Maggie certainly did last night. She’d even scoffed at his answer to her question on how to solve the world’s dilemmas: “Better living through pharmaceuticals.”
Wright pulled on the hand line of the net and brought in a nice-sized Asian Banjo fish. The locals would have eaten the ugly fish, but he wasn’t interested in eating a fish that released mucus that was poisonous to their prey and caused instant death to other fish nearby. He threw the unappetizing fish back.
The brain was a marvelous thing. Even the little almond-shaped structure, the amygdala, deep inside the brain, played an important role in major affective activities like love and affection. When scientists destroyed the tiny amygdala in animals, they became tame but sexually nondiscriminatory. Humans with lesions of the amygdala lost the ability to process the meaning of external information, such as the sight of someone they knew well. They could remember the person but were unable to remember if they liked them or not.
An even smaller and seemingly insignificant group of neurons in the brain stem related to gratification. When a patient had a genetic error and a reduced number of dopamine receptors, they were incapable of gaining gratification from common pleasures in life and sought atypical alternatives, such as alcohol, drugs or a compulsion for sweets. Wright often wondered if he carried this genetic abnormality. He understood Zelutex’s medications were trying to affect brains that were different from male to female and from person to person. He realized the wiring of the human brain was not static, not irrevocably fixed—brains were also adaptable—so they were shooting at a moving target. Maybe someday, with the new pharmacogenetics, they would develop individualized treatment for patients. Wright had recently okayed twenty million dollars for a project to examine how the cortical and limbic systems worked together.
Maggie had expressed the puzzle last night. She worried about being of two minds in her feelings for him—her head told her one thing and her heart told her something different.
He’d said she didn’t understand that the rational cortex could tell a person one thing and the instinctive limbic system another. That’s when the fight started. She was adamant that scanners, microscopes, and brain chemistry couldn’t explain every mystery. When he argued that we truly are double-minded, she insisted the Bible knew that long before all the fancy instruments said so. She believed that emotions and pain couldn’t be cured by pills but could only be understood and healed through a relationship with God.
“You think you can find the answers to all of life’s problems in medication,” she’d said. “I don’t have a problem with using medications when they’re needed. Sometimes they can be life saving. I have many friends who’ve been helped with antidepressants, but there are no shortcuts—there is always a cost. Look at all the side effects of so many of the medications. Even when you’re using prescription drugs, you still have to work through the pain.”
He had to admit, with some of their medications, patients suffered a higher than 25 percent incidence of significant side effects. When he’d jokingly replied, “I can live with that, especially when the company is making money,” she really got angry.
“I could never be with a man that believed that!” she’d yelled, then threw some biblical mumbo-jumbo at him and stopped talking. It had made him angrier than he’d been in a long time. That’s when he stormed out, slamming the door so hard that it broke part of the frame.
Her words seemed to reverberate off the jungle canopy. Negative internal dialogue grew louder in his mind and seemed impossible to shut down.
Wright wondered if he heard an audible voice and scanned the thick jungle. Then he thought he heard laughing from the trees. He dropped the net to the bottom of the boat. Was he having a breakdown?
“Wright,” a dark voice said, and he spun around looking from side to side.
“Ha, ha, ha,” the voice called from one side and then the other.
Wright picked up the large machete that leaned next to his seat and flashed it through the air.
“You’ll never get what you want,” the voice screamed in his ears.
He twisted left and then right, looking for a wild fig tree or a hilltop. He knew the Iban believed that was where good and evil spirits built their invisible habitations.
“You’ve lost control of the situation,” the voice yelled. Now it seemed to come from inside his head.
“Stop!” Wright yelled at the jungle, dropping the machete and covering his ears with his hands. “Stop.”
His head spun, and he sat down hard, bumping his back against the handle of the engine. “Grandmama, help me. Why did you have to leave?”
He was hyperventilating, so he focused his mind to slow his breathing. The screaming decreased and he lowered his hands and looked around. Nothing.
He reached back and pulled the starter rope on the outboard. It sprang to life.
He would apologize to Maggie and beg her forgiveness. He could not live without her. She had to understand that. And if she didn’t, he knew exactly how to convince her. It was time to pull out his secret weapon. He knew it was just a matter of time, and he’d been waiting for the right moment. He knew her faith was everything to her.
His father had given the small book to him as a child. He hadn’t been impressed and had never even opened the cover. But today was the day. He still had no interest in the book, but he knew it was important to Maggie, and he would put on a good show of its value to him. The book was tucked away at the cabin where she was fast asleep—his Bible.
CHAPTER 47
WITHDRAWAL
Nick sat in the family waiting room at the hospital and dialed Maggie’s number for the fifth time. She must be out of cellphone range as his calls went straight to her voice mail. He didn’t know whether to be angry or worried. Even if she chose Wright as her mate, they would always be friends, and he needed to talk with her. Daisy’s cardiac arrest shook him to the very core. Why had he not listened to the sense deep down inside of him, warning him about giving Daisy the medicine? If he acted on every “bad feeling” he had, he would have never operated on anyone. But this time, in retrospect, it felt like the Holy Spirit had told him not to give the dose.
