The Plague Within (Brier Hospital Series)

by Lawrence Gold

  Two hours later, after Andre stabilized in surgical recovery, they wheeled him into the ICU. Beth Byrnes did the admission procedure herself and Curtis asked Jack to consult for medical support.

  Jack’s evaluation showed that Andre could open his eyes to voice command and he even tried to speak. All that came out were garbled utterances. His movement responses were normal, except for slight weakness on the left side of his body. The rest of his examination and the laboratory evaluation were normal. This would be a watch and wait case.

  Archie and Ray arrived later that morning.

  They approached Beth. “Can you get Dr. Brown for us? We need to know what’s going on and what are Andre’s chances for survival and,” he paused, “and, will his mind be intact?”

  “Dr. Brown’s in surgery. He’ll be out this afternoon. You can talk with Dr. Byrnes; he’s seeing Mr. Keller. He’s director of the ICU.”

  “Do you know how critically important it is for us to talk with Dr. Keller?”

  A bit disgusted, Beth replied, “If it has anything to do with PAT and their experimental drug protocol, you bet I do. Sandy Greer is my best friend.”

  Sweating profusely, and showing the strain, Archie faced Beth. “Ray, Andre’s chief research technician and I were on our way to the lab at Andre’s request. He called and said that he had the answer to controlling the rapid aging process. He never had a chance to tell us. Now, it may be too late.”

  Beth brought them to Jack. “Dr. Byrnes is my husband, and a good friend of Sandy’s. He has more than a little at stake here.”

  Ray stared at Andre then at Jack. “Is there any way to know if Andre’s going to come out of this, Dr. Byrnes?”

  “In a word, no. Still, there’s reason for hope. First, the injury is acute and there’s a lot of swelling. We’re treating that. Second, his coma scale assessment is encouraging.”

  “When can we expect to know anything?” Archie asked.

  “Andre Keller will be writing his own script, but we should know something in 24-48 hours.”

  “We may not have that much time, Dr. Byrnes. Lives are at stake.”

  “We’ll do everything possible to get him through this and raise his level of consciousness. Shouldn’t you guys have thought of consequences before subjecting patients to dangerous experimental medications?”

  Chapter Forty-Seven

  Archie and Ray were in Andre’s lab looking through all his notebooks, reference folders, and experimental protocols. They even reviewed his emails for the last six months—nothing. They brought in several other technicians to help. They’d scattered folders, thick reports, laboratory journals, and all forms of communication across the conference room table. An air of frenzy, impatience, and irritability suffused the room.

  Andre’s desk had a stack of messages from all over the country, and at least a dozen messages from Angela Brightman. Angela’s messages at first ended with, “Please call me when you have a minute,” while the later ones ended with “Please call me now, it’s urgent.”

  Archie held up Angela’s messages. “Why all these? What’s going on between them?”

  Ray turned to Archie. “Do you remember the missing dose of PAT0075?”

  “Yes.”

  “Angela Brightman was in to see Andre the day it disappeared. I assume he gave it to her.”

  “My God, if that’s so then...”

  Archie dialed Angela’s number. She picked up before the end of the first ring, “Andre, is that you?”

  “No, it Archie Blake, haven’t you heard?”

  “Heard what? Where’s Andre? I need Andre!”

  “Someone shot Andre early this morning; a crazy man, somehow related to Zoe Sims, a study patient who died.”

  “How is Andre?”

  “He had surgery early this morning to remove a large blood clot on his brain. He’s in Brier ICU, and,” he paused, “he’s unresponsive.”

  “My God,” Angela cried, sobbing. “Do you know what’s happening to me?”

  “Did Andre give you the PAT0075?”

  “Yes, he said it was safe.”

  “Tell me what’s happening.”

  “What’s happening...what’s happening,” she paused, trying to control the tears, “is that I’m getting old. Older by the minute. My face, my skin...Oh my God, what’s going to happen to me?”

