Authors: Dorian Paul
"Not much of a head start, but the little bugger certainly made the most of his opportunity, hey Francie?"
Francine actually smiled at Sandra before she continued to address them without the need to even refer to Sandra's chart. "Increased concentrations of neutrophils were present within hours after initial treatment. Samples were tested
in vitro
. Results demonstrated cells were primed to recognize the unique DNA marker used in the vaccine."
"There you go, Claire. Proof the vaccine held up its end of the bargain when administered post-exposure. My innate response was on the hunt, ready to kill. What happened next, Francie? Go on, Francie. Speak up."
"Bacterial growth, which had been increasing, held at steady levels . . . before it began to increase again at an exponential rate."
Claire forced herself not to recoil. Tivaz TB must have hidden within the neutrophils sent to destroy it, waiting like a terrorist sleeper cell while protein kinases assessed the situation and helped plan a counter insurgency. Then it erupted with exponential growth. Doubling upon doubling. Before long Tivaz TB would overwhelm Sandra and she'd die . . . as Leila had.
"Roscoe's DNA vaccine gave me a fighting chance." Sandra lightly tapped her chest, where sores had begun to crack her paper-thin skin. "But I just couldn't get up and over the hill. My response wasn't fast or strong enough. So, what do you do now, girls?"
Girls. Sandra was taking herself out of the equation to put Claire and Francine on the same team to work out the ominous problem before them. She blinked back tears and steadied herself. It was appropriate to give Francine a chance to pick up the ball first. Thank God she did.
"What about using a cell surface protein as our vaccine antigen?"
"Why?" Sandra asked.
"Greater specificity than the DNA plasmid."
"Good, Francie, good." Claire was awed watching Sandra complete her last act as mentor by refocusing Francie on the science. "A specific protein-antigen, yes. Such as, Francie?"
"The cell wall abnormality Claire found in Tivaz TB?"
Bingo! Claire's thoughts exactly. All options had to be on the table.
"Claire, would Francie's idea work?"
"It just might increase the response."
"Enough to cure your next patient?"
She winced at the word 'next,' glad no one could see behind her protective helmet. "Maybe. I don't know, but we can't overlook any possibility."
Even though it won't save you.
"Girls, hammer away at its strength." Sandra coughed up bloody phlegm. "Believe me, you can't play games with this bug. Go inside and rip out its guts."
Sandra was right . . . rip out its guts. A direct cell-killing approach with a bactericidal agent could conceivably destroy Tivaz TB. The major problem was how on earth could they aim a bactericidal drug at the heart of Tivaz TB when it was almost impossible to penetrate the waxy TB cell wall? Hope and despair competed inside her heart and mind.
"Dr. Ashe," the voice of Ian Barker interrupted the contest.
He was the only one with a key to the primate unit and he was standing in the hall outside speaking through the audio device in her headgear.
"Sorry to interrupt. I have Dr. Strong."
Her spirits soared. "Have him suit up and join us."
"He's on satellite phone from Africa. He's fine, but he's been in a helicopter crash."
Dear God, no
.
***
"Don. Are you all right?" she said as soon as she decontaminated herself and rushed to her office to take the call.
"Been better, but guess it wasn't my time. Whacked my head something wicked. I might have a bleeder inside."
Her brain examined every possibility. Subdural hematoma? Concussion? And as much as she was relieved to hear his voice, a bleeder meant he couldn't fly till he was checked out.
"They said you were still in with Sandra Cook. How's she doing?"
"Her bacterial cell count's spiking. The DNA vaccine held Tivaz TB off for a while, but now it's on a rampage. I failed her." Saying this out loud shook her to the core.
"Claire, don't think like that."
"How am I supposed to think?"
"Look, you gave her a fighting chance. She had a weak immune system."
"I know, but so do old people, kids, anybody who's had chemotherapy, people with rheumatoid arthritis. I could go on and on." And she did, ending with "And none of those people will have a fighting chance either."
Silence. This was his way of telling her she'd lost it, and unless she sucked it up he wouldn't re-engage with her. And she needed his help more than ever. She took a deep breath and apologized.
