MAYA HOPE, a medical thriller - The Dr. Nicklaus Hart series 1

by Timothy Browne, MD

  He knew that the Maya should have produced drawings and writings about a great sickness—pictographs of dead and dying people. But only one such image had ever been found.

  In his many books about the Maya—books Pak had given him for his exemplary service—Kwon remembered when the inspiration struck him. He had been flipping through pages of logo-symbolic pictures and actual photographs of pictograph panels rescued from Maya temples. It was as if she jumped off the page—her presence was that palpable. He had been studying the gods and demons worshipped in the culture when he read about tzitzimimeh, a female deity, related to infertility and considered to be a demon. She was feared by midwives and pregnant women.

  The demon deity was portrayed as a skeletal female figure with claw-like hands and feet, a snake-like object slithering between her legs, and an animal figure on her shoulder. She was Kwon’s inspiration. Surrounding her were heartbroken women and their babies­—drawn head downward—indicating they were dead. The text in the book explained that tzitzimimeh was the demon that embodied the souls of barren women. It was the animal figure on her shoulder that fascinated Kwon the most—the animal looked like a ferret.

  Could the Maya have died off by attrition, so the impact had never been depicted?

  Kwon shrugged, finished inserting the blood and fastened a cap securely on the vial. Then he put the vial in a separate tray.

  The ferret was key, and no one else would have understood.

  Only a microbiologist would know that the ferret was the best animal model scientists had for carrying the influenza virus. But the influenza virus was not known to be associated with infertility or stillborn babies. The only virus that Kwon knew of that had any association with sterility was mumps. Kwon understood that both the mumps virus and the influenza virus were single-stranded RNA viruses that come from closely related orthomyxoviruses and paramyxoviruses.

  There was one fact about the mumps virus he had forgotten until he happened to be reading one of his textbooks. A paramyxovirus follows the rule of six; that is, the total length of the genome is always a multiple of six. Kwon knew very little about the Bible, but had read parts of Revelation in his search for understanding epidemics and the end of the world. He nearly fell out of his chair when he realized that the mumps virus was 666 nanometers in length.

  It was then the big revelation hit him. Maybe the Maya did not die all at once from an infectious disease, maybe they just died off. If a virus could cause sterility, how long would a civilization survive? Not long.

  If a virus was the cause of the Maya demise, Kwon had to find the original virus. It wasn’t going to be easy. His own stores of biologic elements were full of the mumps virus, but the current mumps virus caused sterility in humans in about five percent of cases. The original virus must have mutated in order to survive and still keep its human host alive.

  The only way Kwon could find the non-mutated virus was to search for it in Guatemala. Ancient blood was not easy to find, but if a remnant could be found anywhere, it would be in Tikal, the heart of the Maya kingdom. If he could find an animal that carried the virus, recovering it was possible. After all, the HIV virus was discovered in monkeys in Africa.

  Kwon and his protégé Suk surmised the non-mutant mumps virus might be found in local ferrets. The HIV monkeys didn’t develop disease from that virus, and they thought it was possible that ferrets would not show ill effects from the non-mutant mumps virus.

  As it turned out, Tikal was exactly where the virus was found. It was very much dormant and very much present. Its only mutation was that it was no longer contagious to humans. But that was easy to overcome; Kwon and his team supercharged its infectious nature.

  A former student of Kwon’s, who had defected to the Netherlands, had recently mutated H5N1, the avian flu virus. He had combined it with the highly contagious H1N1 flu virus to create a doomsday virus. Kwon admired his student’s courage to publish the results in the journal Science, in an article titled “Airborne Transmission of Influenza A/H5N1 Virus Between Ferrets.”

  CHAPTER 31

  * * *

  Church

  Pak was irritated. He sat in the back seat of his limousine and waited for the bus to arrive at the church. The only good thing about this was that it signaled the end of a very long week with these baboons from the United States. The fake basketball game had been a disaster. The Americans were supposed to lose, but they were so much better at pretending to lose than the home team was at pretending to win. And Pak could have done without the singing. When star player Karl Oakland sang “Happy Birthday” to Kim Jong-un, the boy blushed like a school girl. What an embarrassment. The whole week was a joke. The person responsible for the visit would take the fall. A bullet more likely.

