“Exactly, only she hasn’t responded. As soon as the new blood goes in, it’s attacked by the virus and the red blood cells begin to disintegrate. The intravenous antiviral medicine, amantadine, doesn’t seem to have any effect on the virus whatsoever.” He banged his hand on the table. “By the time we get viral cultures back so we can identify the specific virus, TJ’ll be dead.”
“Isn’t there any way you can do a smear, or look at the virus under a microscope to at least identify the family it belongs to?”
Matt began to shake his head. “No, viruses are much too small to be seen with an ordinary microscope. You’d need an electron microscope to be able to identify the virus. . . .”
“Wait a minute,” Sam said. “What about the possibility of a mixed infection?” she asked.
Matt paused, thinking furiously. “You’re right. We’ve assumed that the only infection Sam has is viral because of the low white blood cell count, but if she has a mixed bacterial and viral infection, that could explain why she hasn’t responded.”
Sam nodded. “Severe mixed infections, especially with gram-negative organisms, can sometimes lower the white count just as pure viral infections do. Do you think you should call her internist and check with him?”
He glanced at his watch, frowning. “No, it’s three o’clock in the morning.” He stood up, anxious to try out this new theory. “Come on. Let’s go get a blood sample and I’ll take it to the lab and stain it for bacteria and see what we find.”
* * *
The cells under the microscope were a mixture of indigo blue and bright carmine red. As Matt searched the smear, his heart began to beat faster. “I can’t believe it, Sam. You were right, she’s loaded with plasmids.”
Sam asked, “Plasmids? What would plasmids be doing in her blood? I know that they’re used by the infectious disease docs in some obscure way to cause bacteria to mutate, but that’s about all I remember about them.”
Matt continued to search and review the slide as he answered her. “Plasmids are usually associated with bacteria, and are one of the ways that bacteria build up resistance to antibiotics. The plasmids take pieces of the bacteria’s DNA and transport it within the cells the bacteria is infecting.”
Sam’s brow furrowed. “But, you said TJ had a viral infection. Are plasmids ever associated with viruses?”
“No, of course not.... Well, wait a minute . . . I seem to recall a paper in one of the journals last year.” He went to the computer terminal on the lab desk and turned it on. After a few minutes spent punching keys, he hit pay dirt. “I’ve found it.” He leaned over and read off the screen, “‘The Use of Bacterial Plasmids in the Transfer of Infectivity by Viral RNA.’ ” He looked at Sam. “You want to guess who the author was?”
Puzzled, Sam began to shake her head, then stopped. “No. You don’t mean Dr. Niemann wrote that article?”
He nodded. “Yep, the son of a bitch must have been doing research on himself.” He walked around the desk and sat in front of the microscope again, but hesitated before bending to look. “I wonder if this has something to do with what makes someone a vampire. Perhaps it’s some sort of contagious disease that can be cured, or prevented with a vaccine.”
Sam looked horror-stricken. “Matt, maybe he wasn’t just . . . feeding on TJ. Maybe he was trying to turn her into one of them.”
Matt shook his head. “I don’t know, Sam. But I’ll tell you one thing. If he was, I’m gonna do everything in my power to stop it.”
* * *
The next morning, Matt presented his findings to the other doctors on the team, without mentioning the vampire part of his thesis.
Dr. George McEntyre, the internist, said, “So, Matt, it’s your contention that Dr. O’Reilley has somehow become infected with a virus carried, or somehow enhanced, by bacterial plasmids?”
Matt did his best to remain professional and discuss the case as if it were just another clinical presentation. “Yes, it is. I’ve told you how I found the plasmids on gram stain smears of the blood last night. That would explain why the virus is impervious to amantadine, and why the virus is so quick to attack and destroy the blood we’ve given her.”
Jonas Johnson, the infectious disease specialist, said, “Yes, Matt, I’m aware of Dr. Niemann’s fine research paper, but we’ve never encountered this type of infection outside of the laboratory. I’m afraid that beginning treatment on nothing more than a wild guess would be . . . reckless, to say the least.”
