by Ezra E Manes
This left the remainder of the team to focus on running thorough diagnostic tests of systems aboard the New Horizon, in particular the automated control system interfaces with the communications system. Samuel had run out of ideas for testing the communications system itself, and nothing of value came out of discrete discussions with the system designers at the Messier Colony. He would continue to consult with those working on the New Horizon as he participated in the medical team activities.
The selective rejection of messages containing Third Moon Rising information was more than a little troubling to Carlos. He and Gloria continued creatively wording messages, trying to convey the essence of the third moon event without triggering whatever was rejecting the messages. They couldn’t even remotely allude to the event or interpretation of prophecies by the Zilans, even when communicating by Hycomms; if they did, the system would not transmit the message.
Earth’s leaders were particularly pleased with the turn of events in getting the Zilans to cooperate in the areas of medicine, agriculture, and food processing. They were also enthusiastic about the Zilan leader’s invitation for the team to help identify the cause of the male-infertility problem. They congratulated the mission team on the success in evoking such cooperative responses from the Zilans, but Carlos chafed at this, for he sensed some undertone to the messages from Earth that he couldn’t figure out.
The first test of the team’s resolve to cooperate with the Zilans came sooner than expected. In the fourth week after the Primary Two-Moon Phase, Caron asked Alex and Laura to examine an esteemed religious leader who was terminally ill in the Zilerip Medical Center. The individual was High Priest Pilone Kilerah, a strong supporter for reform even though he was elderly.
Alex and Laura hesitated to proceed, but Carlos indicated they must do so because it could seriously damage relations at this point to back away.
Caron Cenenteh escorted the team doctors into High Priest Kilerah’s hospital room, and Alex and Laura could tell almost immediately the likely cause of the problem. The priest’s skin was yellow, with splotches of discolored skin visible over his exposed flesh. They pulled out items they would need from their medical kit and began conducting a thorough examination while asking questions of the two attending doctors waiting in the room.
The priest woke during the examination and asked weakly what was going on. Caron introduced Alex and Laura and indicated that they were conducting an examination at the request of his seniors at the Temple of Zilerip. The high priest smiled and nodded his head positively.
The attending doctors were correct in their diagnosis that the liver was failing. In addition, Laura suspected the enlarged kidneys were infected and probably the bladder as well. The attending staff had not been able to insert a catheter into the priest to relieve pressure due to blockage of the urinary tract, and his body was retaining too much fluid. Alex and Laura did not understand why the staff had been unable to insert a catheter before the swelling became so bad, but they were not there to criticize.
The attending doctors shuffled nervously when Laura inserted a needle to begin drawing blood samples, and the lead doctor started to stop her. Fortunately Pilone Kilerah was still awake and held up his hand to stop the doctor from interfering.
“Please, let them do what they can,” he said in a weak, trembling voice. “I am dying. If we can advance understanding using their techniques, I would be blessed.”
Alex and Laura knew they had to get a catheter installed quickly to relieve the pressure in the priest’s bladder and asked for one from the staff. The device provided was archaic by Earth standards, so they asked if there were any objections to using one from their medical kit. There were none, and the attending doctors were very observant as the insertion began.
The small catheter was fed through a handheld device that vibrated the tube tip at a controlled, variable frequency and also administered fast-acting local anesthetic and lubrication from the tip as the catheter advanced through the urinary track. A miniature lens located on the tip of the catheter provided an image of the surrounding tissue as the tip advanced along the urinary tract. It was a two-person procedure, with Laura operating the control and monitoring device while Alex worked the catheter into place.
To the astonishment of the Zilan doctors, the insertion was successful on the first try, though with some pain to Priest Kilerah, who gamely kept silent. The rush of urine discharge initially contained blood, but this quickly cleared. The flow slowed to a dribble within minutes, and the relief to the priest was obvious. He smiled and thanked them.
Laura and Alex used the catheter to look around at the tissue on the inside of the bladder, and it was clearly infected. Laura then collected the urine and blood samples and departed to perform analysis in the hospital laboratory. Alex began discussing the patient’s condition with the doctors hovering close by.
The blood and urine analysis revealed the priest indeed had serious infections in his liver and bladder, and Laura recommended treatment with a strong antibiotic. Caron Cenenteh agreed that they could proceed with administering medication based on the earlier comparisons of DNA and RNA. Laura administered an antibiotic brought down previously from the New Horizon.
High Priest Kilerah was greatly improved and sitting up in bed within two days. He also began showing a hearty appetite. However, he continued having acute pain anytime he did anything that brought pressure on the lower abdomen, such as having a bowel movement.
Alex and Laura reexamined the priest in the company of Caron and the hospital doctors and determined it was highly probable the priest had interstitial cystitis, an infection in the lining of the bladder that was very hard to diagnose and equally hard to treat. This type of infection seldom occurred in men, but was more likely to occur in older men when other serious factors came into play that affected the urinary system.