  What can I say? Archie thought.

  “We’re working hard to discover a treatment. We’ve been at it for two weeks now. Andre said he was getting close, but we don’t know what he had in mind.”

  “I have to see him. To get an answer.”

  “He’s at Brier Hospital, but you won’t get answers from Andre, at least not at this point.”

  “I’ll do anything. I’ll pay anything, go anywhere. You have to help me. I can’t die this way.”

  “We’re doing everything we can. Stay close to your phone. We’ll keep in touch.”

  They’d drawn the window shades at the Greer home. Sandy was deeply depressed. She slumped in her lounge chair. She laughed as she clutched the woolen shawl around her shoulders.

  I’m my own grandmother or great-grandmother.

  Marty had called everyone, followed every lead searching for help. Only from the quacks and the charlatans did he receive any suggestions: colonic therapy, detoxification schemes, psychic surgery, and trips to a variety of religious retreats. Many traditional practitioners or researchers, after hearing their plight, spent their time berating them, the study, and the drug company.

  Where’s their humanity? Marty thought.

  Sandy slept fitfully every night. Getting her up for a trip to the bathroom had become such a chore, that Marty had resorted to Depends, bad enough, and finally, the bedpan, the final humiliation.

  “You won’t forget?” she asked for the hundredth time.

  “I promise you sweetheart that when the time comes, nobody will interfere. I love you. Don’t worry. This is the one thing you need not worry about.”

  Jack was making afternoon rounds in ICU when Curtis Brown appeared at Andre’s bedside.

  “What do you think, Curtis?”

  “His intracranial pressure is starting to rise, Jack. I’m thinking of using Phenobarbital-induced coma, what do you think?”

  “We have an unfortunate wrinkle here, Curtis. Just before someone shot him, Andre told colleagues that he’s uncovered a solution to this gene therapy mess. Colleagues were on their way to meet with him. They’re the ones who found him. Of course, keeping Andre in a drug-induced coma for a week or more could be devastating to those now suffering the side effects of this treatment, as they’re nearly out of time. We agree, I’m sure, that the focus needs to be on the patient, but if we could find another way of dealing with this, short of prolonged coma, I’d go for it.”

  “No problem, Jack. Phenobarbital is controversial anyway. We’ll deal with the pressure in more traditional ways, and hope for the best.”

  Jack studied Andre’s lifeless figure. What secrets lie inside your head?

  Chapter Forty-Eight

  Beth confronted Jack as he arrived in ICU that morning. “Jack, we must do something.”

  “I don’t know what else we can do.”

  “Sandy can’t go on much longer. If Andre has the answer, we must find a way to get at it.”

  Intellectually, Beth knew better, but this was her friend, and she’d never be the one to give up.

  “What’s the best scenario? Andre wakes up soon. His mind is intact and he remembers his idea. The idea is legitimate and useful; the lab is capable of producing a treatment immediately; the treatment works, but works to do what? Stop the aging or reverse it?”

  He grasped Beth’s hands. “I think you need to prepare yourself for the worst.”

  Beth’s head fell to Jack’s shoulder, and she wept.

  Archie Blake kept checking the cell phone on his belt as he and Ray Ames worked continuously in the lab searching for some clue to Andre’s discovery. Archie called Jack ev
ery few hours and he had Jack on the phone early this morning. It was a little more than twenty-four hours after the gunshot. “How’s he doing, Dr. Byrnes?”

  “Please call me Jack. At this point, our estimates suffer from subjectivity and wishful thinking. When I pushed Andre this morning, he responded a bit quicker, but not purposefully. He surely couldn’t answer questions. His intracranial pressures are okay and we’ll get him up in a chair, at least for a short time. Have you made any progress on some form of treatment?”

  “Nothing. Andre is a brilliant and innovative researcher and he seems to have covered all the bases. He must have been off on some other angle. God knows what.”

  “I have your cell number if there’s any change.”