Jesus, Matt thought, by the time I convince these mossbacks of the truth, it will be too late for TJ. And if I try to tell them Roger Niemann is a vampire and infected TJ on purpose, they’ll have me committed.
He suddenly had an inspiration. “Yes, I know, Jonas, but it’s just that . . . well, perhaps I’d better not say any more.”
McEntyre and Johnson glanced at each other, then at Matt. Johnson began, “Matt, if you know something. . .”
“Well, I hate to make any accusations, but TJ has been working in her spare time on some research with Dr. Niemann. I would hate to think that she might have gotten infected accidentally in the lab, and I would hate to think what implications that might have for all of our research projects. If it ever became known that one of our projects caused the death of a young doctor . . .”
Johnson’s mouth opened, but he couldn’t think of anything to say. McEntyre just frowned, probably picturing the public relations nightmare such a happening would cause. Matt interjected, gently, “Perhaps it wouldn’t hurt if we treated Dr. O’Reilley as if she were infected with plasmids and a virus. After all, it only means adding an antibiotic effective against plasmids to what we’re already doing.”
Johnson glanced at McEntyre over the rims of his glasses. “He’s right, you know. If we add one of the aminoglycoside antibiotics to her current treatment it will probably inhibit any plasmid activity and enable the amantadine to begin to eradicate the virus.”
McEntyre stood. “I agree.” As he and Johnson walked toward the door, Matt heard him say, “Of course, nothing about plasmids or biomedical research need be mentioned in the progress notes on the chart.”
Matt grinned to himself. Sometimes you just needed to know what buttons to push to get things done.
Forty-one
Matt was sitting in the doctor’s lounge having a cup of coffee with Shooter and Sam, trying to explain to Shooter the difficulties they faced in treating TJ, when Damon Clark walked in. He had a videotape in his hand.
“Hi, Shooter,” he said, nodding at Sam and Matt. “How’re you doing?”
Shooter tried a not very convincing smile and shrugged his shoulders. “Okay, I guess. At least I know TJ’s in the best hands possible. Matt and Sam’ll get her well if it’s humanly possible.”
Clark held up the tape. “I brought the tape that was in James’s minicam. You have a tape player in here, Matt?”
“Yeah. It’s right over there on top of the TV. Here,” Matt said, rising to take the tape from him. “I’ll start it up.”
“I want to warn you,” Damon said, a serious look on his face. “It’s not pretty.”
“If it’ll help us cure TJ, we’ll look at it,” Matt said, pushing the button to start the tape.
The videotape was horrible and fascinating at the same time. It was the first time anyone had seen the monster in action and lived to tell about it. By the time the tape was finished, they all had tears in their eyes, even Damon, who had seen it before.
“So much for your theory about the silver bullets, Matt,” said Shooter, bitterness in his voice.
“Well, we knew it was a long shot,” Matt mumbled, feeling terrible that his mistake might have cost Sherry her life.
“Hey,” said Shooter, patting his knee, “it’s not your fault bullets don’t kill the guy. It was a damn good idea, even if it didn’t pan out.”
Matt looked over at Damon, whose face had become noticeably flushed, and who had actually gotten up out of his chair and turned away when the tap
e had shown the creature begin to rend and tear Sherry’s body in his final rage. He reached over and turned the set off.
As the chief looked up, Matt noted his eyes brimming with tears. “Shooter, I want that son of a bitch so bad . . .” He turned and began to pace the small room, discreetly wiping his eyes with a handkerchief.
“Chief, perhaps you should show this tape to the mayor and the PC?” said Sam.
After a moment, Damon said, “Not just yet.” He leaned forward, hands on the back of a chair. “Let’s play this one close to our vests. We’ve got a multiple homicide involving both police officers and media personalities, so I think both the PC and the mayor are going to pull out all the stops on this one and give us just about anything we need to catch this bastard. Let’s save the tape. Who knows when we’ll need an ace in the hole.”
“Sure, Chief,” said Shooter.
Damon looked closely at Shooter. “How’s Dr. O’Reilley doing? I assume you’ve got her covered?”