The normal cystitis treatment was to use nanoagents, in this case a specific bacteriolysin programmed to penetrate through the bladder wall, to get at the infection between the linings. However, Laura and Alex knew the Zilan doctors would consider introducing foreign agents into the body to be very radical and hence contentious. The alternative was to apply long-term, low-dosage antibiotic treatment, which was more in keeping with the Zilan medical approach, and Alex and Laura decided on this approach privately. The high priest would undergo discomfort and some pain longer, but it was the appropriate approach considering the circumstances. With approval of the Zilan doctors, Laura initiated this treatment, which the hospital staff would administer thereafter.
The medical center doctors were impressed and appreciative of the help in saving the high priest but remained somewhat reserved during the summary medical review session after the treatment. This was a natural reaction to Alex and Laura upstaging them in treating the priest, and recognizing this, the two were professional and deferential in the medical review.
Without a doubt, they had made a strong ally in Pilone Kilerah, who indicated he would do all he could to break down barriers to adopting advanced medical practices. Caron Cenenteh was in awe of the two after watching them perform routinely in saving the critically ill priest.
The incident made Alex and Laura painfully aware that a major change was in order in their approach to working with the medical community. If the medical center staff was not successfully applying procedures as basic as inserting a catheter to relieve bladder pressure, then what other essential procedures were they not applying aggressively and successfully? There were likely many of them in areas of invasive techniques that were personally offensive, or that went against religious beliefs.
Clearly the team needed to first spend time working in the University Medical Center observing the normal Zilan medical practices, and then revise their education and training approach accordingly. Caron championed a change to incorporate this approach, which the medical center representatives in the planning group readily accepted.
Carlos directed those working to assess the agriculture
and food processing sectors to adopt a similar approach to the medical team approach: first to closely observe activities in the field, then to decide what should be done to help the Zilans. They proceeded to work with the Zilans to assess current practices to provide the basis from which to proceed with expanded interaction.
However, even with the request from the supreme leader to address the male infertility problem, the team ran into major obstacles getting the medical community or anyone else to work with them on this issue. This prompted Carlos to initiate a meeting with Ceripe and staff to develop a strategy on how to proceed in addressing the infertility problem.
He asked Laura to lead the discussion because her medical specialty was internal medicine, and she had extensively reviewed the information sent from Earth about infertility and impotence in the recorded history of the human race. Of course, Alex attended, and Ceripe brought Starke and Caron to the meeting.
Carlos opened the meeting. “We understand this is a very sensitive, personal issue to discuss for anyone, whether they are from Earth or Zilia. Here, as it was on Earth at one time, the problem of infertility must be addressed openly and thoroughly if its cause is to be found and corrected.”
“We agree,” Ceripe replied with a slight flush to her face. “The alternative of eventual extinction is not very attractive. We will do all we can to solve this problem with your support, but even I find it repulsive to discuss. The intimate lives of our people are very private in spite of what you might think considering our multiple-wife marriages.”
“We understand this,” Laura injected soothingly. “The most likely cause of infertility is something in the environment, not a problem inherent in your people. This was the case on Earth some three centuries ago, and that is what we want to concentrate on first.”
“What was the specific cause of the infertility on Earth?” Ceripe asked.
“It was caused by extensive use of pesticides, herbicides, and chemical cleaners that polluted the environment,” replied Laura. She went on to explain what these agents were and how they had polluted the environment for decades before safer products and techniques were developed. But by the early twenty-first century on Earth, the damage had been done, and the fertility of men in rural areas had dropped dramatically. The drop in fertility for those in urban areas was less, prompting mass migration of people into cities and a shift to automated food production.
“Finding something in the environment would certainly help with our males,” Caron said. “The thought of infertility conjures up feelings of inadequacy, that something is wrong with you personally.”
“Your comment brings up another question that we should deal with up front,” Laura said. “Are we talking only about infertility, or does male impotence also play a significant role?”
The three Zilans were quiet for a moment, prompting Laura to add, “To us, impotence means the inability to perform the intimate act.”
Starke smiled and twisted the tip of his mustache nervously. “No, we do not have that problem in any significant percentage of our male population.” He looked over at Caron, who nodded his head in agreement, though with eyes downcast.
“Then on to another sensitive topic,” Laura said. “Our best chance of finding what is affecting the male population is to examine select individuals who are known to be infertile. It would be best to examine candidates who have sired children and then developed infertility. We can look for physiological changes related to any changes in their environment or in what they consume.”
Starke responded again, with considerable emotion in his voice. “I have two wives and three children, of which I am very proud. I sired all the children early with my first wife and have not sired any others in many years of trying. We have come to believe I am infertile. You can examine my body to help solve this problem, but you will have to be patient. I have the same biases apparent in all of our citizens. I will encourage my wives to participate, but I offer no assurance they will. That is their choice.”
