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Authors: Mark Atkisson,David Kay

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“Sounds like a plan. When do you expect I will
receive the first data packet?” asked Ben.

“Probably around 5 p.m. today. I have ten regions
and I expect it will take me at least an hour per region. I also have to look
at the live batch results and then I should receive my family’s test results
around three this afternoon. I will try and get you at least five of the
regions today. If you come up with anything in the meantime, let me know.” said
Katie.

They both agreed that this would work and they
parted ways. Katie had a lot of work ahead of her but now at least there was a
plan and she knew that without a plan there would be no result, except death.
Meanwhile, she needed a Diet Coke.

Chapter 19

 

 

Resident physicians at
Johns Hopkins adored Dr. Stephanie Metcalf. In a paradoxical way, Dr. Metcalf
was affectionately known as “Grumpy,” for her mild mood slumps in early morning
rounds before her first coffee kicked in. She was therefore always the
recipient of a ritual cup of “Grumpybucks” -- a Mocha Frappuccino to be exact
-- from one of her Residents as daily rounds at the Medical Center began. The
Residents even kept a “Grumpybucks Call Roster” and woe be it to the one who
forgot to get the coffee!

Dr. Metcalf was a renowned hematologist once
nominated for the Nobel Prize for Medicine for her ground-breaking work with
hemoglobin analysis. Now late in her seventh decade of a rich life, she
remained as sharp and energetic as ever, leading Dr. White’s team tasked with
covering the western hemisphere. But Grumpy had suddenly fallen ill the day
prior, and Dr. White and the entire team were worried about her.

With each passing day in the face of the daunting
task before him, Dr. White refused to lose hope in finding the pathogen behind
this unseen enemy, an elusive foe one of his brightest fellowship students
repeatedly termed the perfect pathogen -- a student nick-named Sneezy for his
seminal and precocious work on the pathology of allergens and the immune
system.

As a scientist, Dr. White knew this perfect
pathogen was out there somewhere to be found, all he needed was time to find
it. Yet in his stolen, restorative niche moments each day, like when driving
his new Audi A6 to and from work, he could not help wondering if this might be
the end of the human species. Never had science confronted such a phenomenon
like this and his gut was asking him -- no, his scientific mind was telling
him, given the speed of the disease’s course -- humanity could be facing a mass
extinction event.

Many scientists had been suspecting an extinction
event could eventually impact the human species, just as it had already
happened to so many individual species in the modern age and before: the Dodo
Bird; the Passenger Pigeon; the Eastern Cougar; the Javan Tiger; the Carolina
Parakeet; Cro-Magnon man; the wooly mammoth. Some experts had suggested the
major threat would come from an evolving human disease brought on by climate or
environmental change, and not by rising tides or wide-spread drought.

Ensconced in the new car smell he enjoyed so much,
Dr. White wondered aloud to himself: Measured in geologic time, had the
Holocene extinction, known also as the Sixth Extinction, now come to visit the
human race?

 

CHAPTER 20

 

 

Katie returned to her
office around noon and Beth was there collating the data regarding the
longevity study into regions. “I don’t know what I would do without Beth,”
thought Katie.

“Hi Beth, how is everything going?” asked Katie.

“Pretty good. I am just about done separating all
the data files by region and then you’ll be able to access the database for
each person based on their group.”

“That’s fantastic,” said Katie. “I do have a favor
to ask of you. Starting on Monday, I will start working out of the main office,
so I need you to supervise the operations here. This should only last until we
come up with a solution to remedy the illness caused by SDX. Can you do this
for me?”

“Sure. What is SDX?” asked Beth.

“Oh, I’m sorry. That is the name the Johns Hopkins
Team has given to whatever is causing the deaths among the elderly. It stands
for symptomatic disease unknown.”

“Well, I guess it is easier than saying, that
disease or bug, or whatever,” Beth chuckled. “…and yes, I will be happy to run
the place while you are downtown. I expect most of the action will be taking
place down there anyway, don’t you think?”

“Probably, but I may need access to some of the
hard copy files on occasion, so it will be good to have you here since you know
where everything is.”

“Like I said, no problem,” said Beth while giving
a thumbs up gesture.

Katie went into her office and powered up her
computer. She was hoping the test results on the living group were in her email
so she could start analyzing the results.

