The Proteus Cure

by Wilson, F. Paul

  But now Dr. Gilchrist said she had to be stopped.

  “Doctor Sheila?” Shen said, hoping for a different answer. “I must stop her?”

  Dr. Gilchrist’s gaze faltered. He turned and stared through the windshield again.

  “No one can be allowed to threaten my sister’s dream. No one.”

  PAUL

  Paul sat down at his computer with a bottle of beer. He turned on the banker’s lamp and stared at the dark screen. Two nights ago he’d left the protagonist in his novel, Grisbe, on page 220, hanging in a precarious situation.

  Paul had started novels before—lots of them—but always with invented characters plunked into fictional settings. That was how he thought writing fiction worked. He tried to copy his idols, John Irving, Charles Dickens, Wally Lamb. But his work always sounded forced, even to him. His characters seemed cardboard-flat, living in manufactured situations. Paul beat himself up with criticism. He’d finally decided he simply didn’t have what it took and threw away all the old partial manuscripts.

  But a few months ago he started a new book. The hell with it, he’d decided. He was going to write a gritty, semi-true account of a part of his life he wished had never happened. No Beverly Hills setting with a Brad Pitt type as the lead. But reality, starring Paul Rosko. Or rather, Jim Grisbe. Ever since that decision to write from his heart, the novel had become an obsession. Each night when Coogan went to bed, Paul slipped into their den and poured out his heart, his memories. What a release.

  After a day like today he needed a release. But too much was going on now to escape into fiction. Coogan was still in the hospital and Paul needed to find those old medical records. Tonight Grisbe would have to wait.

  He descended to the basement and knelt on the dusty floor. Under a naked sixty-watt bulb he started sifting through a large plastic storage bin, kept tightly lidded to protect the papers from the damp.

  Years ago he’d planned to finish the basement, but after the divorce it seemed a waste. Lots of things had seemed like a waste then. So the space had become a repository for whatever overflowed from upstairs. That included Paul’s free weights and punching bags, set up at the other end of the space. Paul found something cleansing in sweating and making his muscles ache.

  Right now he felt an ache in his throat as he sifted through the boxes stacked in the container. The history of Coog’s life. A life that almost ended yesterday.

  Some boxes held the good years—the baby records, the first drawings, the homemade Santa Clauses, Easter Bunnies, and Halloween ghosts. And the photos. Good God, he’d taken so many shots of that boy, all preserved in albums.

  He opened one with YEAR 4 Sharpie-printed on the cover and scanned the photos, shaking his head at shots of him together with little Coog. They’d looked so much alike back then. What had happened? When had Coog developed that cleft in his chin? Where had that come from?

  He moved on to the bad years: two boxes of medical records, hospital bills, doctor reports … the detritus of a desperate battle.

  And somewhere in that mess lay Rose’s histocompatibility results.

  Took him an hour and a half, but he finally found Rose’s printout. And his too. As he hefted the two reports he remembered Sheila’s warning.

  Even though the test won’t change Coog, a negative-paternity result will alter a crucially important part of his life.

  Will I be different? Will I be hurting Coog?

  He put down the reports and walked over to his workout area. He pulled on a pair of Everlast gloves, stepped up to the speed bag, and began working it.

  He moved to the heavy bag and began punching away. No fine rhythm here, just brute force, pounding jabs, uppercuts, and roundhouse rights and lefts until his arms ached.

  And by the time he’d finished and stood there bathed in sweat and gasping, he’d made up his mind.

  He had to know.

  THREE

  SHEILA

  The first thing Sheila had seen in the morning’s emails was a note from Hal Silberman, wanting to talk to her.

  Yes!

  She made a beeline for his office. “No need to tell me who this is about,” she said on entering. “Tanesha Green, right?”

  “Right.” He pointed to the only other chair in his cramped office. “Have a seat.”

