10
"Jeanette is not the first in my clinical trial to exhibit personality changes," Fielding said.
Kate bit back her anger. She sat half turned in the passenger seat as Jack slowly cruised the empty, tree-lined streets. Fielding was a dark blob in the rear, lit occasionally by a passing street lamp.
"What do you mean?"
She could feel her emotions running wild, tugging her in all direc-tions. She wanted to charge back and drag Jeanette from that house; but she also wanted to hear what Fielding had to say. That might be more important right now.
"Over the past month or so I've had calls from the families of a number of patients in the study. They all complained of personality changes or strange behavior."
"Why didn't you say that when I called you this morning?"
"Because I didn't want you jumping to conclusions. And I couldn't handle a barrage of questions for which I had no answers."
"That's why the house call," Jack said, and Kate picked up on his tone… disdain or disappointment, or perhaps a little of both. "It wasn't for Jeanette's sake. It was for yours. There's been a screw-up somewhere and you're trying to cover your ass."
"I did it for many reasons," Fielding said. "I needed a first-hand look at this strange behavior that was being reported. I figured I'd start with Jeanette, then see if I could observe others. I never dreamed I'd find everyone in the trial in one room."
"Everyone?" Kate said. The night was warm but she drew her legs up under her to ward off a sudden chill.
Fielding was nodding. "All eight."
"What's the big deal about that?" Jack said. "They all went through the same thing, so—"
"They shouldn't know each other," Kate told him. "It's standard procedure in clinical trials to keep the patients anonymous. So, if they've never met during treatment and don't know each other's names, how did they get together?" She turned back to Fielding. "Any ideas?"
"Holdstock said by accident, but that's impossible. And how all eight recipients of the same vector strain managed to—"
"Same strain?" Kate exclaimed. "You mean they all were treated with the same virus?"
Fielding didn't reply.
Jack said, "I believe she asked you a question, doc."
"All right, yes," Fielding sighed. "Terrence Holdstock was the first, Jeanette the most recent."
Kate swallowed. She had an uneasy sense about where this was going. "What's different about that strain?"
"I have no idea."
"He's lying," Jack said.
"I am not!" Fielding sputtered.
"Trust me," Jack said, his eyes on the road, his voice flat. "He's lying."
How can he be so sure? Kate wondered. Or is he just guessing and trying to goad Fielding? Kate decided to weigh in with her own prod.
"One way to find out," she said. "Go to your medical center's practices and standards committee and ask for a full review."
"That won't be necessary," Fielding said quickly. "I've already reported it to the hospital board and to NIH."
"NIH?" Kate felt a wave of nausea. He wouldn't contact NIH unless it was something major. "Why?"
"That's the National Institutes of Health?" Jack said. "Down in DC?"
"Bethesda, actually," Fielding replied. "You see…" His voice shook and his words seemed to dry up. He wet his lips.
This is going to be bad, Kate thought. She gripped the edge of her seat, squeezing it. Oh, Lord, this is going to be terrible.
"You see," Fielding went on, "after connecting the complaints to the same vector strain, I took out the cultures and ran an analysis on the virus. It… it has mutated into two separate strains."
"Mutated?" Jack said. "Does that happen a lot?"
"No," Fielding replied. "That is, some viruses mutate frequently, but not adenoviruses. This was totally unexpected."
Kate closed her eyes. "Mutated how?"
"The original strain remained but the mutation had altered the thy-midine kinase gene."
Kate groaned.
"That's bad?" Jack said.
She said, "It means the mutated strain was injected into the tumor along with the original vector virus. But without the thymidine kinase gene the mutation is immune to ganciclovir. The drug killed off the vector virus and the infected tumor cells—"
"But not the mutation," Jack said. "Oh, hell."
"Right. That means that Jeanette and the others have a mutant adenovirus running through their brains."
"Is it contagious?" Jack said.
"Yes and no," Fielding said. "Adenoviruses usually cause mild infections—pinkeye is a common one—but are caught only from people shedding the virus. These people are not shedding the virus."
Kate turned to Fielding. "We've got to do something!"
"I told you: I've contacted NIH and they in turn should be contacting Jeanette within a day or two."
"I mean now!"
"What do you suggest?"
"Find a way to kill the mutation!"
"I've already begun testing various virucidal agents against it. I'm confident we can find an effective cure."
"But in the meantime," Kate said, "what about other complications?" She envisioned the viral particles invading Jeanette's neurons, multiplying inside, then rupturing the cell membranes and moving onto other cells, their numbers growing exponentially. "What about meningitis? Encephalitis? What about an abscess eroding into an artery and hemorrhaging? She could die, Dr. Fielding!"
"I'm working as fast as I can," he said. "But even if I had a cure in my pocket right now, it might not help us."
"What are you talking about?"
"Consider: why am I here instead of home? Because Jeanette refused to come in to be checked. How do we cure a patient who refuses treatment?"
Kate's stomach knotted as she remembered Jeanette's words this morning: Why would I want to see Dr. Fielding? I'm fine. Never felt better . . .
"It's a gray zone," Fielding was saying. "If the patients aren't complaining, if they deny anything's wrong and don't want treatment… you can see the problem, can't you."
Yes, she could.
A wave of fatigue swept over her, leaving her chilled and achy.
Fielding said, "I'll keep testing the mutation while we wait to hear from NIH. I'm sure a call from them will convince Jeanette and the others how serious this is and that they all need help."
But as far as Kate was concerned, Jeanette already did want help—she'd told Kate so this morning. Pleaded with her for help. And Kate was darn well going to see that she got it.