Shooter looked up. “Matt and Sam say she’s making progress.” He glanced at Matt and he nodded, showing somewhat more encouragement than he felt. “She’s guarded twenty-four hours a day, plus I’ve got her on the jail floor so that the windows are barred. There’s no way that son of a bitch can get to her.”
“Okay, Shooter. Take whatever men you need and go find that bastard. I’ve arranged for all of the TV channels to televise his picture every hour and to ask that we be notified if anyone sees him, but I doubt if that’ll be much help.”
As Shooter opened the door, Damon said softly, “Shooter, if it’s at all possible, I would like to be in on the end of this one.”
Shooter nodded and turned to go. “And, Shooter,” Damon added, glancing at Sam and Matt, “just between us, I don’t want this bastard to go to trial. Tell the men to shoot first, and ask questions later . . . you understand?”
Shooter smiled grimly. “Don’t worry, Chief. I’m way ahead of you on that.”
Matt nodded at Damon. “See ya later, Chief. We’re going to take Shooter up to visit TJ now.”
* * *
Shooter nodded at the guard in front of TJ’s room as they approached. “Anybody in there?”
“Naw, the nurse just left. She said Dr. O’Reilley was still unconscious.”
Matt opened the door. “We’ll just be a minute.” Shooter followed him in, pulling up a chair and sitting next to TJ’s bed. Sam and Matt walked to the window and stood looking out, arms around each other, trying not to intrude on their privacy. Shooter reached out a hand and put it over hers.
Softly, he whispered, “Hey, TJ, it’s me, Shooter. I know ya probably can’t hear me, but I thought I’d come say hi anyway.” He placed his hand against her cheek and gently rubbed it against her skin. “We’re working real hard to get the guy that did this to you, and I’m personally gonna make sure that he never hurts you or anyone else again. I just want you to know that I love you, and I’m gonna wait for you no matter how long it takes you to get well.”
He leaned over the bed and kissed her on the cheek. When he turned and left the room, Sam and Matt followed him out into the hall. He said, “Matt, her skin is so cold, and she’s so pale . . .”
Matt put his arm around his shoulders. “That’s because of the anemia, Shooter. Hopefully, the blood transfusions will cure that.”
He stopped, took Matt’s hand, and smiled a grim smile at Sam. “I’ll see ya later, guys. I’m going hunting.”
“Shooter,” Matt said, “what are you going to do if you find him, since bullets don’t seem to have any effect on him?”
He shook his head. “I don’t know, exactly. I plan to carry a twelve-gauge shotgun loaded with 00-buckshot. I figure if I put enough of those into him, they’ll blow him to pieces.” He shrugged. “If that doesn’t work, I’ll try hand grenades or bazookas.” He hesitated. “One thing’s for sure, he can be killed, or he wouldn’t be afraid of being found. We just have to figure out what his weakness is and hit him with it as hard as we can.”
* * *
TJ dreamed that Shooter was talking to her, but she couldn’t quite understand what he was saying. She had a sense that he was touching her, but it was as if her skin had been anesthetized and she could barely feel his touch. She wanted to talk back and tell him that she missed him, but somehow she couldn’t get her lips to form the words.
Suddenly, she felt him approach her more closely and she could smell the warm blood coursing through his veins, so close that she could almost taste it. She was so hungry . . . if only they would feed her what she needed.
Her heart began to beat rapidly as she pictured in her mind taking what she needed from Shooter’s neck, and her mouth watered and her teeth began to change. Before she could arouse herself enough to take it, the smell of the blood was gone and she sank back into her slumber with only a slight quiver of her lips.
Forty-two
Matt took his tray and joined McEntyre and Johnson at one of the tables in the hospital cafeteria reserved for faculty members and attending physicians. “Good morning, gentlemen.”
They looked up from their coffee, both bleary-eyed and unshaven, and mumbled their hellos. Matt began to talk as he smeared butter on his biscuit. “I reviewed Dr. O’Reilley’s chart this morning. I see that her temperature stabilized at a little over one hundred degrees, and that she had no further spikes during the night.”
