Killing Dragons

Chapter 5

Five

Thursday, February 11, 10:14 A.M. CDT

Children’s Hospital

Kansas City, Kansas

Dr. Thomas Sternberg stopped with his oncology team outside his patient’s isolation room. He enjoyed walking rounds, as it allowed him to get out of his windowless basement lab, which always made him feel like a velociraptor trapped in a cage. Since his days on the Navy SEAL teams, it was best if he avoided dim spaces.

His patient, Nevaeh, was on the other side of the glass, like a lonely fish in a fish tank. She slept, holding an orca plushie. The nurse at her side wore full isolation gear: blue mask, yellow gown, and purple nitrile gloves.

As the med student began her presentation, Thomas idly fingered his ancient fishhook necklace, which had once belonged to his grandfather in Hawaii, and his grandmother, who he affectionately called tutu--the Hawaiian name for grandparent, had passed it down to him. He had trouble concentrating on the med student’s dry recitation of facts; his mind insisted on plumbing the deeper mystery of the patient’s illness.

Nevaeh had initially presented with a rare melanoma—one with a particularly poor prognosis. The enlarged electron microscope photo of her biopsy looked like a demon inkblot. So, her parents reluctantly opted for Gene Therapy Adenovirus Cytokine, or GTAC, a cancer-fighting gene therapy Thomas had developed. That technique allowed Thomas to kill cancer cells from the inside, by putting cancer killers inside a common cold virus, then infecting the cancer cells with it.

Nevaeh’s response to the treatment was near miraculous. He even let her go out to dinner with her family to celebrate her birthday at a local seafood joint. But when she returned to the hospital, she had flu-like symptoms. That could have simply been an indication that the gene therapy was working to kill the cancer, but hospital protocol dictated that she remain in isolation while they worked her up for infectious diseases.

Thomas recalled the morning he first met Nevaeh. It was in the activity room, where his brother, Daniel, the head curator at the Sternberg Museum of Natural History, was giving a presentation. He showed the kids models of skulls, including those of an anaconda, a Komodo dragon and a Tylosaurus, which were all genetic cousins. Nevaeh immediately identified what all the skulls had in common: a second row of razor-like teeth on their palate.

“If they swallowed you, they would bite you twice,” she had said.

She has spirit. She’ll make it, Thomas had thought at the time.

Now, he wasn’t so sure.

The med student finished speaking, and Thomas addressed his team. “Which infections are on our differential?”

One eager medical student spoke up. “It could be bacterial, viral, maybe even a fungus—”

But before she could go on, the nearby elevator doors opened, and Dr. Katrina Stephenson stepped out and strode toward them. Her blond hair hung in waves over one shoulder, and under her white coat, her tight sweater showed off her cleavage, something Thomas appreciated because in addition to being an infectious disease specialist, Kat was also Thomas’s girlfriend.

Thomas smiled beneath his mask. “So, Dr. Stephenson, what’s the verdict?” he asked as she approached.

Kat fastened the top button of her white coat. “The PCR tests are all negative. So, I think you should consider other diagnoses. She has a fever, which suggests infection, but her inflammatory markers are normal, and her white blood cell count isn’t even elevated.” Kat sighed. “Sometimes, it’s what’s absent that gives us the most information. Dr. Sternberg, this isn’t an infection.”

So, what is it then?

Thomas gritted his jaw in consternation. Nevaeh had survived her deadly melanoma, and he wouldn’t allow her to now succumb to some mystery disease.

Kat gave him a direct look. “This could be a side effect of your gene therapy.”

Thomas blew out a breath. “It’s possible, but unlikely.”

Kat shook her head. “You’re playing with fire, Thomas. There’s consequences to meddling with the genetic code.”

She had a point, but to challenge him like this in front of his team was crossing a line. “It’s the path to a cure,” he said firmly.

Kat turned to sign off on an order on the computer. “Well, I’m discontinuing the big gun antibiotics. We’re pushing antibiotic stewardship. I see no reason to continue them.”

Thomas held up his hand. “Hold on a minute. At least help us figure this out. If it isn’t an infection, and—bear with me—if it isn’t a side effect of the gene therapy, then what else could it be?”

Kat shrugged. “Whatever it could be, it isn’t my field.” She turned and strode away.

Thomas took a box breath, a yoga-like breath that he’d learned as a coping mechanism back in his Navy days. Then he turned back to his team.

“Is there anything else on the differential, besides infection or side effects from the GTAC?”

The same eager student started to speak again, only to be interrupted a second time—this time by the code blue alarm. Thomas looked through the glass and saw the nurse placing an oxygen mask over Nevaeh’s face. The orca plushie had fallen to the floor.

The code blue was for Nevaeh.

He immediately started suiting up in a gown and gloves to enter the room. If she didn’t have an infection, he certainly wasn’t going to give her one. But then the code blue team appeared and barged past him into the small isolation room like African wildebeests in migration, none of them donning the isolation gear.

Moments later, in the cramped space of Nevaeh’s isolation room, Thomas stood by the head resident of the code team and supervised as she intubated Nevaeh. He could not let anything happen to his patient. She was his responsibility.

Anxious for the young girl’s life and not knowing why she was so toxically ill, Thomas’s breaths came fast and shallow, and the world around him shifted and spun. He pushed the vertigo away, not wanting to see the past memories it tended to bring.

But he failed, and the flashback came…

In the ship’s hold, beneath the cacophony of sea lions barking, a dolphin whistles in distress. Taffy pokes her head over the side of the deflating pool, and there is blood streaming down her head. Still, she smiles. She always smiles.

He rushes to her, yanks off his T-shirt, presses it against her head to staunch the flow of blood. He yells at the sailors scurrying around the ship’s hold.

“Get the sling from the Zodiac—hurry or she’ll die!”

Thomas took a deep breath, willing the flashback away.

The head resident of the code team was yelling at him. “Dr. Sternberg! We didn’t have to use paralytics to tube her. Did she already have something on board?”