Silent Fear, a Medical Mystery (27 page)

Danny expressed his joy for her with a laugh. “Look at you. Braces gone. Your teeth look spectacular, like you.” He realized she had recently backed off the tomboy look just a bit.

“Thanks, Dad,” she said, “and thanks for getting them for me in the first place.”

The waitress came with their drinks, scribbled Sara’s order first, and went on to the others.

“Sara,” Danny said in a low tone, appreciating her orange ginger aroma, “besides your new job, how did your date go Saturday night?”

Sara hesitated. “I am so happy to be back teaching, you have no idea.” She wiggled her beaded necklace for Julia’s amusement. “And my date? He’s a nice man.” She paused and a small smile crept over her face. “Actually, I was going to call you tonight. Thank you for the flowers. They are lovely.”

“I’m so glad you liked them.” Danny’s eyes softened. He hoped she wouldn’t be going out with the principal again.

“So what happened, Danny?” Mary asked. “Did he have good news?”

“Oh, not good news. Fantastic news.” He sat Julia on the table in front of him, holding her hands. “I will keep Julia all the time, except for Rachel’s supervised visitation every two weeks. I’ll fill you in later with details, but that’s the gist of it.”

Mary sat dumfounded while Casey raised his glass in congratulations. Sara smiled at Julia, who stared at Sara’s double strand of beads. The girls chirped in. “Guess I can make extra money babysitting,” Annabel said, “when you need someone extra, Dad.”

“Hey, I can help, too,” Nancy pouted. “That’s great, Dad. Julia has a better family with us than whoever she’s been with.”

“That sure blew up in Rachel’s face,” Casey said.

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On Wednesday, Joelle opened her drapes to a pretty morning. The rising sun beaming on the scattered, departing clouds from the day before deflected color on the horizon and up into the sky. She smiled because of her condo’s view, at least it was something to make up for her asphalt
city life.

Today she anticipated the big PAM meetings the team would conduct in the afternoon, first amongst themselves and then with the media, so her choice of clothes was carefully planned. She slipped on a burgundy dress with pewter-looking buttons down the front and pulled on a belt as an accessory. She slipped on a pair of sandals with very little height and a pair of amber and silver earrings. Then she pinned a small crystal fruit cluster brooch on the lapel of her dress.

As Joelle put together paperwork for her brief case, her cat jumped onto the top of the desk. She stopped sorting her things, and scratched Bell under her neck. “You’re a sweetheart. I’m glad you don’t belong to the medical campus.” Joelle gave her another swipe and left for the big day.

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After routine catch up with her ongoing research work, Joelle examined the previous PAM work she had started before the canine contributions. She made notes and went over twice to the young student by the window, who assisted her for the day. Results so far, except for the ray of hope with the dog saliva or enzyme penetrating the organism’s outer wall, proved to be futile. When would the incidence of PAM breakouts stop? When would its morbidity and mortality be put to an end by medical miracles stemming from a lab?

Rhonda showed up at noon, sacrificing her own lunch time to evaluate Joelle’s plates and slides and offer any suggestions. She popped to the lab door with all the enthusiasm of a fifth grader and began donning a mask. Joelle turned around. “You changed your nose ring, I see.” She frowned. “Less conspicuous. I like it better.”

“That’s what everyone says,” Rhonda said. “Hardly anyone comments about a woman’s bracelet, or necklaces, or earrings, but everyone notices nose rings. I think I’ll start a company to market and sell them.”

Joelle grinned. “If pet rocks were a big thing, you may have something there.”

“Yeah, think of the cool possibilities. Nose jewelry mimicking cat whiskers and elephant tusks. The more bizarre, the better.”

Joelle’s eyebrows rose. “Will you stay in veterinarian medicine and research?”

“Hell, yeah. You have to have a real day job.”

“Good, glad to hear it. You had me worried for a minute.”

Rhonda started glancing at Joelle’s table for slides. “I’m about ready to put them on the scopes,” Joelle said. “I have in order here sample four, five, and six. The beagle, Labrador retriever, and greyhound.”

“I thought you were also doing Dr. Tilson’s dog that dunked his tongue into his wound?”

“I did, but I didn’t get it until a day later, so it’s not ready yet.”

“And why do you have two sets of each sample again?” Rhonda asked.