Johnson, the infectious disease man, just grunted and shook his head as he chewed his bacon. He pointed at Matt with his fork. “Yeah, that’s good as far as it goes, but the bad news is her hemoglobin and ’crit aren’t coming up and her white count is still under two thousand.”
McEntyre nodded his agreement. “It looks like the aminoglycoside antibiotic has stopped the plasmids from replicating and spreading the virus throughout her body, but the blood is still infected and the new red blood cells we give her become infected as soon as they enter her circulation.” He shrugged his shoulders. “We’re holding our own, but not making any new progress.”
Matt glanced at Johnson. “What about the amantadine? Isn’t it effective against the virus?”
Johnson shook his head. “Apparently not, and to make matters worse, her liver enzymes are starting to rise and we may have to discontinue it soon.”
Better be very diplomatic with this next idea, Matt thought, and said, “Do you guys mind a suggestion from left field?”
McEntyre and Johnson looked at each other for a moment, then both looked at Matt and shook their heads. “Matt, at this point, I’d listen to a first-year student if I thought it might help,” McEntyre said. “We’ve discussed this until we’re blue in the face. We’re stumped. This virus acts like no other infection we’ve ever seen. It’s resistant to amantadine and uses plasmids to replicate and spread itself, for Christ’s sake. Hell, I’d write this case up for the Journal of Microbiology if I thought anybody would believe it.”
Matt leaned forward and spread his hands. “Okay, let’s look at what we have so far. We have a virus that we seem to have isolated to the bloodstream. It can’t spread, but we can’t eradicate it using normal methods, correct?”
As they nodded, he continued. “Now, our patient seems to be developing a reaction to the amantadine and we may have to discontinue the only medicine capable of eradicating the virus, which will almost certainly lead to the further spread of the virus and the eventual death of the patient. Still correct?”
McEntyre and Johnson looked surprised at his bluntness and both began to sputter, “Well, now . . . I don’t know if it’s that bad . . .” began Johnson, while McEntyre said simultaneously, “Now, Matt, I wouldn’t put it that . . .”
Matt leaned back, crossed his arms, and stared at them. “Let’s not bullshit each other, guys. It’s exactly that bad and we all know it. Am I correct or not?”
Both the specialists looked down at their plates, unwilling to acknowledge the truth, even to themselves. Matt thought to himself, Well, here goes nothing. “Let me prop
ose a possible solution.”
They looked up, giving him all their attention, though both appeared skeptical that a lowly emergency room doc could come up with an answer when two exalted specialists were stumped. “How about if we attack the virus in the blood the same way we do leukemia, by killing the cells that house the virus?”
Johnson said, “But . . . but that’s impossible. If we kill all her blood cells, she’ll die anyway.” McEntyre nodded his agreement.
Matt held up his hands. “Not if we do it carefully, replacing her blood volume as we go, and using another antiviral agent at the same time.”
McEntyre’s eyes narrowed. “What do you have in mind?”
“I propose that we discontinue amantadine and start Dr. O’Reilley on intravenous acyclovir.”
Johnson blurted out, “Acyclovir? But . . . Matt . . . acyclovir is for herpes!”
Once again Matt spread his hands, trying to keep the exasperation out of his voice. “Herpes is a virus, and TJ is infected by a virus that appears to be resistant to amantadine. Acyclovir is the only other antiviral antibiotic available to us.”
McEntyre nodded slowly, thinking. “But, Matt, acyclovir is extremely dangerous when given intravenously and it only works against RNA viruses. We haven’t had time to discover just what sort of virus Dr. O’Reilley has.”
Frustrated, Matt raised his voice without realizing it. “Goddamn it, just listen to yourselves! TJ has a disease that most assuredly is fatal. If we don’t find some way to treat it she will die. Now, when I offer a possible treatment, you want to hold off because it’s dangerous and you don’t know for certain that it will work.” He took a deep breath and let his voice return to a more normal volume. “Okay, I can accept that.” He leaned back and again crossed his arms on his chest. “Then, give me an alternative treatment.... Come up with something other than acyclovir and chemotherapy to destroy the red blood cells. . . .”
Night Blood Page 30
