Natural Causes (37 page)

“And all he wants from us is an empty room with an IBM compatible terminal?”

“And a modem.”

“In that case, we’re all set,” Sarah said. “Glenn Paris has provided us an office in the data processing unit.”

“No questions asked?”

“No questions asked. Rosa, do you think this is something significant?”

“I have believed all along that infection of some sort was the most likely—though certainly not the only—explanation for the DIC cases. So yes, I believe this day could prove most interesting and eventful.”

The week just past had been most eventful as well. It began with the surprise decision by claims adjuster Roger Phelps of the Mutual Medical Protective Organization to settle Sarah’s case. Then there was Rosa’s flight to Long Island to draw Lisa Grayson’s blood. And finally, just a day ago, there was the letter from Sarah to Phelps—formal notification that she had opted to reject the MMPO’s no-guilt-admitted, $200,000 settlement. She would either have the case against her dropped entirely, or go to trial at her own expense.

There would be no settlement
.

Sarah swung onto the exit ramp leading out to the airport. The early-morning overcast was beginning to burn off. The day, with temperatures predicted in the
sixties, promised to be near perfect. Sarah had some clinic responsibilities and some library work she needed to do. But she had no surgery scheduled, and planned to spend as much time as possible with Rosa and her virologist.

“Five whole minutes to spare,” Sarah said, pulling up in front of the Delta terminal departure level. “I’ll wait here. I don’t imagine he’ll have to go through baggage claim.”

“I should think not. He’s booked on the three-fifty flight back to Atlanta.”

Rosa hurried into the terminal. She emerged a short time later, arm in arm with a cheery, ruddy-cheeked fellow who was taller than average by any measure, but positively gargantuan next to her. He had a curved meerschaum pipe bobbing from the corner of his mouth and looked more like the
Burgermeister
of some Bavarian village than a scientist. By the time they had passed through the Sumner Tunnel and back into the city, though, Sarah knew why Rosa spoke of Ken Mulholland’s dedication with admiration that bordered on awe.

“There ain’t much of our little viral friend in your lady’s blood,” Mulholland said with something of a midwestern twang. “But he’s there, alive and kicking. For now, until we’ve got something a bit more scientific, we’re calling him George. Although we could just as easily have made him a Georgia. The first evidence we got was indirect—an antiviral antibody that didn’t match any of the ones we know about. Now we have some actual electron microscope pictures of the little guy. Handsome. A veritable matinee idol. Might be in the adenovirus class. We’re going to be working today on completing the chemical dissection of his DNA. But as far as we’ve gone, he’s a perfect match with the DNA sequence from the previous sample you sent us from Lisa Grayson. How much time before we get to your hospital, Dr. Baldwin?”

“Ten minutes. Less actually. Listen, though. I’m
afraid that when I’m being addressed by someone to whom I already owe a great deal of gratitude, I’ll have to insist on ‘Sarah.’ ”

“Well, then, Sarah—and you, too, Rosa—supposing I use the drive time we have left to give you both a little background of what we’re up against, and what we’re going to try to do today. I’m glad I decided to conduct this business up here. It’ll be much easier for me to operate without looking over my shoulder every other minute. I’ve disconnected the screen on the terminal in our lab. The modem’s hidden beneath a pile of papers. My department head—or yours, Rosa—could be standing three feet away, and he’d have no idea that data’s pouring out of the place.”

“Thank you for going to all this trouble,” Sarah said.

“Just being cautious. This woman here’s a star. It’s time some people down there besides me know it. Now, then. There’s no question your Miss Grayson has a low-grade viral infection of some sort.”

“And not a commonly known virus?” Rosa asked.

Mulholland shook his head. “Hardly. We’re going to finish mapping out George’s DNA as soon as we get your computer booted up. But even at this point, I can say that whatever George is, he ain’t in the books I’ve checked. He could still be something natural that we just don’t know about yet. But I doubt that. A much better bet is something man-made. With luck, we’ll know for certain by lunchtime.”

“Then what?” Sarah asked.

“Well, assuming we finish our DNA sequencing and still suspect George is a product of man rather than a production of God, I think it will be time for a crash legal course on
Diamond versus Chakrabarty.”