  After the game, Kim Jong-un insisted the players be taken to the new Masik Pass ski resort, recently built at a cost of slightly over $300 million dollars. The lavish resort had infuriated Pak when he thought of his daughters going without rice day after day so that stupid man could have his own ski hill. The ski trip had been a nightmare even though some girls were provided to entertain the players.

  Pak glanced at his watch for the tenth time. At least the week hadn’t been a total waste. He had received the vial and the note, and confirmation the plan was on schedule. Professor Kwon was busy working on manufacturing mass quantities of the virus and a vaccine. I wonder when I will be vaccinated?

  The bus pulled into the church parking lot. It wasn’t Sunday, the customary day of worship in the U.S.; the team was here because one of its members had asked about freedom of religion in North Korea. It became incumbent upon the authorities to demonstrate that freedom, no matter that it was irrelevant. So, before the players boarded the plane, they were taken to the church.

  The building was designed to look like the Presbyterian churches in South Korea; it was such an odd sight in the North. Kim Il-sung had built it as a monument to his mother who was a devout Christian, when North Korea worshipped one God. That was before the Kim dynasty and the cult of personality requiring the worship of the false trinity. Pak knew that it was rumored that Stalin himself commanded Kim Il-sung to remove Christianity from North Korea.

  The church was a sham, like the basketball game. It was a propaganda tool to show religious tolerance to visitors. Kim Il-sung and his son were the only ones who were worshipped in this place. He wondered how that affected Kim Jong-un’s personality. Probably why he was so brutal—if you can’t be worshipped, you should at least be feared.

  He was glad he didn’t have to go into the church. Just being in the vicinity of this place made him uneasy. He was there to observe and to make sure the plan was on track.

  The basketball players were ushered to the front pews in the church. His agency had handpicked faux parishioners to sit through the short service. A so-called priest gave a sermon on the deity of Kim Il-sung, and the players were ushered out. That was that—mission accomplished: a demonstration of religious freedom.

  While the Americans were in the church, one of Pak’s trusted agents entered the team bus with an order to search for anything suspicious. He was actually there to insert an envelope into Charles Hall’s pack. When Hall returned to the U.S., another of Pak’s agents would intercept him and take the envelope. Other agents would see that the message got to Guatemala. Pak recalled with satisfaction the note inside the envelope. It read: Excellent work. Great rewards await you. The Professor states that it is everything you have said. Will await aerosolization testing to move to Noah Initiative.

  CHAPTER 32

  * * *

  Good versus Evil

  Maggie arranged to bunk Buck and Tod in Nick’s room. The Hope Center did not have housing for couples or families, but Tod’s wife, Kim, and their daughters were happy to bunk with the women from California. With their constant chattering, Nick wondered if the girls got any sleep that night.

  He certainly didn’t. It was because he was worried about the difficult surgeries ahead, but Buck
’s snoring didn’t help, and neither did his dream.

  It was the third time since he arrived that Nick dreamed of John. All the dreams were similar. This time, he and John were in their beloved Mission Mountains. Nick remembered how peaceful it was, sitting next to each other beside the campfire on the shore of the high mountain lake. Until a powerful storm kicked up—a wilderness storm with death on its breath—thick, dark thunder clouds crackling with lightning. The tempest began so suddenly and with such force that Nick panicked trying to escape. He got separated from John and was terrorized by the isolation. As he stumbled through the raging storm, he heard John calling him. He followed the sound of his voice to safety and shelter behind a huge boulder.

  Buck’s alarm jangled, and Nick startled awake. He heard Buck stretch and pray, “Thank you, Jesus, for a great sleep.”

  “That makes one of us,” Nick yawned.

  “I didn’t snore, did I?”

  “Heck no,” Tod broke in. “But there may not be any paint left above your bunk.”

  “Man, I should have warned you guys. I’m sorry.”