“This first row is the new dog’s saliva simply put with the organism. So we’ll see if the saliva’s contents wormed its way through the wall, like the Newfoundland’s did. The second set is where I have injected the saliva into the organism, to see what it does then.”

“Obviously you’re hopeful one of them will destroy the amoeba from inside,” Rhonda said.

“Precisely.”

Joelle put the first set under the stage clips on each microscope to hold the slides in place. She then peered through the scopes from left to right with Rhonda following her lead. “Wow,” Joelle said, standing straight and speaking fast. “None of these dogs’ saliva penetrated the amoeba like the Newfoundland’s.” She tightened her lips, wishing she could change the results.

“”This isn’t good,” Rhonda said. “But at least we’ve had one that did.”

Joelle took the slides off and clipped on the next three, where the samples had been microscopically inserted into their killer creature. She went around Rhonda and again started on
the left. Joelle focused with both the coarse and fine adjustment knobs. All she stared at was an intact trophozoite amoeba – inside and out.

“I guess a beagle is no good to us,” she said. Rhonda also looked and nodded in agreement. Their theories were going out the window.

Joelle went to number five, the Labrador retriever. The exterior of the eyepiece had a fleck of dust so she reached for a lens cleaner and smoothed the cloth over the glass. The two ladies frowned at their dismal attempts to get results.

Leaning over again, Joelle peered down at a hazy slide, so she fine-tuned the knobs. Finally, her picture looked crystal clear. She held her breath, stood up and rubbed her eyes, and looked again.

Joelle let out a gasp. “Another mother of pearl,” she said.

Chapter 25

Joelle’s arms broke out in goose bumps. She stood tall, squared her shoulders and smacked Rhonda’s upper arm. “Look at this!”

Rhonda viewed the slide. “Damn, Joelle, that saliva has decimated the cytoplasm. And it’s made mince meat of the nucleus.” Taking her eyes off their work, she looked at Joelle with wide eyes. “This is fantastic!”

Joelle bit her lip. “Wow. In vitro we’ve killed this brain-eating amoeba. Now we have to combine what the Newfoundland’s saliva did by getting into the cell with what the Labrador retriever’s saliva did once it was inside.”

Rhonda’s hair along her arms stood on end. She pushed her blonde bangs away from her preppy glasses, walked a few steps and turned abruptly. “So we don’t have Dr. Tilson’s dog done yet?” she asked absentmindedly.

“No, we’ll check on it by tomorrow.”

“And what breed did you say it was?”

“I didn’t.”

A smile crept over Rhonda’s face. “Pray, do tell me.”

“A Chesapeake Bay retriever.”

“Hot dog.” Rhonda said. “I have a crazy idea. But I just don’t know.”

“Rhonda, you know what Albert Einstein said, don’t you?”

Rhonda stared at Joelle, a blank expression on her face.

“If at first the idea is not absurd, then there is not hope for it.”

Rhonda nodded. “Thanks,” she said. She turned and started towards the door.

“Where are you going?”

“To get you more saliva from Chessie’s other than Dr. Tilson’s.” She turned with a huge smile. “If my suspicions are correct, I’ll pierce your nose if you want.”

“No thanks,” Joelle said. But Rhonda had already disappeared into the hallway.

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Late in the day, the conference room came alive on the upper administrative floor outside Robert Madden’s office. All the major physician and nurse players broke from their other duties and patient care. Everyone made sure their beepers were set correctly so any nursing calls about meningoencephalitis patients would come through during their absence. They wanted the most up to date information before heading into the news conference to follow. Joelle came in last, scurrying in her flat sandals and lugging her brief case. She had received six pure breed samples from Rhonda before leaving the lab and had quickly gotten them processed. Rhonda had procured them from both the vet school and a dog breeder she knew who bred several large pedigrees on the outskirts of Nashville.

Ralph looked like a tired, jet-jumping business man, not like a non-clinical physician from the CDC. His receding hairline had taken the next row of seats. “All right, y’all,” he said standing in front of Robert Madden at the head of the table, “we’ve got to push on downstairs where the national news media wants information to make ‘em stuffed as a hog. Since we’re standing in the hospital where the outbreak started, our info has to be right off the press.” He looked back at Robert Madden, the poor CEO who’d been standing up to a stiff board of directors, news media, and patients’ families since the whole mess started. Robert grinned back at Ralph, jammed his hands into his pockets, and prayed there would be no major surprises.