“What’s that all about?”

The virologist nodded respectfully toward Rosa Suarez.

“Well,” he said, “it’s about these hungry little bacterial beasties that eat oil slicks. I suspect that when we get
to that point, Dr. Rosa, here, will tell you all about it, since she’s the one responsible for introducing it to our unit. Before we can do anything with
Diamond versus Chakrabarty
, though, we have to get a more detailed biochemical picture of George.”

Sarah pulled up to the security gate at the MCB campus.

“We’re just going in to drop some things off, Joe,” she lied. “We’ll be out in half an hour. Probably less.”

Finding parking within the enclosed campus was never any great problem. But getting past the security guard often demanded inspired guile and panache. This morning Sarah had both. She found an empty slot directly behind the Thayer Building.

“Welcome to the Medical Center of Boston, Dr. Mulholland,” she said.

On the far side of the campus, workmen were setting up barriers around the antiquated, decaying Chilton Building.

“Is that the building they’re going to blow up?” Rosa asked.

“Blow down, from what I understand,” Sarah said. “An implosion. Next Saturday. The hospital press release said that the expert doing the demolition is the best in the world. He claims there won’t be so much as a brick outside of the barriers.”

“Should be quite a show,” Mulholland said.

“Almost everything that happens around here is quite a show. Glenn Paris, the president of the hospital who’s providing your computer today, is the one primarily responsible for that atmosphere. This time he’s actually having grandstands put up. He’s also raising money by raffling off the chance to be the one who actually presses the button. I bought five chances myself.”

“Sounds exciting,” Rosa said. “Well, if I’m still around here, perhaps I’ll join you.”

•  •  •

By noon they were getting close to identifying the man-made recombinant DNA virus that Ken Mulholland had named George. With the exception of a five-minute break to stretch and plod to the men’s room, the virologist had not moved from in front of the screen. Seated to his right, equally immersed in the evolving puzzle, Rosa Suarez determined various probabilities with a calculator and took notes on a yellow legal pad. Sarah, feeling at times like a fifth wheel, came and went, seeing her patients in the clinic, and trying to do some reading for an article she was writing. She returned to the small office each time with coffee or Coke and Danish—always politely refused by Rosa and inevitably wolfed down by Mulholland, who seldom took his eyes off the screen to see what he was eating.

He was younger than Rosa by two decades or so, but it was clear the two of them delighted in working with one another.
Three hundred IQ points between them
, Sarah estimated.
Probably more
. She felt a spark of anger at those who had the audacity, arrogance, and self-serving immorality to have tampered with their BART investigation results.

“Okay,” Mulholland said, still transfixed on the screen, “this is the next sequence. A-T, A-T, C-G, A-T.”

A-T: adenine and thymine; C-G: cytosine and guanine. The paired deoxyribose bases that were the building blocks of life. From medical school courses, Sarah knew the rudiments of DNA structure, function, and replication. But these two, working with Mulholland’s biochemist in Atlanta, were operating in the stratosphere of the subject. At the Atlanta end of the modem connection, the chemist—a woman named Molly—had used specific enzymes to chop the viral DNA into small segments. Those segments had been identified and now were being sequenced by computer to re-create the complex, three-dimensional, DNA double helix that was, in essence, the virus. Mulholland and Rosa were
pausing with each new set of data to extend the model they were building on the screen, and to compare it to an extensive library of knowns.

Sarah watched Ken Mulholland down a pastrami sandwich as he recited the latest sequence of phosphates and deoxyribose units to Rosa.

That’s all she wrote
,
Ken. What you
have is what George is. I’m finished
… and famished
.
Good Luck
.
Molly

The message appeared on the screen, and was followed by a Gary Larson Far Side cartoon in which two geeky scientists, peering intently into their microscopes, were themselves beneath someone’s huge microscope lens. Rosa took a turn at the keyboard, running the final piece of structural information against the library of known viruses. In just a few minutes she shook her head.

“Not here,” she said.

Rubbing his eyes, Mulholland swung his chair around to Sarah.

“George is some sort of adenovirus, but he’s had parts added,” he said.