“I also volunteer,” Caron said with an unsettled look on his face. He had been noticeably quiet during the discussion. “I am married, and we have tried unsuccessfully to have a child. I have not married a second time because it appears I am sterile. I can find additional volunteers within the medical community who will participate, though reluctantly.”
“This is a good start,” Laura said. “We will also need candidates from various other occupations and locations to improve our probability of finding the problem if it is indeed related to the environment.”
The momentum of the discussion picked up from there, with Ceripe indicating that she would find other candidates willing to undergo personal examinations. Examination of Starke and Caron would begin that week, with others to follow. In addition, the agricultural and food production teams would look for common agents in the environment that could affect males.
The plan of attack met everyone’s approval, and the meeting was about to break up when Ceripe asked a leading question.
“Is there any reasonable expectation that we can reverse the infertility in our male population, or are we only talking about prevention for those not yet affected?”
“It depends on what has caused the infertility,” Laura replied. “But there is a good chance we can alleviate the problem, or at least that we can do something to make possible the desired pregnancies.”
This latter statement caused Caron to probe what Laura meant. She summarized the full range of techniques available to assist couples in having children, including in vitro fertilization, fertility drugs, and the extreme measure of cloning. She slipped in the reference to an ability in some techniques to control the gender of the resulting fetus but did not make expansive comments on this. There would be time for that once the infertility problem was resolved.
Most of the techniques, except the use of fertility drugs, were repugnant to the Zilans, but they ruled nothing out except cloning if the situation turned more critical with respect to keeping their race growing. The meeting concluded with the agreement that a special team would be set up to investigate the cause of the infertility problem, and another to focus on the best alternatives for beginning remedial treatment for those currently afflicted.
Carlos was pleased with the steady progress made over the next several months as they worked to fulfill the exchange agreement commitments, but it was slow going, as resistance to change came from every direction. Nevertheless, patience and perseverance, and the help of Ceripe’s staff, kept activities advancing.
Carlos was uneasy about holding back the others, who completed the system diagnostic tests on the New Horizon in a matter of three weeks. However, he kept them aboard the spaceship for the most part and did not advise Ceripe that they had completed the tests. He would soon have to present some plausible reason for the continuing delay in expanding technology exchange activities. He hoped Ceripe’s staff would stay busy with other activities until the medical team had come up with ideas about what was causing the infertility problem.
Unfortunately, something happened that overshadowed all other concerns by the Zilans, the mission team, and Earth itself. Late in the fifth lunar cycle after the Third Moon Rising event, all members of the mission team began showing symptoms of an unknown, serious illness. This was something most feared on a mission to foreign soil and presented the greatest challenge the team had encountered yet on the mission.
TWENTY-THREE
FATAL DIAGNOSIS
It was particularly disturbing to Carlos that all members of the team developed symptoms of the illness simultaneously, not just the members on the surface. Those onboard the New Horizon started showing symptoms at approximately the same time as those on the surface. This added to the mystery because several of the team members had been in space for over two lunar cycles when the symptoms first became apparent.
The initial symptoms included mild fever and a red rash on the upper extremities of the body. Nausea and chills followed the next day, and the
rash spread to the lower body. The day after that, all team members began experiencing diarrhea and the shakes, and loss of appetite. Examinations of everyone on the surface by Laura and Alex did not reveal anything that could be causing the illness. The symptoms were very similar to those of viral influenza, except for the rash, but no virus could be isolated.
Carlos was on the surface when the symptoms first appeared. However, this did not make it any easier to communicate with Ceripe and her staff to minimize concerns and reactions to what must be done to address the illness, including controlling its potential spread. The Zilans just did not embrace the concept of quarantine when it came to the Earth team.
“Ceripe, it is best we pull our doctors back from the Zilerip Medical Center,” Carlos said. He had called her office from the embassy, and this was the first time he had made any mention of a move toward quarantine of his team.
“How can we help you if you start withdrawing?” Her tense voice conveyed much more than the question.
“Alex and Laura need to give their full attention to examination and treatment of my team,” he replied. Then after a pause, he added, “And I want to minimize further exposure of your people to whatever has infected us.”
Conflicting emotions caused her facial expression to undergo rapid changes, then solidify into solid resolve. “We want to help you. We need to help you!”
Her emotional statement tore at his resolve. “Believe me, I understand. Being a leader means that sometimes you have to make un popular decisions. Protecting your people is as important to me as protecting mine.”
“All right. But I don’t like it at all. Let us know what we can do to help.”
“Well…we need Smara Trunia and her staff to vacate the embassy until we determine what is causing our illness.”
Ceripe’s face screwed up into a stern frown. She gave every appearance of being ready to lash out at him.