“There it is,” she said excitedly to herself.

Katie immediately opened up the file and did a
quick visual of the data. The data was arranged in columns so she moved quickly
to the tests of interest. Just as she thought, they were all high on the first
test. With information provided by Ben she had been able to improve her
algorithm so that it would check for possible elevations, but also for
mismatches at the same time. She thought she should be able to run the algorithm
on all 37 samples in a little under thirty minutes.

In short order, she had all of the data uploaded
and got the analysis underway. She planned on doing the same thing with her
family’s data when she received it later that afternoon. She started to think
about the DVC earlier that morning and the visceral reaction that Jim Redman
had when he heard her say he was probably positive for SDX. It wasn’t unlike
her own reaction, only she was the source of the information and not the
messenger in her own case. She wondered how the others on the list would take
it when they found out. If the people were as important as Sarah had said, and
if they were positive, then she was sure someone would be lighting a torch
under someone’s butt to find the cause and remedy pronto. In a morbid sort of
way she found this kind of humorous. But then she remembered, if she was right
then her family was also at risk and all she wanted was to save them right now.
Her humor quickly disappeared.

As she was reviewing her email, she noticed the
live data analysis was complete and ready for final review. She jumped into it
with great vigor, for she wanted to know if she was right or wrong. She looked
at the first sample and saw exactly what she expected. Next, she checked the
date and location where the blood was drawn:  It was five months ago at NMMRC
Bethesda. Then she checked for mismatch data and there was none. Each of the
six tests out of normal range. She paused, and looked at the biographic data
for this test subject. He was 58 years old. She wondered how much time he had
to live. With that thought in mind, she remembered how critical it was that she
make no mistakes.

Each test took her about five minutes to review
and double-check. At 2:30 p.m. she was about halfway done and she decided to
take a five-minute break. Every test subject was positive for SDX so far, just
as she thought. She expected the same for the rest, but she had hoped that
there would be at least one negative, so that there would be at least one data
point to investigate.

By half past three, Katie had reviewed all of the
data. All the tests were  positive. Katie sighed, saying to herself, “Only bad
news here.” She called Sarah to break the news.

“Hi Sarah. I have just finished reviewing the data
for the 37 living blood sample batch tests. Unfortunately, it is as I expected.
All are positive for SDX.”

There was silence on the other end of the line.
Then Katie remembered that one of the tests was Sarah’s. “I guess she was
holding out for the possibility that she wouldn’t be a carrier of SDX,” thought
Katie.

Then Sarah spoke. “I guess I am still a little
stunned, although I have been trying to prepare myself for this all day. I
heard what you said earlier during the DVC, so this should not be a surprise to
me. It’s just a little devastating, and I know you know what I mean because you
seem to have already come to grips with this new reality. I need to pass this
on to all of the key players. I am sure there will be some questions. Will you
be in this weekend?”

“I plan on working all day tomorrow, but I won’t
be in on Sunday as I need a break. Anyway, there won’t be anything specific for
me to look at on Sunday since I will have completed my analysis and my data
will be with Ben for evaluation,” explained Katie. “I am going with the family
to see Rob and my parents on Sunday, but I’ll be on my Blackberry. There is a
real possibility that this will be the last time we see them alive.”  When
Katie said this she started to sob.

She pulled herself together and said, “I want to
think I‘ve come to grip with all of the possibilities, but the reality is,
there is the potential for so many deaths which will affect every family in
America, and the world. I am not sure how the average person will hold up under
all of this grief.”

“Be prepared for a visit to the White House
tomorrow afternoon,” said Sarah. “It isn’t for certain, but I have a feeling
the President will want a briefing directly from you. What is your
recommendation now that we have the live batch information?”

“I discussed this briefly with Ben earlier today
and we want to get the blood samples from the submarine crew, and at the same
time, I think we should extend the testing of live samples through use of blood
bank samples. This is less invasive and won’t cause as much  fear in the
community. Obviously there is a chance that someone at one of the blood banks
could put two and two together and draw some conclusions. It may be hard to
keep this under wraps,” said Katie.

“Good idea Katie. Let me see what we can do without
raising too much concern. I think we should get samples that have a large
geographic and age separation. What do you think?”