As if his fingers were too heavy, Ralph rested them in his suspenders. “I have today’s numbers,” he said with utter annoyance. “This damn amoeba is running rampant faster than a scalded dog.”

Joelle elbowed Danny, who was sitting beside her. “Funny he should mention a dog,” she said. “I’ve made some progress with in vitro experimentation, but need to bring the two parts to work together.”

Danny nodded. “Sounds hopeful?”

“Perhaps. But then even if we get somewhere…”

Danny nodded again. “I know. Then there’s the problem of applying it to humans.”

“Precisely.”

They kept their voices low as Robert took the floor and announced their admission stats on meningoencephalitis patients.

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On the ground floor, Robert Madden, Ralph Halbrow, Pamela Albrink from nursing, and the team of doctors single filed between the rush of reporters outside the meeting room. A stream of questions bombarded them as well as flashes from cameras.

At the front of the room, two young technical men helped their CEO with a microphone. Robert cleared his throat. “Thank you all for coming. Today I have assembled everyone from this hospital who has been directly involved with our cases of PAM - either patient care or research to find a cure. We also have Ralph Halbrow from the CDC in Atlanta. First, for those of you who don’t know him, Dr. Danny Tilson is one of our neurosurgeons. He was responsible for our source case and involved with the initial diagnosis. He has a recent development which we didn’t break yesterday since the family situation was a bit precarious.” Robert handed Danny the microphone and stepped aside.

“As previously reported, the first case which sprouted this outbreak came from a fourteen year old named Michael Johnson. Michael came in on a Sunday, seventeen days ago. It is with great sadness that we are reporting Michael’s death yesterday.”

Reporters pushed forward, hands waving in the air, and camera clicking noises competing with each other.

“What about that length of time? Wasn’t that longer than other PAM patient hospitalizations?” a reporter said clearly over the others.

“Yes, Michael’s sixteen days of survival after contracting PAM is the longest so far. Perhaps his age had something to do with it. Michael received the same treatment as other patients. And those antibiotic treatments continue to fail.”

“What were the circumstances under which Michael came to the hospital?” a man asked with a camera crew close by.

“He hit his head on a boat console while boating with his family. I did surgery on him because he had an acute subdural hematoma. However, something else was going on with Michael and he became the source of a rapidly disseminating infection. He acquired the sinister organism from jumping off a cliff into Center Hill Lake. The fresh lake water carrying the amoeba was forced into his nose, which can penetrate the brain by this route.”

“Does this organism only live in that lake?”

“No,” Danny said. “First, it only thrives in fresh water. It is widespread. It is the mode of transmission which is important. Like most of us, little did Michael’s family know this.”

“Why isn’t modern medicine helping us out here?” a tall female with a small name tag asked. “Is there any progress regarding a cure?”

“I’m sure Dr. Ralph Halbrow has an update.”

Ralph leaned over and said, “We continue twenty-four hours a day at the CDC in Atlanta to discover a treatment. So far, I have nothing substantial to report.”

“Dr. Joelle Lewis struck a small ray of optimism today,” Danny said. “I’ll let Joelle say a word about that.”

Joelle stood next to Danny and took the mike. “I have nothing concrete to tell you. Just a researcher’s gut feeling that we’re working on in the lab. We’ve made two small, yet highly significant independent steps at disarming this organism.”

“Dr. Lewis, don’t keep it to yourself,” a burly reporter said. “Tell us anything nonsubstantial as well. Is it a break-through antibiotic or what?”

“No.”

“Then what’s causing your gut feeling,” he said, despite other reporters clamoring with their own questions.

Joelle sneaked a peek at Danny and grinned. “Dog saliva,” she said.

The reporters indistinct mumbles sounded throughout the room and a throng of reporters yelled out their questions. “That’s really all I can tell you right now,” Joelle added.

Ralph took the microphone from Joelle. “Ladies and gentlemen, y’all will have to let Dr. Lewis answer questions at a later time, when she gets more facts.”

Things quieted down and Ralph continued. His tone turned pensive. “I have today’s CDC numbers to report. Nationwide, the total number of cases reported is two hundred and eighty-three and there have been ninety-five deaths.”