  Angela Brightman was in full panic mode as she watched the relentless changes in her body. Over the years in her work, she’d come to know physicians all over the county. She’d been calling them for days receiving sympathy and nothing else.

  I need a miracle!

  She slept poorly, awakening every hour.

  Vivid dreams intervened: a stone grotto, a brightly lit triangular candle array, and hundreds of people walking solemnly and filling containers of water from stonewall taps.

  She reached Archie in the lab. “Any progress? How’s Andre?”

  “No progress and no change.”

  “I don’t know what to do, Archie. I can’t sit and wait for the end.”

  “Please don’t give up. We’re working hard.”

  “My dream,” she said in a soft voice. “I recognize the place. I’ve seen it before in pictures. It was Lourdes in France, the grotto, and the holy waters. It’s calling to me, Archie.”

  “Don’t do anything foolish, Angela. We need you here if we come up with anything.”

  “It’s calling to me, Archie.”

  She hung up on him.

  Jack’s phone rang, jolting him awake. It was 3 a.m.

  “Dr. Byrnes, we have Brier intensive care on the line. Can we put them through?”

  “Of course.”

  “Jack, it Carla. Something’s happening with Andre Keller. I can’t reach Curtis Brown. He’s in surgery at Children’s Hospital.”

  “What’s happening?”

  “I’m not sure. He’s thrashing around. Can’t tell what it is and I don’t want to sedate him until I know it’s the right thing to do.”

  “You’re great Carla...always in there thinking. I’m on my way.”

  “What is it?” asked a groggy Beth.

  “That was Carla. Something’s up with Andre. I’m heading in.”

  “Give me a sec and I’ll go with you.”

  Jack didn’t know how she did it, but Beth was ready when he hit the front door.

  They drove through the overcast, drizzly night, the ground fog at third-story level. When they got to ICU, the unit was dark except for the overhead light above Andre’s bed. Two orderlies stood at the bedside restraining Andre’s flailing arms and legs.

  “Has he said anything?”

  “Garbled, maybe a few recognizable words of profanity.”

  Jack moved to the bedside and sat beside Andre. “Release him,” He instructed the orderlies.

  When they released Andre, he struggled transiently against the leather restraints, and then lay still.

  Jack leaned over directly in his face. “Andre.”

  His eyes were open, but they did not fix on him. “Andre, it’s Dr. Byrnes. You’re in Brier Hospital. Do you understand?” Jack talked too loudly as if Andre were deaf or didn’t speak English.

  His eyes continued to waver, but twice stopped to fix on Jack’s face.

  “Andre, can you see me?”

  “Whaaa,” he moaned, again pulling against the restraints.

  “Those are restraints so you won’t hurt yourself. Do you understand?”

  He shook his head in a vigorous “no” motion, but Jack couldn’t tell if it was purposeful or random.

  Jack placed his index and third fingers into the palms of both of Andre’s hands. “Squeeze as tight as you can.”

  After a ten-second delay, Jack felt the left then the right hand begin to compress his fingers. Jack had him repeat this three times, and each time Andre reacted a little quicker.

  “Beth, get Archie Blake in here ASAP.”

  “Arch...” Andre mumbled.

  “Yes, Archie Blake. You were supposed to meet him about your research. Don’t you remember?”

  Andre’s eyes closed and he collapsed back into silence.

  Jack performed a quick update examination including a neurological. Andre showed no localizing signs like you might see in an injury to a specific part of the brain. His reflexes were exaggerated. Jack then reviewed his chart and most recent laboratory data, and had today’s tests drawn immediately.

  Twenty minutes later, Curtis Brown called in. “What’s up Jack?”

  Jack described Andre’s reactions and his findings on examination. “His intra cerebral pressures are normal, Curtis. What do you think?”

  “I don’t have any magic, Jack. Any sign of consciousness is good. The next few hours will be critical.”

  “Should we continue to push him, to stimulate him?”