“I agree. I would like to get some data from blood
that was taken from the younger part of the population, say 18 to 25, to see if
they too are positive for SDX,” said Katie.

“Have you analyzed your family yet?” Sarah asked.

“No, the data just came in before I called you. I
will work on them now and then I will start the longevity data analysis.  The
more I think about it, I believe the longevity data may be the best chance for
finding what is causing the deaths.”

“Well, you have been right so far. Keep up the
good work. We are all depending on you Katie,” said Sarah.

“I will call you if I find anything out of the
ordinary as I start to analyze the data from the longevity study. I will begin
sending information to Ben later this evening for his analysis.”

“That sounds great. I will see you get the Sub
crew numbers also. Good hunting.”

Katie hung up the phone and went immediately to the
data for her family. She didn’t think she needed to run it all through the
algorithm just this minute, she could do that later. She wanted to check the
six tests results first for each of them to see how that looked.

She looked at Rob’s results first. The first test
was high. So was the second and third. She was resolved that the news was going
to be bad. Rob was positive for SDX. She looked at the results again and then
started to cry. She could hardly catch her breath. Had she done this to him? 
She didn’t know for sure, but right now she felt responsible.

She pulled herself together and started the
analysis of Brett’s data. She was hoping that the children weren’t old enough
to be carriers, but then the memory of the death at the Center brought her back
to reality. He was also positive for SDX. By now she was trembling.

The next one on the list was Sam. She almost
wanted to close her eyes and wish away the results. The first test was high. So
was the second, third and fourth. After another minute, she had verified that
Sam too was positive. He was only 14 years old and he was going to die if we
didn’t find a cure, she thought. She started to get sick to her stomach. It was
all she could do to not throw up.

The last one was Hope. She thought to herself, why
even check?  She already knew the result. She would be positive just like the
others. As she reviewed the data, her jaw dropped, then a slight smile came to
her face. The first test was negative. The second negative too. She frantically
searched for the other four test results and they were also negative. Hope was
not a carrier of SDX! She was not yet infected!  This was a miracle, Katie
thought as she breathed a sigh of relief.

Katie’s head immediately started to spin with
thoughts of what the best course of action would be now. Should she isolate
Hope?  Have her wear a mask?  Her excitement was so overwhelming she almost
forgot about her own fate, and the fate of the rest of her family. Suddenly
though, she was sure there would be a cure. Her family would be treated and
continue to live the wonderful life they had built for themselves. Yes, she was
sure of it.

Katie knew she needed to share this information
with Sarah and Ben immediately. As she picked up the phone to call Sarah, she
paused briefly, anticipating Sarah’s first question. Why has hope not
contracted SDX when the rest of the family has?

Katie pondered this question for a few minutes.
There were dozens of possible reasons why. Perhaps there are a lot of children
who have not contracted SDX. Maybe it has something to do with her being a
young female, or her Down syndrome. Or maybe the test results were just wrong.
She should have them done again to double check.

Katie picked up the phone for the second time and
shared the information with Sarah. She was excited about the fact that there
had been one live sample that was negative. After they discussed the possible
reasons why, they both decided that the safest bet was to do a retest. It would
be a hassle for Rob to bring her all the way out here this evening, but it had
to be done.

After hanging up with Sarah, Katie picked up the
phone and called Rob. “Hi honey, you remember what we talked about last night.”

“Of course I do, but I guess you don’t want me to
say it out loud on the phone.”

“That is right. I need you to bring Hope out so we
can get her sample again. It looks like there may have been an error in
analyzing her sample. I know it is a hassle, but this is very, very important,”
said Katie.

“We will be out at about six, if that is alright with
you. Maybe we will go to Macaroni Grill this time?” he asked.

“That sounds good to me,” said Katie. “See you at
six.”

Katie had about an hour to start analyzing the
longevity data, but she needed to email Ben first with the information on Hope
to get his take.

Her email read:

 

Ben,

 

I believe that Sarah already told you but all 37 of the
live test batch were positive for SDX. Some new information though, I finished
analyzing my family and they are also positive except for my daughter, Hope. I
am having her come back in this evening for a retest to verify. Any thoughts? 
Also, I should have the first packet of regional data to you in about
forty-five minutes.

 

Stay tuned,

Katie.

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