The Physician's Tale

by Ann Benson

  Lany’s cop nature surfaced. “How did anyone figure it all out? It doesn’t seem like there was much real evidence beyond hearsay.”

  “It’s not hearsay at all,” Kristina countered. “They were maniacs for records—births and deaths, and pretty much every event of significance. But none of this would have ever come to light if it hadn’t been for something that happened in San Francisco in the nineties. There was a gay man into the scene there for years, way back into the late seventies and early eighties, when no one really understood AIDS. He did the bathhouse thing for a long time, had—according to himself—‘multiple’ contacts. He was at huge risk for AIDS, but he never got it. He was tested dozens of times but he’s never been HIV positive. His lovers and friends were dying all around him, men with whom he’d exchanged body fluids, but as far as anyone knows, he’s still alive.”

  Everyone leaned in as if to hear her better, though she was not speaking softly. “So eventually, someone in the medical community in San Francisco decided it might be worth knowing what it was about this guy that protected him. They did all kinds of tests, including a DNA workup. And blammo, right away they saw something unusual on CCR5. He had two copies of a genetic mutation called delta thirty-two.”

  “Double delta,” Janie whispered.

  “Yes,” Kristina said, looking at Janie once again. This time her eyes stayed even longer. But before Janie could say anything, Kristina continued speaking.

  “So they did some DNA dating and were able to determine that the original mutation surfaced abruptly about seven hundred years ago, shortly before the first plague pandemic in the 1300s.”

  Murmurs of excitement went through the group.

  “And then they tested a whole bunch of people, including patients with end-stage AIDS, patients who had AIDS but were doing pretty well, and people who should have been at risk but never got it. The results were pretty exciting—a lot of the high-risk people who never got AIDS had the same double mutation as the original guy. None of the people who were very sick had a copy of that mutation. But what was really interesting is that the people who had one copy, even though they did get AIDS, responded really well to medications and stayed healthy for a much longer time than people who had no copies. That’s one reason why nonwhite people seemed to get AIDS at a higher rate within their ethnic group—the original mutation arose in the northern European population. With further testing of large groups, the researchers were able to determine that the mutation doesn’t exist in blacks, Asians, and South American Hispanics. They have absolutely no genetic protection. But it runs at a rate of fourteen percent in people of Celtic and Scandinavian origin.”

  Evan asked, “But what does this have to do with plague?”

  “It turns out that the infection mechanism is the same in plague and in AIDS. HIV and Yersinia pestis both attach themselves to immune cells in the same receptors, and both of them trick the immune system into carrying the microbe throughout the body. Yersinia pestis rides right into the lymph nodes, which is why people with plague get swellings and bruising around the neck and in the groin. Then it goes everywhere else. In double deltas, the microbe can’t get a lock on the receptor, so it can’t fool the immune system. The person is essentially immune to plague and highly resistant to HIV.”

  It was a large amount of information to process, and the listeners were all understandably quiet for a few moments. Finally, Steve asked, “So why would these folks be wanting to know if we have any double deltas now?”

  “I don’t know for sure,” Kristina said, “but I think I can guess. DR SAM is a receptor-based microbe, so maybe if you have a double copy of the mutation, you’re immune to DR SAM too.”

  It was a long moment before Steve said, “Boy, wouldn’t it be nice to know who is and who isn’t?”

  There was another pause before Kristina said, “There’s one that I know of.”

  All eyes turned to her.

  “And how do you know?” Lany asked.

  “I’ve done genetic profiles on the people in our compound.” She looked straight at Janie, as if in apology. “We’ve all given blood for one reason or another in the time we’ve been there. We have the equipment for me to do polymerase chain reaction, so I can get a very small amount of DNA to reproduce itself, enough for me to prompt a readable sample. I figured it might come in handy someday to know what each one of us is carting around in terms of genes.”

  “Kristina,” Janie said, “why haven’t you said something about this before?”

  She dropped her head and stared at her own lap. “I don’t know. I didn’t think it meant anything. And I guess I probably forgot.”

  No one commented but Steve Roy. “So,” he said, “you’re keeping us in mystery. Who is it?”

  Her eyes went straight to Janie. This time they stayed there.

  The conversation narrowed to Janie and Kristina; everyone else just listened in awe.

  “I don’t get it,” Janie said. “Both of my parents died. How could I have inherited complete immunity?”

  “They had to have been single deltas. You had to have gotten one copy of the mutation from each of them. Was either of them of Celtic or Scandinavian background?”

  “My mother was German and Swedish, my father was Irish.”

  “Well, there you go. They fit the profile. Having one copy doesn’t protect you completely, but…” She hesitated. “It’ll keep you alive longer.”

  “You mean it prolongs the agony.”