"Okay, so what are your next steps?"
It was like a Sandra and Francie replay. "Build a second-generation protein-antigen vaccine and use it in combination with Roscoe's DNA vaccine."
"Which antigen?"
"Tivaz TB produces an irregular cell wall protein during binary fission just when it separates into two cells."
"You've isolated the protein?"
"Not the whole sequence," she admitted.
"Then you're out on a limb, kiddo."
She stifled her resentment. "Roscoe can nail it down."
"You think so?"
"You don't?" she challenged.
He didn't answer.
"Don?"
"Feeling a little lightheaded . . ."
She was frightened, angry, frustrated. Yet one thing she knew for sure was she shouldn't be grilling a man who'd just been in a crash and still made the effort to call her. Nonetheless, he was her lifeline and she needed his blessing, so she rushed on. "I think the quickest thing is to make a second-generation vaccine using this cell wall protein as my antigen. Long term, a direct bactericidal strategy may be the only way to kill Tivaz TB. But it's a long shot and time is running out. What do you think?"
"Bactericidal. The Holy Grail . . ." he trailed off. "Got a nasty headache . . ."
Shame filled her. She'd battered him with questions, and he needed medical attention. Her best hope was to get Roscoe started on the protein antigen vaccine . . . and pray. "Don, get those tests and take care of yourself. And thanks for your help. We'll keep working on everything. I'll see you soon."
She put the phone down, uncertain who she'd let down more, her mentor or herself. She turned to leave her office but David blocked the doorway.
How long had he been standing there? And did he hear the panic in her voice?
"I came to inform you of Strong's accident in person, but events unfolded so rapidly, I thought it best you speak with him as soon as possible."
"Tell me about the crash, David. " Giving voice to her greatest fear was a relief. "Was it an accident?"
"Unclear. Presently, there's civil war in the Congo. Some factions possess sophisticated arms."
Yes, and he should know because he might've sold them the arms. She felt dizzy.
"Every precaution is being taken on Dr. Strong's behalf."
His grim voice told her there was more bad news to come and she wondered how much she could handle.
"Claire, you must be careful, especially after what has transpired with Sandra and Don. Varat could be targeting those in a position to create a cure for Tivaz TB. That puts you at the greatest risk of all."
That's all. Like I didn't know?
"David, relax. I've been in the lab 24/7 since Sandra became infected. I couldn't be any safer."
When he didn't agree and she noticed he was clenching his jaw, she braced herself against her desk with her backside.
"We must discuss Francine Berger."
Chapter 22
"Francine Berger's full legal name is Ditza Francine Berger. She's a native-born Israeli."
So that was her accent. But why was he so sober?
"Her family is prominent in the extreme Zionist movement. They settled on the West Bank and watched their homes bulldozed in conjunction with the one of the recent land for peace accords. They vowed vengeance on those willing to compromise with Palestine . . . and the Mossad is in possession of evidence they've sought it."
She balked. Francie under suspicion? She couldn't, wouldn't accept this. "If we were all judged by our family's behavior, it would be a sorry world. Francine's proven herself as someone I can rely on."
"Agreed, Claire. There may be nothing here."
"Then why bring it up?" Her voice was brittle, even to her own ears. "Now, of all times, with Sandra's life on the line."
"Precisely because Sandra is dying." His hands rested lightly on her shoulders as if to keep her from leaving her office. He understood her all right. She wanted to be anywhere but near him. "You are at risk, and I would be remiss not to inform you of all immediate threats. It is my duty."
"Consider your duty discharged, but Francine is no threat." She stepped out of his grasp. Much as she needed comfort, she was unwilling to accept it from him when he was asking her not to trust Francine. "Excuse me, I've an urgent meeting."
He narrowed his eyes. "Roscoe Smartz?"
"Why do you ask?"
"He's the one individual you have withheld from my questioning."
"Look David, he's producing the vaccine we're giving Sandra."
His eyes quizzed her again. "He can't be spared for half an hour?"