  Hal didn’t match his office. He was trim, always perfectly groomed, and obsessively neat; Sheila had never seen him without a bow tie. His office, on the other hand, looked like a paper-recycling center.

  Tanesha was scheduled for her follow-up soon and Sheila wanted to offer her some encouragement. But she didn’t see that happening.

  The extensive labs—she’d put a stat on the orders—showed nothing. Sheila had done the usual profiles, plus more esoteric tests to tease out some rare variant of one of the connective tissue diseases or evidence of an autoimmune disorder. But every result fell within the normal range. The woman was—to borrow a phrase from her residency—disgustingly healthy.

  Jim Haskins’s dermatology consultation yesterday was equally helpful—as in, not at all. He’d called to say how fascinating she was but his diagnosis was a figurative head scratch. He recommended a number of blood tests—all of which Sheila had already ordered—and deferred a diagnosis until he’d seen the path reports on the biopsies he’d performed.

  That was where Hal Silberman, Tethys’s dermatopathologist, came in. Hal said, “I wish I could add to what’s in there, but …”

  “What do the slides show?” Sheila said.

  “She has some melanocytes that are producing the expected amount of melanin for a dark-pigmented person, but in among them are cells that are producing much less. So even though she appears to be suffering a general loss of pigment in the macroview, histologically it’s spotty.”

  “Not a vitiligo variant, then?”

  “No. Not mycosis fungoides, either. She’s got these normal-looking cells that have simply cut back their melanin production.”

  “Ever seen anything like it?”

  He shook his head. “Never. I searched through a number of sources and couldn’t find a thing that resembled her slides.”

  “Any guesses as to etiology?”

  “Off the top of my head I’d say that inhibition of tyrosinase activity is somehow involved, but don’t ask me how.”

  Sheila knew that tyrosinase stimulated melanin production. Drop activity to zero and the result was an albino.

  “So all the cells are producing melanin, just in different quantities.”

  He nodded. “Right. Which implies that inhibition is originating locally, at the cellular level. Because a systemic process would cause more uniform changes.”

  “Okay. But what about the hair changes? I knew Tanesha from her VG-seven-twenty-three therapy for colon cancer. She was an overweight, very dark-skinned African-American woman. The Tanesha I saw this week has changed into a hefty Jodi Foster. Light skin, straight light brown hair at the roots, but with the kinky black hair at the ends.”

  “That’s another one for the books.” He rubbed his jaw. “Her follicles have changed shape and so, consequently, has her hair. The older portions of her strands are flattened, just as you’d expect in the woolly hair of a typical African. The portions nearest the scalp are oval in cross-section—typical of Caucasians. And the cortices of the newer segments contain less melanin.”

  That explained how Tanesha’s hair was changing from kinky black to smooth brown. But not why.

  “I’m going to send slides to all the big centers and I’m arranging a scanning EMG of her follicles. Maybe we’ll get a hit.”

  “Any chance her chemotherapy could be responsible?”

  “Hadn’t thought of it. Why, are there other cases?”

  “Two weeks ago, a Caucasian women who had the same therapy with the opposite problem. She died accidentally before I could look into it.”

  He smiled. “Never rule anything out. That’s my policy. I’ll research it with that slant, maybe check with the
doctor who sent her back here. I’m sure his name is in the file somewhere.”

  Finally someone responsive to her theory.

  “So you think there’s a possibility the changes could be from the chemo? From VecGen’s therapy?”

  “You never know. Certainly a possibility. Whatever happens, Sheila,” he said, “don’t lose track of this lady. I’d like to do another biopsy next week and compare slides.”

  Sheila left. Silberman didn’t dismiss a link the way Bill did. Certainly a possibility. If Hal found a link, Bill would have to take him seriously. This guy had worked for Tethys since it opened its doors. Slides to all the major cancer centers. He guy didn’t fool around. Sheila felt better already. Between Hal and her, they’d find out the truth.

  PAUL

  “Now,” Paul said, “let’s take a look at the goateed gent in the first panel on the next page.”