  “Yeah and handed out ear plugs.” Nick threw his pillow at his bunkmate.

  “Let’s go get that breakfast Maggie promised us.”

  “And coffee.”

  * * *

  The three-year-old’s foot looked tiny once they got it prepped and covered with surgical drapes. Nick was thankful they were going to sit down for the case. It made it easier to rest his arms on the table to help soften tremors in his hands intensified by the magnification of the surgical loupes.

  With a surgical marking pen, Tod mapped out and explained the landmarks on the child’s foot. “You have to know that the anatomy is always a bit off in these kids.”

  “What causes it?” Anna asked. She sat next to Nick.

  “No one is quite sure what causes these darn things, but all the structures tighten up on the inside of the foot and ankle and they pull the foot over, eventually making it look like a club. As they grow, it gets worse and worse. It’s idiopathic.”

  “What’s that?” Anna asked again.

  “It means us idiots don’t know what causes it,” Nick said, making everyone laugh. Anna translated for the Spanish speakers.

  Tod wrapped the tiny foot and leg with a tight rubber strap that exsanguinated all the blood from the leg. He asked Carmen to inflate the tourniquet. Because the neurovascular bundle was small, they needed a bloodless field to see clearly.

  Tod sighed. “Let’s do this thing.” He held his hand to Juan Carlos. “Scalpel.”

  “Thank you for this food,” Juan Carlos said, handing the knife to Tod.

  Tod looked at Juan Carlos and then at Nick. “Huh?”

  “It’s a long story. I’ll tell you after this case. Just asking for a little holy guidance.”

  “That’s a great idea. Jesus, guide my hands,” Tod said as he made the incision into the side of the tiny foot.

  * * *

  The hour-and-a-half surgery went well. Nick was reminded how good Tod’s hands were when he was a resident; as an experienced surgeon, they were even better.

  “Man, that was great! You did an excellent job!” Nick said, slapping him on the back.

  “Well, great help can make you look good,” Tod shrugged, not one to toot his own horn.

  “His foot looks perfect. Really glad to see those toes so nice and pink.”

  “Obviously,” Tod said, “what we do today is important, but honestly, the follow-up care is super critical. We probably need to talk about that. You can do it or I will need to return in six weeks and remove the casts we put on, pull the pins holding everything in place, and fit them with a removable splint to help keep the foot in place. These things are like teeth. You can’t simply put braces on for a short time and then expect them to stay in place.”

  “Yeah, I thought that might be the case. I’m happy to do it, but you’re always welcome.”

  “Thanks. Who knows? I’d love to see the results of our handiwork.”

  “You ready for a Coke?”

  “Am I ever! You ready for the next patient?”

  “I’m just glad you’re here, my friend!”

  * * *

  In the town of Dolores, the three Koreans loaded the virus into the sprayer. The mosquito fogger was the perfect vehicle to deliver the mumps virus to the small town. They knew from their experience in the other villages that it took an extremely small dose to infect a person, and because it was highly contagious, whoever did not catch the virus from the spraying would catch it from a friend or relative who had caught it.

  It took an hour to drive up and down the streets of Dolores, the mist from the fogger wafting through the houses, businesses, and school. The Koreans took no precautions because, thanks to Hwang’s clumsiness when he dropped a vial of the virus in their rented house, they had already been exposed. Exactly eight days later, they had come down with colds. A week later, Suk’s testicles were a little sore, and the others reported similar sensations. He was surprised; he had expected worse from chemical castration. It was good thing none of them planned on producing children.

  * * *

  At the hospital, the second surgery had gone equally well. Tod led Nick step-by-step through the procedure. It took longer, but they finished both sides in less than two hours.

  “We’re going to make a pedi-pod out of you yet,” Tod teased Nick.

  “I thought I was going to be sick when we took off the tourniquet, and the toes didn’t pink right up.”

  “But they did. The vessels sometimes spasm for a bit.”

  “Yeah…just long enough to give a guy a heart attack.”

  “Always something to keep you humble in this game, right?”