  Kristina hung her head, as if she were more than just the bearer of news, as if she were responsible for its content. “I hate to ask you this stuff, but did your folks die quickly or did they last awhile?”

  What was “awhile,” in DR SAM terms? “Three days each,” she said.

  “That was a long time for DR SAM. Now, I hate to ask this even more—what about your daughter?”

  “Not quite four days.”

  “And her father?”

  “Healthy one morning, dead before midnight,” Janie said. “He went to the school where Betsy was in quarantine.” She glanced at Lany, who let out a sigh as she revisited her own involvement in that incident. Janie’s voice began to tremble and there were tears in her eyes. “He talked his way in, but he never came out.”

  Kristina remained respectfully quiet for a brief moment, as did everyone else in the surrounding circle of listeners. Then she said, “Well, this is all speculation, but I’d venture an educated guess that if we had their profiles, we’d find that each of your parents had one copy, which is how you ended up with two. And that your daughter had one from you, and none from her father, who probably had none himself.”

  Steve Roy rose up and pointed to the hard drive. “So, what does all this mean to us?”

  “I think,” Kristina said, “that we should check all the blood samples I took and determine everyone’s status.”

  Janie sat straight up and looked around the room. “Anyone object? It’s your right, at least in the country we used to live in, to refuse.”

  A stark moment of silence ensued.

  “Well,” Kristina said, “I’ll take that for a no.”

  Kristina and Evan went back over the mountain much sooner than planned so Kristina could do her work. Janie did not relax again until she received the e-mail that they had safely reached the compound and that Tom was doing well. Coming from his daughter, she took the report as truth; Caroline or Michael might have sugarcoated it.

  On the morning they left with the cheek swabs from everyone in Orange, Janie began the process of working up complete medical histories on all the people who lived there. There was an urgency to her work that she had not felt before the double-delta revelation. It was a relief, after the CCR5 revelation, to discover that with minor exceptions they were a spectacularly healthy lot. She removed a few suspicious-looking moles, shaved off a few corns, and cataloged the aches and pains of all the adults and children. Her diabetic patient was doing very well indeed.

  Two days lat
er the news about delta status came, in a cryptic message:

  J and L do more than rhyme

  The son shines every single day

  The king’s book is half readable

  Janie and Lany were doubles, Evan a single.

  “‘The king’s book’? What does that mean?” Steve said in confusion.

  For a moment, no one had an answer.

  “The King James Bible,” James finally said.

  “But I thought…” Lany did not finish the sentence.

  “My mother was white,” James said.

  The argument over the invitation to go to the double-delta Web site was heated, and lasted long into the night. Eventually, it was decided that Lany’s assertion that they ought to know their enemies made sense—if these folks turned out to be enemies. With a little bit of luck, they would be friendly, and a whole new world would open up to both communities, a world they all hungered after.

  But going onto the Internet again was like sailing to the edge of the world—a confusing mix of terror over the unknown and excitement over what might be found. The browser worked and worked; the hourglass hung on the screen for what seemed an eternity, until finally the page unfolded. Everyone gasped as the images rolled open, as if they were seeing the Internet for the first time.

  The date in the corner of the page was correct.

  “Well,” Steve said, “I guess it’s current.”

  The same information that had arrived in the e-mail was posted on the page itself, stating the date, time, and location of the gathering of deltas.

  “This is scary,” Janie said. “I thought I’d be so delirious if we got the Internet back again. Now I don’t know if I want it.”

  “I want it if it’s friendly,” Steve said.

  “It wasn’t entirely friendly in the time before,” Janie reminded him. “Pedophiles, identity thieves, all sorts of scams—a lot of those bad guys will probably have survived. They were sitting in front of their computers, isolated from everything, while the rest of us were breathing airplane air and touching door handles.”

  “Look, there’s a mission statement,” Lany said. She grabbed the mouse from Janie’s hand and—before she could protest—clicked on the link. She began to read aloud.

  We believe that we have been set apart by our Creator’s hand and

  He has blessed us all with

  “Oh, no,” someone groaned from the back of the group. “Religious fanatics—”

  “Wait a minute,” Lany said. “Give it a chance.” She read on.

  an unearned ability to withstand certain ravages of nature, which He also created, in which He placed us to live. We believe that this blessing calls us to a higher purpose, and we aspire to rise to that calling. To that end, we set this goal: to spread throughout the entire human population, by benign means, the genetic code that enabled us to survive when so many died.

  Lany sat back in her chair when she finished reading the short paragraph. “That’s it,” she said.

  Those who’d gathered around were silent for a moment. Finally Steve said, “Seems pretty simple, doesn’t it? At least on the surface. But what’s this?”

  He pointed to a link in one corner of the page. It said, The Story of Mecklenville.

  “Go there,” he said.

  Lany was reluctant, but finally she clicked on the link.

  http://www.mecklenville.in.us.gov

  The site unfolded before them.