  He sat at Coog’s bedside. His boy looked pale this morning, but not nearly as pale as when he’d had leukemia. Stronger than yesterday, and he was eating a regular diet, but still had an IV running. The nurse said she expected Dr. Brody, the internist overseeing his care, to order the IV pulled and discharge him when he made his morning rounds.

  Paul refocused his attention to the matter at hand: He and Coog each held a copy of The League of Extraordinary Gentlemen.

  A comic book, Paul thought. No, check that: a graphic novel.

  He’d never dreamed he’d be reading and discussing such a thing—and with his son of all people. But he’d come to regard this as an extraordinary work of popular fiction. He hoped that by pointing out the literary references in the comic he could induce Coog to check out the originals. Anything to divert him from those damn videogames.

  Paul had tried to get into the games with Coog but all too quickly learned that he lacked the reflexes, the manual dexterity, and—most important of all—the patience. One day it had taken everything he had to keep from ramming the damn controller through the screen.

  Coog shifted in his bed and winced.

  “The ribs?”

  Coog nodded. “They’re not so bad if I stay still, but rolling over is the pits.”

  “Want me to have them give you a pain pill?”

  He shook his head. “Nah.”

  Paul smiled. “Think they’d give me one?”

  Coog laughed and grabbed his side. “Don’t make me laugh! Please! It kills.”

  The boy’s pain subsided and he went back to flipping the pages.

  “I never knew all this stuff was in here.” He looked up at Paul and smiled. “It’s so cool, Dad!”

  Dad …

  Despite all Sheila’s caveats, he had to know. He’d never been one to take things on faith. He knew he had a lot of St. Thomas in him, had to stick his finger into the wounds, confirm the gap in the flesh, feel the congealed blood.

  Learn what’s real and then deal with it: That was the way he lived. He couldn’t stand being in limbo.

  That was why he’d dropped of the HLA reports at her office this morning. Soon he’d know—

  “Are you mad at me?”

  Coog’s voice snapped him back.

  Paul forced a smile. “No. Why would I be mad at you?”

  “Because of the accident?”

  “That wasn’t your fault.”

  “Yeah, but I should have seen him coming.”

  “And I should have insisted you go to the skateboard park.”

  On reflection, Paul had realized that he had to shoulder some of the blame. Yes, the guy in the Hummer should have been going slower and paying attention instead of yammering on his cell phone, but Coog should not have been skateboarding in a parking lot. Paul had to take full responsibility for that. It had seemed harmless then, but it was a dumb thing to allow. He’d somehow assumed that if he was there watching, everything would be okay.

  Wrong.

  The memory of Coog’s skinny, angular body sprawled unmoving on the asphalt would stick with Paul the rest of his life.

  “You sure you’re not mad?” Coog said.

  “Positive. Why do you keep asking? Am I acting mad?”

  “Well …” he twisted his mouth to the side, a tic Paul found endearing. “Maybe not mad. But different.”

  Different …

  The word sucker-punched him.

  Was his relationship with Coog changing already—even before the results? Was he unconsciously distancing himself?

  No. He couldn’t allow that. Biological son or not, this blessed boy was at a critical stage. Feeling rejected by his father … who knew what that could do?

  Paul hid his turmoil.

  “Maybe I’m suffering some residual shock because I almost lost you. You’re all I’ve got, Coog. If …”

  The swelling lump in his throat choked off the rest.

  He couldn’t jeopardize moments like this. The mere possibility was unbearable. He’d tell Sheila to cancel the paternity test.

  He looked at Coog’s smiling face. This boy was his son. He couldn’t allow some lab test to change that.

  SHEILA

  Sheila’s shift was nearly over and she was signing off on the last of her charts. She heard two of the nurses talking and laughing, discussing their plans for the evening. They were going to see a Johnny Depp movie. Simple, but at least they had somewhere to go. And after the last few days, she needed a quiet night alone, but it seemed quiet nights alone were all she ever had.

