Tuesday, November 27, 2007

Twenty-First Century Festering Wounds-7

Armed with the knowledge of genetics research, I felt ready to cure Sam Vespucci.
The real question that needed to be answered to get to a cure, was what on earth I was supposed to do with the knowledge of the gene that had crippled his ability to clot properly. Coagulation was the key, but really how did knowing what was wrong do us (and more importantly, Sam) any good?

I wanted a few months to mull these thoughts over, maybe present these meetings at a high-impact science conference, so that I could formulate the best way to be there for this dying soul, but such a luxury was not mine to be grasped.

I had to take this basic understanding and convert into some sort of life-saving elixir, and do it fast. But was such a thought impossible, left to the mythical worlds of alchemy and magic?

It was not clear, but there was only one thing that was clear to do, and that was to try to apply this knowledge. The WASP gene is critically important for clotting and other forms of cellular skeleton building, and Mr. Vespucci had lowered his expression of this gene. Could I turn the gene on somehow? Replace it with some other factor? Perhaps something artificial? Nothing sounded like a logical, or at least possible solution.

As my mind raced from option to option, it was clear that my tools in the laboratory would not suffice. Would I only be able to tell Sam why he was dying, without telling him of a way to avoid his demise? I hoped and yes, I even prayed, that he would survive thanks to some insight that I could provide. I hadn't slept in days, pondering literature on WASP as a molecule, but it didn't make sense. It's not as though he was born with a clotting problem. What happened to this guy to make him so unable to clot?

Greg Kim, my M.D. friend, gave me a call. It was the call that I had dreaded since I had started this project.
"It appears that Sam is in full shock. His wound has been infiltrated yet again, and this time it looks like it may go systemic. His whole body will be a crawling bacteria incubator in a few moments. If you have made any progress with how WASP could be important, now is your chance."

I started stuttering, wanted to say something, but nothing would satisfy our question. Nothing intelligible left my lips, except for the clear message that I was unable to give an answer.

"You don't know, do you? Well then, I'm wasting my time on the phone."

The phone hung up on the other end, as Dr. Kim doubtless had to go off to attend todo all that I could, but I was still hopeless. What could I do with my knowledge? If it was merely kept up in this storehouse of facts called my brain, it would make for interesting party conversations, but without any ability help someone it would have been better to have never known what was wrong.

Like the man on death row who knows the date of his doom, had I merely told him the composition of the chemicals in the lethal injection? Would he even come out of the sepsis that poisoned his body and mind? Would I spend the rest of my life knowing that I had come close to a cure but had faltered at the end? I needed to see him at least one more time, perhaps that would help.

Leaving my office, my eyes wavered from side to side through the halls of labs, hoping that some clue would open my eyes to the way to apply my knowledge, but to no avail. I might as well have looked at a blank slate. Nothing came to me.

Pulling into the hospital, I parked in the temporary area. Parking tickets and car towings could come and go, that was unimportant. What mattered most was to not let this chance to see Mr. Vespucci at least one more time slip away.

When I crossed the threshold to his room, I remembered the first day when we met. The odor that first knocked me to the floor had worsened to new heights, or should I say depths. He was unresponsive but still alive as a team of medical technicians used that frighteningly harsh cleansing apparatus to remove the bacteria from his wound. Hopefully that would stop the constant flow of new bacteria into his blood. But would his body be able to clear the bacteria that was there?

His temperature had surged to 103.8 degrees Fahrenheit, and it seemed that nothing would stem the tide that swelled waves of death into this room. I was so powerless, that again, I could not help but cry out to whatever god may have been listening at the time.

The team took a break from swabbing the wound in his thigh, and the once pristine webs of plastic fabric had so much blood and pus that you would never have guessed that the apparatus was once man-made. It looked like some sort of pulsing alien life form.

As I kept the contents of my stomach deep within by trying to take my mind off of the gore that was so repulsive, I asked the resident M.D. a question that may be the most important question I have asked while walking the face of this earth.

"Um, excuse me, but who is the vendor of these surgical swabs?"

He told me the company, which was famous for making various hi-tech swabs out of forms of polystyrene that were touted to be the best in the business, far superior to any soft cotton-based swab. Realizing this, my heart sank precipitously, before it rose into the heavens. For at that moment, I realized what was wrong with Sam. You see, I had called the swab frighteningly harsh, and by that all I had meant was that it must hurt like the worst torments to have one's wound cleansed. Such soul splintering pain would be the worst case scenario for you or me if we had to have the same procedure done on one of our wounds, but we were not dealing with a festering wound on your leg or my leg. We were talking about Sam Vespucci's problem, and after all, his mutation in WASP made things not just painful, but maybe it had made him unable to clot by the mere force of our procedure!

The expression "the cure is worse than the disease" usually speaks of some strategy that is fundamentally flawed. In this case, I wondered if that blood and pus-covered swab had been the perfect cure for your standard 21st century wound-a wound that would be healed by cells that had enough WASP to do the job. And maybe Sam never had a clotting problem before because he had never had a polystyrene based swab rubbing his cells to the point where they could no longer work. It was all so clear!

The resident had opened a fresh swab to finish the job, and as my mind raced a mile a second I jumped up from my science-inspired dream to grab his arm.

"I've got it, I've got it, I've got it. You are killing him by saving him. Put that damned tool down this instant!" I sounded like a raving lunatic, and if I hadn't worn my lab coat (which I almost never do) he probably would have punched me in the face.

"Greg, Greg, get over here!" Greg Kim rushed to the room, looking at me and his exasperated resident. My words were jumbled and I tripped over myself, but in a frenzy I was able to convey the general idea that the technologically advanced swab was just too much for his WASP-mutated cells to handle.

"Calm down Andrew. I don't think that you're right, and even if you were, I think the patient won't survive this episode. But let's give it a shot. Johnston, you heard the man. Get us some soft gauze, the kind that we used to use when I was training, and let's see if you can get that wound cleaned up."

I let out a deep breath and knew that this could work. Even if it didn't I would never have another shot at understanding how this one gene could weaken his cells so.

It wasn't clear that Sam would live long enough to see whether my hypothesis would work. I tried to watch his vital signs near his bed, but I had no energy left after all of this literature searching and pondering. I fell asleep, and as I lost consciousness I sincerely prayed for the third time in my life, and like the other two prayers, they were all uttered on the same day.

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