What in the world was he doing? He had prayed and sensed that God gave him the green light to take the job, even though he was full of self-doubt. Had he really heard from the Father? Right now, he thought he’d been listening to the deceiver. He really was a fish out of water. If he wasn’t going to continue with this job, then what? He felt like an amoeba floating in space and time with no skeletal structure.
“Trust me, Nicklaus.”
He sat up straight and listened. “Yes, that is definitely your voice, Father.” He was aware he’d spoken aloud. He glanced around the waiting room and was relieved to be alone.
Chang’s discussion of Abraham’s “hope against hope” floated through his mind. “God is looking for people that can look beyond the horizon,” Chang had said. Nick nodded. Better to look beyond because the foreground looks bleak right now. “Father, help me see past all this crap,” he said aloud.
At least Daisy was doing okay after her reaction to the medication. The residents would, of course, watch her closely over the next few hours. Fang did not expect her care plan to change, except for the obvious—she would receive no more Revivere.
Nick’s winning lottery ticket numbers seemed to evaporate just as he was counting his fortune. If Revivere caused that bad of reaction in even a handful of patients, it would kill the drug.
Nick dialed Kerri Kim’s office number, and she answered on the second ring.
“Dr. Hart, how are the trials at the hospital going?” she answered cheerfully.
“Not well. The medication about killed the little girl.”
There was a long pause.
“What happened?” she finally asked.
“Her blood pressure dropped out, and her heart stopped.”
“Oh, my…”
“Yeah. It wasn’t pretty. Thank God the team
was able to resuscitate her.”
“Is she going to be okay?”
“Except for a little burn on her chest from the cardioversion paddles, yes.”
“Thank goodness.”
“In the original clinical trials did you all see anything like this?” Nick asked. “I don’t remember seeing any severe reactions in the report.”
Kerri didn’t answer. Finally, she said, “Dr. Hart, let me call you back later tonight. It will be from my cell phone. I’ll have to leave the building.”
* * *
Nick was hesitant to give Robert his final dose. But he’s done so well. Nick prayed and thought he got an affirmative to administer the drug. Thankfully, Robert did fine.
Nick had one other item on his to-do list before he helped get Robert home, and that was to track down Daisy’s father. It wasn’t easy. The doctors had admitted him to the psych ward, and Nick had to get clearance from the hospital administrator to get through the locked doors.
A young female resident at the nurse’s station was happy to help. She took the patient’s chart and escorted Nick to the room. They passed many patients sitting outside their rooms in various states of drug-induced stupor. Nick wondered if the treatment for psychosis had changed from his days as a medical student rotating through psychiatry. Back then they administered heavy doses of Thorazine or Haldol. The drugs that combatted hallucinations, paranoid delusions, and thought disorders left patients with drool dripping from their chins.
The resident stopped at a locked door with a small, thick window and opened the patient’s chart. Nick looked through the window to see a man resting comfortably on his bed. The room looked more like solitary confinement in a maximum-security prison than a hospital room; there was nothing the patient could use to harm himself, not even a sheet on the mattress.
“This man suffered an acute psychotic episode, with hallucinations and passivity phenomena,” the resident said and smiled at Nick.
“Remember, I’m a bone doctor…help me out. Passivity what?”
“It’s when they have delusional beliefs that others can control their will or feelings, even their limb movements and bodily functions.”
Nick nodded.
The young doctor flipped a few pages of the chart, studying each one.
“The note from this morning says he is being weaned off Haldol and may come out of lock-up tomorrow. He seems to be doing much better.”
She flipped the page. “His history and physical says he was on some pharmaceutical trial?”
“Yes,” Nick said.
“Well, all his admission labs were within normal limits,” she adjusted her glasses and looked at Nick. “It says here they postulate that the medication increased his dopamine levels to the point that sent him into schizophrenia. Either that or the medication was stopped abruptly, and he was having symptoms of acute withdrawal.”
* * *
Nick and Robert took a cab to the docks and a boat taxi to Wright’s island. It wasn’t as stylish as the helicopter and took longer, but Nick thought Robert handled it well. He was helping Robert up to the house when Kerri Kim called back. He smiled at Christian who met them on the path and handed Robert off to him as he answered his phone.
“Dr. Hart, I’m sorry about the delay. I hate to sound paranoid, but I didn’t want to talk about any issues over my office phone.”
“What am I missing here, Kerri?” he was anxious to get to the point and to get Robert inside.
“The first clinical trial of IGF-1 medication, Revivere, had a 15 percent autoimmune reaction, sometimes severe. We thought a protein in the medication’s carrier was to blame. We removed it and hoped that would stop the reaction. This is the first trial since that adjustment.”
“Why wasn’t I told about this?” Nick tried to not put too much heat into his words.
Again, there was a long pause. “Dr. Hart, I’m sorry. The team thought we’d solved the issue.”
“But the reactions in the first trial were not in the reports.”