“He’s bioengineered,” Rosa said.
“No es de Díos
. Not of God. The questions now to be answered are:
By whom?
and
Does George have anything to do with DIC?”

“Diamond versus
—” Sarah was going to attempt the other name in the case, but Mulholland spared her the effort.

“Chakrabarty,” he said. “Rosa, do you want to explain?”

“No, no. You go ahead, please.”

“She’s too modest,” Mulholland said. “Okay.
D. versus C.
is the landmark case for patenting new life forms. Ananda Chakrabarty was a microbiologist working for
General Electric. Back in the early seventies, he genetically altered the naturally occurring bacterium
Pseudomonas aeruginosa
. The resultant bioengineered germ could digest a number of the hydrocarbons found in crude oil, breaking chemical bonds, and in effect turning a disastrous slick into fish food. The discovery was potentially worth hundreds of millions. But the U.S. patent office refused to allow him to patent the beastie. In 1980, the U.S. Supreme Court reversed the decision, saying in effect that there was no difference between building a better mousetrap and building a better mutant.”

“How does that help us now?” Sarah asked.

“Well, it might not help us at all,” Mulholland responded. “But then again, it might. That’s where Rosa, here, came in. With bioengineering companies popping up from sea to shining sea like corks, the possibility of an outbreak of disease caused by a new life form seemed more than possible. The Andromeda Strain in the novel was from outer space. In truth, we no longer have to go nearly that far for trouble. So Rosa made a deal with the U.S. patent office to share their data with us. Whenever a new life form is patented, we get a description.”

“By law,” Rosa explained, “the patent description must be detailed enough so that the life form could be identified and reproduced by an expert in the field. Now a majority of genetic engineering firms cooperate with us directly by submitting descriptions of their new microbes, and often even their work in progress, for inclusion in our data banks.”

“Amazing,” Sarah said. “So now you can tap into your data banks in Atlanta and see if you can come up with a match. Do you have that many new life forms on file?”

“You don’t want to know how many,” Mulholland said.

“Do you want to take a break before you start that
process?” Sarah asked. “We should allow at least an hour to get you back to the airport.”

“In that case, I’ll have lunch on the plane,” the virologist said. “Or have I already had it? No matter. This part shouldn’t take too long, thanks to the miracle of how much money we convinced Uncle Sam to spend on our mainframe. Rosa, why don’t you do the honors?”

“Seria mi placer,”
Rosa replied. “What we’ll do, Sarah, is start with the largest commonality, in this case the type of virus initially used.” She typed.

Adenovirus

onto the screen and entered it. “Then we work our way down. If we get a no match at any point, the game is over. The truth is, the computer could probably do the whole process itself, but I like the adventure.”

“She likes the adventure,” Mulholland echoed reverently.

Piece by piece, Rosa entered George’s DNA sequence and asked the Atlanta mainframe to search for a match. Sarah was astounded at how many recombinant viruses there were.
And the field of genetic engineering is only in its infancy!
Rapidly, though, the number of matches to their virus got smaller and smaller.

“Okay,” Rosa said. “This next piece of data should separate the man from the boys.”

She entered another of George’s sequences, and a second or so later.

No Match

appeared on the screen.

“Damn,” Rosa whispered.

The word was barely spoken when the screen flashed another message:

Typo suspected - Check for data
entry error or repeat inquiry

“We’ll have to find that programmer and give her a raise,” Mulholland said.

“I never could type,” Rosa muttered, studying her notes, then again entering the sequence. “Next time I
will
let the computer do it.”

In just seconds, data began to appear on the screen.

Unknown matched to access number
ACX9934452; probability of
confluence - 100% - Please type
access number and your security
code to continue.

“Bingo,” Rosa said.

She did as the mainframe requested. And almost instantly, George had a new name … and a home.

CRV113 - BI0-Vir Corporation, 4256
New Park, Cambridge, MA 02141;
(617) 445-1500; U.S. Patent #
5,665,297; RDV332, 210 (1984).
Adenovirus spliced with thrombin-
thromboplastin producing genes;
potential application: rapid wound
healing, hemostasis. No further
information available.