great if Katya's Charlie had a mother like that!" he adds after a few seconds. "For that matter," he continues, "it'd be great if Charlie would just check up with a doctor. But the islands are different. It's all so different here. So have you, uh, analyzed the cat's brain tissue?" he ends tentatively, not sure how to phrase the brain analysis question.
"No, the cat's still alive," Baldwin says, answering what he guesses to be the underlying intent of his friend's question. "It's in a cage in the other room," he adds, pointing toward a door at the far end of the lab. "I discussed the case with the boy's doctor and we decided it'd be better if we just try the cure I have now first. In all the samples from the islands, from the whole Gulf of Mexico area, we've only seen one strain of the parasite."
"The thing I do want to do with the cat, though," he continues, "is check the bodily fluids and tissue samples that I can get without killing it, so we can try to find non-lethal tests for the pathogen, apart from feces samples. Something that might be applicable to humans as well. I'm getting the hospital to collect a lot of samples from the boy too. After that, well, if the boy has cancer, they'll treat for that, and I'll give the cat back to the mom. If the boy has the infection we're targeting, and he responds to the cure, then I'll cure the cat too and, again, return the cat to the mom. If the boy doesn't respond to any treatment, that's when I'll have to analyze the cat's brain tissue."
"Can't you do a, uh, brain biopsy of some kind?" Zeph wonders. "Get a sample of brain tissue without killing it? Because that could also be done on people."
"Probably could. I talked to a brain surgeon about that today. He says they can do brain biopsies to diagnose brain cancer, but it's an expensive procedure. First they do a scan to locate the tumor, then they do the biopsy. I don't want to waste government money on a brain scan of a cat. And without it, we wouldn't know where to take the sample. Think of it this way: If you had a wart on your left big toe, and I took a tissue sample from your toes at random, maybe the toe next to it, maybe even the pinky toe," He stops to gesture at Zeph's left foot, to help him imagine the situation. When Zeph looks down at his foot, Baldwin continues, "Well, I probably wouldn't find anything. Unless you had another wart that just happened to be starting to develop on that other toe. You see the problem?"
&nbs
p; "Yeah, I do. Hunh," Zeph responds. "So you could do brain scans?"
"I could get them done. That would tell us there's a tumor or growth of some kind in the brain, and where it is, if the growth is big enough. But the growths we're looking for might not be that advanced yet, so they could be too small to spot. The boy was scheduled for a brain scan today, by the way. He's probably already had it by now. I got the government to pay for his treatment, since he's agreed to participate in clinical trials. This kid must be a genius, or super sensitive or something. I mean, the boy was coherent enough to realize he had a problem and then walk himself to a doctor. Or maybe it's just the family structure here. Very close knit. The mom or dad might have spotted it, and the kid listened. This kid has even given his mom medical power of attorney. And since she turned over her cat, we know the mom cares. So this is a perfect setup for me, from a clinical trial point of view. I may have actually gotten hold of a case in its early stages. Anyway, after the brain scan, if they find anything unusual, then they'll do a biopsy. I'll finally have access to brain tissue samples from a living victim in the early stages of infection. Meanwhile we treat with what we have. Especially because our treatment is harmless. If it turns out to be cancer, if he has an ordinary cancerous brain tumor, well, cancer treatments can be pretty debilitating."
Baldwin pauses.
He looks at Zeph for a studied minute before bringing up Zeph's own problem. "Charlie could have a brain tumor, too, you know," he suggests, not for the first time. "Has Kat taken him to a doctor yet?"
"Charlie won't go to a doctor," Zeph answers. "Thinks there's nothing wrong with him. He doesn't have headaches, apparently, and he doesn't acknowledge the mood swings and aberrant behavior. His mom thinks the change is wonderful: Now he works together with his mom on the political campaign! She's delighted. So, we treat with what we have?"
"Yeah. We'll send Katrina what we've got. In fact I already packaged it up for her this morning," Baldwin says, walking over to nearby cabinet and pulling out a small linen shopping bag. Inside the bag is a decorated metal tea canister with a red and gold Oriental design. Nestled next to it is a small red-tinted screw-top jar made of translucent plastic on the outside, lined with clear glass on the inside. The jar contains a few sugar cubes. Inside the bag, next to the jar and the canister, sits an Oriental-style combination teacup and individual teapot, the kind used to prepare a hot drink for one person from loose tea. The bag smells like spiced tea. Baldwin has in fact soaked it overnight in a strong spiced tea infusion, to permeate it with the smell, in case a Coast Guard dog might notice it. A sniffer dog search is an unlikely scenario, not just because of funding cutbacks, but because such dogs are trained to detect specific drugs. The herbal cure won't be on that list yet. Baldwin is careful and thorough by nature, though, and he has taken the extra precaution.
"Here," Baldwin says, handing his friend the bag. "Doug can take it tonight. Call her and let her know what's coming, what the precautions are. The sugar cubes are the vaccine," he says, picking up the sugar cube jar as if for illustration. "Have her take one of those herself immediately. If it works, it should prevent her from contracting the disease. She should take a second one a week later. Sort of a booster. I've included a few extra sugar cubes in case she wants to immunize anyone else close to her. Obviously it's too late for her boyfriend. He'll need the cure. The vaccine won't last much longer than a week unrefrigerated, maybe ten days, so tell her to use it right away."
Baldwin puts the sugar cube jar back into the bag. He picks up the tea canister and holds it at eye level. "The cure is a different matter," he says. "Anybody already infected can only be saved by the powder in this tea canister. That's our cure. Distilled essence of Azacca's powder with a few added enhancements of my own. And I don't know the shelf life on that, though heaven knows I've added compounds to try to increase it. A quarter of a teaspoon twice a day is the best dose, if she can get it into him. Once a day is probably enough, but it'll take longer to work. How long it will take also depends on how advanced the growths are, and how strong his immune system is. If the cure doesn't cure him, she needs to get him to a doctor to scan for a brain tumor. Those kids are way outside the known geographic range of this epidemic."
"The known range, yeah," Zeph says, taking the bag. "But that's the thing about epidemics, isn't it?" he adds. "They spread."