Michael Palmer - Fatal

"You going to stay over there?"

"I don't want to."

"And I don't want you to."

"So, what am I doing over here?" He sat down beside her. "Tell you what. How about I work some of that tension out of your shoulders while you enlighten me on spongiform encephalopathy?"

"I think Stanley would like that." She turned onto her stomach as he began to knead at the considerable tightness radiating from the base of her neck. "Mmmmm. Just a little softer. Oh, that's it, that's perfect. Okay, let's see, you already know that prions are little particles of protein that have the ability to reproduce themselves. No DNA, no RNA, yet they can reproduce. Amazing."

"That's pretty much the sum total of my knowledge."

"You're slowing down. You want to learn about this stuff or not? Much better. Okay. Prions are present normally in humans and possibly in every other organism with a nervous system. PrPC is the abbreviation for these normal prions. Some people and animals are unfortunate enough to have a mutation occur in one or more of their PrPC prions. The result is a gradual buildup of a toxic prion known as PrPSc. The brain and nervous system unknowingly adopt this imposter prion. Then the normal nervous tissue slowly comes apart, and the host organism dies."

"Humans and cows."

"And minks, and deer, and cats, and even monkeys. I suspect that the more we look, the more spongiform diseases we'll find. And prions may be at the center of some other neurodegenerative diseases, as well, such as Alzheimer's."

"My mother's disease," Matt said.

"Yes. That made me so sad this morning when you told me about her."

"Most of the time I think she's handling it better than those around her."

"Well, it's still too early to know, but possibly she has a prion-mediated disease. Are you getting tired doing that?"

"Nope."

"In that case, a little farther out toward the shoulders, please. Nice. That's it. Oh, doggies, that feels good."

"So, is mutation the only way to get prion disease?"

"No. Any means that gets the germs into the body will do the trick. The prions that cause Mad Cow disease or kuru are eaten. Patients receiving corneal transplants from someone infected with spongiform disease can get it that way. I would suspect that other routes of administration would do it as well."

"And there is a long delay before symptoms develop?"

"Maybe decades. So far there have only been a hundred or so cases of Mad Cow disease in Great Britain, despite the tons of beef that those people ingested before the condition was recognized and warnings were sounded. That could mean there are thousands of cases still brewing. But I don't think so."

"What do you think?"

"The arms. I think you should work on the upper arms. You're very good at this."

"Thank you."

"Are you like all those guys who say they love giving back rubs, then after a girl starts dating them, it turns out the first back rub is all they really enjoy giving? From then on it's do me, do me."

"Maybe. That's for me to know and you to find out. So, don't leave me hanging. Why do you think there won't be thousands of cases of BSE in humans?"

"Partly because there haven't been thousands — tens of thousands — already. It seems to me that only a very small percentage of those who are exposed to PrPSc prions get infected. How could it be otherwise?"

"Why is that?"

"Why do you think that is?"

"Genetic factors?"

"Quite possibly. As with most diseases, we really don't have any idea why one person exposed to a germ gets sick and the person standing right next to them during the exposure doesn't. A little harder, Doc. Perfect. You tell me bad luck, and I'll tell you that right now for most infectious diseases, that's as good an explanation as any. I believe that those who develop spongiform disease are either lacking some sort of protective gene or else have a gene that in essence invites the altered prions in."

Nikki rolled over, drew Matt's face down to hers, and kissed him lightly on the mouth.

"Tell her what she just won, Merv," he said as she finished. "Congratulations, you just won another two hundred hours of massage."

Matt cupped his hands over his mouth and imitated the roar of a crowd.

"I'll tell you what, big guy," she said. "We'll stop in some city in New Jersey and I'll just file a report with the FBI office there. Then I'll go with you wherever it is you want to go. Deal?"

"I'm agin it."

"I know you are."

"Okay, deal… There's something else you want to add. I can see it in your eyes. What is it? What?"

"Matt, I hate to say this, and I don't want you to get upset or discouraged, but the mine theory isn't holding together well for me."

"What do you mean?"

"I mean the connection between the toxic exposure and the syndrome we've encountered."

"The waste dump is there. I saw it."

"Given. Let's assume the two miners had the same spongiform disease that Joe found in Kathy. Spongiform encephalopathy, at least the four or five different types we know of, is caused by prisons, but I just don't know how a toxic exposure can cause a prion infection."

"Well," he said after some thought, "let me take a crack at that. There are good, life-sustaining prions that everybody has and loves, right?"

"Yes."

"And there are bad, spawn-of-the-devil, PrPSc prions that cause spongiform disease, right?"

"Essentially, yes."

"Then, how about the toxic exposure increases susceptibility to bad prions… or… or causes mutations from good to evil? Organic toxins cause mutations that go on to cause cancer."

"That's a fact. But remember, these conditions seem to take years to develop — in some instances, decades. So if a toxic exposure did occur affecting our three cases, I would think it occurred before any of the subjects was old enough to be working in the mine. And what about Kathy? She never even came close to the mine as far as we know."

"What about groundwater contamination?"

"The toxins from the mine get into the water and accelerate prion mutations. Is that what you wish to believe?"

"That is what I would like to believe, yes," Matt said.

She kissed him once again, then pulled her pillow in tightly as she drew her knees and arms in.

"Works for me," she said dreamily.

But Matt could tell that it didn't. He waited until her breathing said that she was asleep.

"G'night," he whispered.

He rolled over and drifted off, his mind playing images of an underground river churning past countless barrels of poison, then coursing off into the darkness.

Newark, New Jersey. With four stops for directions, which were invariably given to them in dense Newarkese, it took longer to locate the FBI office than it had to make it to Newark from Stamford. They chose Newark because they expected it would have a good-sized office, and because neither of them wanted to drive into Manhattan. Matt rolled slowly down a tree-lined street, past the tall, nondescript Gateway Center on Market Street, and stopped half a block away.

"So," he said as Nikki stripped off her helmet, buckled it to the bike, and ran a brush through her hair, "here we are."

"Here we are," she echoed, hands on hips. "Matt, you're looking distressed. I thought we had decided on a plan."

"I just don't feel comfortable about this."

"I understand. How about making it a little easier on me." She reached her arms out to him. "Come on," she cooed.

"Sorry," Matt muttered, accepting the invitation to hold her. "I still have trouble coming to grips with why people don't accept my point of view on any given subject as the only viable one, let alone the best one."

"You can come in with me if you want."

"The FBI agents might not look charitably on any guy with a ponytail who isn't Steven Seagal. Tell you what, I'm going to call my uncle from that pay phone we saw on the next block. After that I might come in."