  “That’s for sure. Hey, before we finish for the day, can I show you a little baby with syndactyly and see what you think?”

  CHAPTER 33

  * * *

  The Lord is My Refuge

  Nick, Tod, and Buck could hear a buzz of conversation as they approached the small hospital ward of the Hope Center. Seven children and their families occupied almost every inch of the room, and Maggie and Anna chatted with all of them. Carmen and the local nurse focused on Isabella’s family. Isabella’s sister, Elsa, was due for surgery that morning. The air was charged with hope.

  Maggie had squeezed cribs for the smaller children between the hospital beds so their mothers could stay with them. Maria sat in a rocking chair, rocking little Danilo back and forth. He was scheduled for surgery that afternoon.

  Nick was glad to see Elena sitting next to them, nursing her baby with the syndactylized hands. Maggie had told him how the other mothers and their children had helped Elena bond with her infant, how they had put a blanket of love around them both. Last night, when Nick brought Tod to see the baby’s hand, he barely recognized Elena. Her whole countenance had changed, and light had returned to her eyes. Her baby girl had already gained two pounds. She would be christened Anna Elena—something that Anna from Alabama could not stop smiling about.

  Tod and Nick decided they would spend some time that evening researching the standard of care in hopes they could separate her tiny fingers on Friday. The baby was still very small, but they weren’t sure when they would ever have another chance to correct her deformity.

  When Nick, Tod, and Buck came into the crowded room, the chattering stopped.

  “How are the tres amigos today?” Maggie smiled.

  “Thanks to the ear plugs you gave us, well rested,” Nick poked Buck’s arm.

  Buck put his hands together beside his tilted head and pretended to snore loudly. The room erupted in laughter. Even Isabella smiled. Buck spent the previous day entertaining the troops. He showed off his prosthetic legs and amazed them with his soccer skills. He was a huge hit with the families and the orphans of the Hope Center.

  The men stopped at the first bed where a mother held her toddler with a bright blue cast. The child eyed the crowd and retreated shyly into his mo
ther’s arms.

  Nick noticed that everyone was watching them and waiting. “I guess we’re doing group rounds today,” he said sotto voce to Tod.

  “So much for HIPPA regulations,” Tod laughed, referring to the strict U.S. regulations for patient confidentiality.

  “I could excuse everyone,” Maggie whispered.

  “That’s okay. I think we’re all in this together,” Nick reassured.

  Tod picked up the bright blue cast attached to the shy child. He pushed back the cotton wrap from the boy’s foot and revealed five pink toes that wiggled as he touched them. He looked at Anna and motioned to the mother and asked, “Your son do okay through the night?”

  Anna translated, and the mother smiled and nodded. “Si. Gracias doctor. Que Dios bendiga ricamente te.”

  “Thank you, doctor. May God richly bless you,” Anna repeated.

  Tod smiled. “I think He already has.”

  The doctors moved down the crowded row. A mother stood next to a crib, stroking her sleeping daughter’s black hair. She uncovered the girl’s lower body to show hot pink casts on both legs.

  “Nice touch with the color,” Maggie admired.

  “You think she’ll be able to keep them clean for the next six weeks?” Nick asked her.

  “Oh yes. You’ll be amazed. Even with dirt floors.”

  Nick touched the girl’s toes, and she opened her eyes and smiled at him as her toes wiggled. “Kids are so resilient,” he said to Tod. “I can see why you like working on them. The first thing my patients usually ask is when they can smoke and then go through alcohol or drug withdrawal.”

  “You can always stay here.” Maggie said, blushing when everyone looked at her.

  * * *

  The three amigos sat in John’s office as evening fell. The surgeries on the three children that day had gone perfectly with no complications, except when Nick drove one of the pins too far through Danilo’s foot and into the palm of his own hand. He pulled his glove off, inspected and cleansed the hole in his palm with alcohol, but didn’t think he needed to worry about exposure to HIV or hepatitis. At the MED, a whole battery of tests were initiated on both patient and doctor to assess the risk after a stick. The only risk Nick now faced was teasing from Tod.