  Mecklenville, Indiana, United States of America. Population as of this writing, 1. Population as of three months ago, estimated to be 62, all survivors of DR SAM.

  There was a link that said Photo Gallery. Lany clicked on it. It took a few moments for the page to unfold; when it did, those gathered around the computer saw a group of people who looked pretty much as they did. The caption under the first photo read, Mecklenville gathers to celebrate the renovation of the power plant. Behind the smiling folks was a Quonset hut of rippled steel, painted in camouflage colors.

  The next photo showed a smaller crowd. The faces of the people were sad and bewildered. The caption was disturbing: Mecklenville buries three of its own.

  The one below that showed an even smaller group, who by their expressions were all in a state of something like shock. Mecklenville buries twelve more.

  There were no more photos on that page, only a link to another. That page contained a personal letter, with a photo of a young man who looked to be in his mid-twenties, sitting in front of his computer.

  As I write this letter, I know that I am already sick; I can feel it taking over me. I don’t know why I was left here to document all these deaths; God must have it in His plan for me. At least that’s what I’m hoping, because I would never have chosen this for myself.

  If you are reading this now, I am dead; I set up my computer to automatically load this last page if I didn’t initiate a certain command; I’m at the computer every day if I’m well, because it’s all I have left.

  Like all of you who may stumble on this page, we were afraid to go out and make contact. We didn’t know what we’d find; we had a good little community here and we were getting by. But DR SAM came back again and took us all, only this time it was very slow. In the time before, it swooped in like lightning and took out so many of the people we loved, but this time it was long and agonizing.

  I’ve watched every one of the townspeople take ill and die over the period of a month.

  I liked it better when it was quick. Not that I like it at all.

  In the last few days, I’ve read about the deltas. Please, if you are reading this, support what they are trying to do. It’s our only hope.

  As everyone around her was silent in response to what they’d just seen, Lany went into the quiet, stern discipline of cop mode. She wrote down all the information about the New England gathering—there were apparently meetings all over the country, if what the delta Web site purported was true. She studied the map of the route to the Worcester Armory that the delta group had placed on the site and marveled that it was so close to the campus of Worcester Technical Institute. “I think I’ve been there for training,” she said.

  As soon as she stopped scribbling the details on the slate, she went after Janie as if no one else were there. “We should go and hear what they have to say. Worcester’s about forty miles from here,” she said. “Especially after what we just saw. A day and a half on horseback.” She looked directly at Janie. “What do you say?”

  Janie didn’t respond immediately. “I don’t know,” she said.

  “What would hold you back?” It was almost an accusation.

  “I have my son’s future to consider.”

  “As do I,” Lanie said. “And they both deserve long lives. If we go out there and find out what’s going on in the world, they might have a chance at that.”

  Janie pointed to her shoulder. “DR SAM’s not the only danger out there.”

  She didn’t need to say a word about Tom.

  “I know there are all sorts of hazards, but with two of us—both theoretically immune—we stand a chance of getting there and back again safely. We can continue to look for signs of renewed infection in places we haven’t looked before. And if what we’re seeing on the Net is true, there’s a developing world out there, and we can find a way to connect with it. Someone might have one of those crazy natural cures for DR SAM for the people who aren’t double deltas. Maybe there’s some kind of vaccine!”

  Janie stood. “There isn’t going to be a vaccine,” she said. “We’ve tried since the day we locked ourselves into the compound to develop something that would work, and even if we or someone else could come up with one, DR SAM is a bacterium—a vaccine isn’t going to confer longtime immunity like it would if it was a virus. Six months to a year, at best. Then you need a whole new immunization, if it doesn’t mutate in that period.”

  “But there are still lots of good reasons to go,” Lany said. “There are other groups out there—we’ve seen their smoke. The
y can’t all be bad.”

  “So why haven’t any of them tried to contact us?”

  “Same reason we haven’t tried to contact them. They’re afraid. They don’t know we’re all friendly any more than we know they’re friendly. But this…With that mission statement, they’ve got to be friendly. But we’ll never know if we don’t try. Look, I’m not saying we should rush right out tomorrow. But for God’s sake, let’s give it some thought.”

  All eyes were on Janie. When the hot seat became intolerable, she got up and left.

  “An exploration,” Lany said when she caught up to her. “Think of it that way. And I’m sorry, I didn’t mean to put you on the spot like that.”

  Janie stopped walking and turned. “It wasn’t pleasant.”

  “I know. I am sorry.”

  “I’m too old to be an explorer.”

  “No you’re not. You’re healthy and strong. And you’re smart.”

  “Right about now I should have been thinking about retirement. My husband and I should be planning a trip to China or a safari in Africa. He was a lawyer, I was a doctor, for God’s sake.”