  She heard Randy the orderly call someone. She leaned in to hear.

  “I’ve got a gig tonight. Can you make it? Great, bring friends. Lots of friends. It’s gonna be a great time.” He hung up.

  She studied the tall, longhaired man, his wavy locks tied in a ponytail. She’d heard him talk about the metal band he played in part time and wondered why everyone else seemed to have outside lives except her? At the end of her shifts all she could imagine was going home and putting her feet up. Once in a while she visited Abra, but that was more a mother-daughter thing. No friends her own age, no men calling. Work had become her life. It had been that way since Dek died. There never seemed time for anything or anyone else.

  One of her dad’s favorite songs echoed back to her. Don’t get around much anymore …

  Ain’t that the truth.

  As she headed for the parking lot, she felt a little jealous that all these people were going out while she’d be home alone. Again. Spending her night re-watching You’ve Got Mail or As Good As It Gets. Or going to Abra’s and re-watching Casablanca or The Maltese Falcon.

  Her life: She worked and she went home, worked and went home. And it wasn’t so bad, really.

  She reached her 4Runner and had just started it up when she saw a familiar figure waving.

  Paul.

  She turned and watched him hurry down the walk from the hospital wing carrying a skateboard. She cringed recalling Coogan’s accident.

  She pointed to it. “Don’t tell me you’re—”

  He laughed as he stopped. “Not a chance. This wound up in the lost and found and Coog wanted it back. Not that he’ll be on it any time soon.”

  “I hope not.”

  “How’s Coog doing?”

  “Great. Doctor Brody’s discharging him today. Hurts all over, especially those broken ribs, but otherwise … it’s like a miracle.”

  She hesitated. Here was why doctors were advised not to treat family members or friends. Narrowing the distance between physician and patient could lead to major mishaps—like missing or delaying a diagnosis because you don’t want to believe it’s that diagnosis—or minor predicaments like being the bearer of bad news to someone with whom you have more than just a professional relationship.

  Sheila faced that with Paul.

  As an oncologist here, she never had to tell anyone that they had cancer—they all knew that before they passed through the gate. But she’d had to tell too many that she could offer them no hope. The experienced oncologists had warned her about becoming emotionally involved. A high perc
entage of her patients were going to die no matter what she did.

  So far she’d failed to develop that hard shell. She hated to think that one day she’d be viewing her patients as tumors, or problems to be solved, rather than as people. But she supposed it was inevitable. Allowing yourself to care, and then failing people you care about, dashing their hopes, numbering their days … she’d have to build that shell or go mad.

  And now she had bad news for Paul. But at least not cancer.

  Sheila shut off her car and stepped out. Paul leaned against Hank Belson’s silver Jaguar in the neighboring space. He folded his arms. His eyes locked onto hers.

  “I’m glad I caught you. I wanted to talk to you about that paternity test.”

  Here we go.

  She said, “The results—”

  He waved a hand. “I know they’re not back yet. I just wanted to tell you to cancel it.”

  Sheila blinked, startled.

  “What changed your mind?”

  He shrugged. “Like you said, finding out may change me. It would change something. I realized it doesn’t matter. So, thanks but no thanks. Please cancel the test.”

  What a wonderful man, she thought. Why aren’t there more like him?

  Yet she wished he weren’t quite so wonderful, because what she knew would rattle his world to its foundations.

  Her heart urged her to shred the results, but she knew the billing department’s computer had already charged Paul’s insurance company for the test; the company would soon send him an EOB and then he’d want to know what she was hiding.

  Better to deal with this now than later.

  “The results came in this morning.”

  His eyes widened. “So soon?”

  “It wouldn’t be so quick if we were dealing with a commercial lab, but we do our own.”

  Paul had dropped off the HLA reports and she’d delivered them to the lab. This afternoon’s printout had confirmed Paul’s fears and added a result she’d never anticipated. Something he should know.