  “Yes, but if he looks like he’s running out of gas, give it a rest then come back later for more.” He paused for a moment. “Jack, let’s not get excited yet. These changes may be nonspecific, and they could be an omen of something far worse.”

  What could be worse? But of course, I knew the answer.

  Chapter Forty-Nine

  A very excited Archie Blake arrived in the ICU. “Is he awake? What does he remember? May I speak to him?”

  Jack led him back to Beth’s office and they sat by her desk. The office, more like a large closet, was windowless and lit by harsh overhead florescent lighting. One wall was a blackboard, another a bulletin board filled with announcements, signup sheets, and OSHA regulations.

  “I’m sorry, Archie. I may have acted in haste. He’s much better, but still a long way from being able to answer your questions. Have you made any progress in the lab?”

  “Nothing. May I see him?”

  “It won’t do you any good, but sure.”

  They walked back to Andre’s bedside. He was asleep.

  Archie looked Jack’s way and Jack nodded his approval.

  Archie moved to Andre’s side, leaned over until their faces were inches apart. “Andre, it’s Archie. We have to talk.”

  No reaction.

  Archie repeated, this time much louder. “Andre, it’s Archie. I need to talk to you.”

  Suddenly, Andre’s hands were grasping Archie arms and pulling against the restraints. Andre’s eyes wandered then fixed on Archie. “Archie, it’s you. What’s going on?”

  Jack removed Andre’s restraints.

  Archie grasped Andre’s hand. “Do you know me? Do you remember what happened?”

  “I called you and Ray. I drove to the lab and then, nothing.”

  “Andre, I’m Dr. Byrnes and you’re in Brier Hospital. Someone shot you.”

  Andre began examining himself for a wound. “What, where?”

  “It was a head wound. These words may sound funny to you, but you are lucky to be alive and it’s even more incredible that we can have this conversation. How do you feel?”

  Andre paused for a moment in thought. “I have a slight headache.”

  Everyone burst into laughter.

  Andre looked around. “What’s so funny?”

  “You’ll get it later,” Jack said.

  Jack turned to Archie. “Go to it.”

  “Andre, you never told us what you had in mind—your solution to stopping or reversing the aging process. We’ve been through everything in your lab and can’t find a clue.”

  Andre wriggled in bed, trying to find a comfortable position. “Can I sit up a little?”

  “Of course.”

  Jack raised the head of the bed forty degrees.

  “Andre, what is it?
”

  “I’m surprised that it didn’t occur to you, Archie. Maybe you’re not so smart after all.”

  Archie shook his head. “Now you sound like your old self.”

  “We had everything we needed. I preserved cell cultures from each patient on the clinical trial with their unique DNA sequences. All we needed was a way to get it back into their cells. Each animal, and undoubtedly each patient, developed antibodies to the adenovirus vector so broad and so strong that using it again would be impossible. We need another way to get it in, and Archie, you have it. You use it in your lab every day.”

  “I don’t know what you’re talking about…what is it?”

  “It’s the vehicle—you invented the technique, Archie.”

  Archie stood and slapped his forehead. “The liposomes! My God, I should have thought about them.”

  Beth looked confused, so Archie turned to face her. “Liposomes are an interesting form of blood fat called phospholipids. On a molecular level, they look like sperm with two tails, the head repelling fat and the tail repelling water. More importantly, we can load the head part with DNA fragments and get them into cells. We’ve made liposomes that target T-cells in our HIV studies, but they have many other uses.” He turned to Andre. “You’re a pain in the ass, but as usual, a genius.”

  “You’ll use the liposomes,” Jack said, “to carry the DNA segments into the cells and avoid the allergic reactions you’ve seen with the viral vectors.”

  “That’s the idea. I must get going back to the lab. Can you put a phone at Andre’s side? We’re going to need his help.”

  Beth called Sandy. The phone rang seven times, and then Marty answered on the eighth.