Kerri blew out a loud sigh. “Dr. Hart, we need to talk about this. All I can say is that Ms. Boxler’s office filters all reports.”
Nick nodded. He was getting the picture. “And reactions or withdrawal symptoms from Welltrex?”
“I was not on that team.” She hesitated. “But I’ve heard rumors. We need to talk about this face-to-face. You need to understand there are huge amounts of money on the line.”
“Understood.” Nick disconnected the call and stared at his phone. What in the world have I gotten myself into?
CHAPTER 48
MADNESS
The mighty fisherman brought no dinner home. Wright returned to the cabin like a dog with his tail between his legs, looking sheepish, and apologizing for his failure. Fortunately, the refrigerator, freezer, and pantry were fully stocked, and he set to work preparing a delicious shrimp pasta dish, continuing to apologize until Maggie insisted he stop.
After dinner, when he pulled out the Bible, he knew he had hit the mark. As soon as she saw the book, both her spirit and her eyes lit up, and now they sat comfortably on the couch together sipping tea and chatting.
“Wright, everyone has faith in something,” Maggie was saying. “It’s how we’re hardwired. Most people around the world have faith in the divine, in God, but even the atheist believes in something—even if it’s themselves or their organic garden or the crystal hanging around their neck. I don’t think I’ve ever met a person that doesn’t hold something dear. It’s just not possible.”
Wright sipped his tea. He would have to agree with that. He did not believe in a supreme being, but he had faith in how the human genome came from the sea and continued to evolve.
“Whether you want to believe it or not, there is a spiritual world,” Maggie continued. “Every religion acknowledges that. I remember when I went on my first mission trip to Guatemala. Next door to where we were staying there was a witch doctor of sorts. We would sing and pray each morning and night. He got angry with us because he could no longer cast his spells and do his magic. We believed our worship had changed the atmosphere and ushered in the Kingdom of God—pushing away the darkness.”
Wright frowned and shrugged.
“What so many people need to understand and think about is what spirit they listen to—the Holy Spirit or an evil spirit,” Maggie said.
“But I’m not a religious person,” Wright said.
“See, that’s exactly where people get hung up. It’s not about religion. They pick apart something about a church or organization, or they get offended by a street-corner preacher or televangelist and miss Jesus’s whole message. Yes, yes, yes, there have been terrible abuses in all religions, including Christianity. But the truth remains the truth, whether you believe it or not.”
“How do you believe in someone we don’t even know existed?”
“You mean Jesus? Oh, come on, Wright. That argument always gets me. Do you question the existence of Abraham or Moses? Everything in history tells us they walked the earth and no one seems to dispute that, but they want to say Jesus was some myth. That argument doesn’t hold water.”
“Okay, I guess I’ll concede and say Jesus existed, but I think of him more as a great moral teacher, like Buddha or Muhammad.”
Maggie shook her head. “But there is a great and important difference. None of the other people you or anyone else like to equate with Jesus ever said they were divine…that they were God Himself.” Maggie leaned forward and set her teacup down.
“We all have to decide if Jesus is truly who He said He is. I love how C. S. Lewis debated this point to those that wanted to accept Jesus only as a great moral teacher. Lewis told people that Jesus made it very clear; He was the Son of God. He leaves us with no other choice, either you believe He was a lunatic, or He is the Messiah—Jesus left us with no other choice.”
Wright wanted to argue but decided to back off and not start another war. He hoped he wouldn’t be sleeping on the couch again tonigh
t.
* * *
The question of sleeping arrangements didn’t come up because Maggie and Wright had fallen asleep on the couch. When she awoke and realized this, she was glad she hadn’t had to make a big deal about not sleeping with him in the bed. She sat up and discovered she was wrapped in a soft blanket and Wright was standing over her with a steaming cup of mocha. It smelled delicious.
“Good morning,” she said and stretched.
“I’ve made you a special coffee with Mexican chocolate. I hope you enjoy it.” He handed her the cup.
She blew at the steam rising off the top and took a sip. The cinnamon chocolate was rich and soothing.
“Thank you. How did you sleep?”
“Uh, not so well,” Wright said. “Like not at all.”
“Sorry to hear that,” Maggie said, watching him pace up and down the floor. She wondered why he was so agitated, rubbing his head as though he was shooing flies away.
He caught her quizzical look and said, “I thought we could go out this morning and look for some of our ancestors.”
Maggie tilted her head, confused as she watched him place a holster and pistol through his belt and slap it in place.
“There is a family of orangutans that live in this area. I thought we could go out looking for them.”
“Are you okay this morning?” Maggie asked. “You look a little pale.” She wasn’t sure what else to say, but he was definitely off. Even his beautiful eyes seemed dark and disoriented.
“I’m fine. Finish your coffee and let’s go.” His voice registered anger.
* * *
Before Maggie’s father had found peace in his relationship with God, he was an angry drunk. Like so many of her Blackfeet elders, he lived in hatred of the white man and was ireful at his lot in life on the reservation. Alcohol was his drug of choice, but it worked poorly, only making him more belligerent and angry.
The Rusted Scalpel Page 31