"I need him to take what we've learned and develop an enhancement."
His eyes didn't let up. "If you say so, but I will question him before this day is ended, be assured."
Fighting him would be a losing battle and so she reminded herself they were in this together. He was doing his job, even if they didn't always see eye to eye. And she would do hers.
***
The Ladies Room mirror didn't lie. Her face was drawn, and the long days of unrelenting pressure made her look like hell. She loosened her hair, finger-combed it, and pulled it back again in a tight ponytail. On to Roscoe. They needed to talk turkey.
She thought about the first time they met the morning he showed up at Don's lab on a racing bike, full of disarming energy. He didn't look any older these days. His black curly hair was a little shorter than he wore it then, and maybe he had a few more lines on his face, but he still displayed that whiz kid spirit. And boy did she need a whiz kid!
"Roscoe, I want you to stop producing the DNA vaccine. It's not working."
Immediately his defenses kicked in. "How do you know for sure? If we started it as soon as Sandra was infected, it might've worked."
No getting around the facts anymore. She checked to be certain they were alone and spoke in a near whisper. "I started treatment three hours after she was exposed."
Roscoe's blue eyes bugged out as he did the calculation, subtracting backwards from the time the expedited E.U. approval arrived. In a flash he knew she began treatment before the First-In-Man came through. "Gutsy call, Claire." Now his eyes twinkled an invitation to a
pas de deux.
"I like your style, always have."
She ignored his comment. "Will you report me?"
"Claire, you should know me better than that."
"I know you're smart . . . and ambitious."
"Then why admit to me you broke the rules?"
"Because I need your help to develop a protein antigen vaccine. To get the science right, you need to understand exactly what happened with the DNA vaccine."
"This time we'll get the science right. We're dynamite together. Where do we start?"
He was all smiles. It was a relief to have him jump on the bandwagon so fast but she was still a little wary. "I've found a cell wall protein abnormality that develops when Tivaz TB replicates."
"You've isolated the protein?"
Hadn't Don asked the same question? Wasn't this proof Roscoe was her best bet? "I've mapped the location, but not the exact sequence."
"I'm your man, Captain," he saluted. "You want to use this abnormal protein as our antigen instead of my DNA strand?"
"I want to use both. With two antigens we have two ways to attack Tivaz TB."
His arms shot up in a cheer. "I love it. We offer the Toll receptors two kinds of pizza, one with pepperoni and one with pineapple. If they don't like spicy, maybe they'll bite on sweet."
"That's the idea."
"Great. And with both of us contributing an antigen – each of us owns a piece of the legend."
Only if it works.
"I'm on it pronto. May take me a day or so to isolate the protein."
Way too late for Sandra, but the next attack could come any time. "Ideas of how we could speed up the process?"
"Might be faster to build a separate vaccine. And we should store them separately so one doesn't displace the other. Don't want to dilute the effective dose."
This was why she put up with Roscoe's shenanigans. "If that's the fastest way, so be it. Two vaccines."
He grimaced. "Means two separate injections. Not very elegant."
"Roscoe, elegance isn't the goal. The next person infected with Tivaz TB won't give a fig about two needle sticks."
"Gotcha, Claire. Hey, we're going to get a prize for this. Definitely."
A prize? All she wanted was a cure . . . and to hold her head up high, even though she'd bent the rules with First-In-Man.
***
Sandra's labs continued in a rapid downward spiral. Keeping her comfortable with hospice drugs was the best they could do. Through sheer force of will Sandra remained alert enough to contribute what she deemed 'useful ideas.' At last she dozed off and Claire asked Francine, "Do you want me to stay, or do you prefer to be alone with Sandra at the end?"
"At the end you must go, Claire. Sandra and I have a plan. You should not be part of it."
Assisted suicide. Her hands shook inside the protective gloves. It was illegal in Britain, in most countries. How could she condone it? Yet, having sat with Leila, how could she deny Sandra? But it was wrong. And what if Tivaz TB hit
en masse
, what then? Let everyone decide for themselves? "Francine –"