Richard Mabry - Lethal Remedy

Chelsea's lower lip trembled. A tiny tear formed at the corner of one eye. "I… I still can't move my legs. And my arms are weak." Sara pulled a reflex hammer from the pocket of her white coat and checked Chelsea. No reflexes in the legs, and definitely weakened responses in the arms. The immune globulin was reported to work most of the time in cases of severe GBS. But so far it hadn't seemed to help. There must be something different about the syndrome that Jandramycin triggered.

And she had no idea what that difference was. "Well, we have a few more tricks up our sleeve. I'll see you again this evening when I make rounds. Meanwhile, you keep your chin up." Chelsea nodded weakly, then turned her face to the wall. Sara eased from the room, feeling lower than she'd ever felt as a physician. God, I absolutely don't know where to go from here. Got any suggestions?

Lillian Goodman paused outside the treatment room door. This time she was well aware of who was inside, but still she hesitated to enter. John was getting his daily IV dose of Jandramycin. She held up her hand to knock, then dropped it to her side. Would John appreciate some company during the time he received the IV? Or would he prefer to be alone? This is silly. I'm just visiting a friend. She tapped on the door. "Yes?" Good enough. Lillian entered and closed the door behind her. She tried to put a smile in her voice as she approached the treatment table where John lay. "How are you?" "Not too bad." He held up the arm that wasn't receiving the IV and wiggled his fingers. "My hand is pretty much back to normal. No redness. No swelling. Not even a little tenderness. Rip thinks it's healing fine, and I agree. So the magic medicine is doing its thing, even against the superbug." The words hung in the air as they both considered the possible late consequences from the drug now running into John's veins. Lillian tried to find words to change the subject, but they wouldn't come.

Negative thoughts crowded out anything positive about the situation.

John must have sensed her struggle. "Look, I know everyone's worried that I might be going from the frying pan into the fire with this treatment," he said. "But look at it from my side. If we do nothing, we know what would happen. We've been over that. It's either accept a 100 percent chance that the disease will kill me, or at least make me lose my hand, versus a 15 percent chance of some sort of autoimmune response that could possibly be controlled with steroids or something else." He shrugged. "It's a no-brainer." Something clicked in Lillian's mind. "You came out with that 15 percent figure awfully quickly. Where did that come from?" "Rip was able to contact almost all the thirty-nine patients in Ingersoll's study. Of those, six had complications we think are due to the Jandramycin. Simple math. Six of thirty-nine. Fifteen percent chance of problems." "Which poses the bigger question. What is it about that 15 percent of patients that makes them vulnerable to this sort of response?" Lillian pulled a straight chair to the side of the treatment table and sat down. "Has your group come up with any answers?" John recounted what had been done and the dead ends they'd encountered. Every time Lillian suggested a possible avenue of investigation, John countered with the roadblock that stopped them getting the information they needed. She stood and began to pace. "So it appears that we need to know how Jandramycin really works before we have any realistic chance to figure out how to prevent that 15 percent of patients getting late complications." "Right. And if you have any ideas, you're welcome to contribute them." He raised himself on one elbow. "And would you please sit down? I'm getting dizzy watching you pace." Lillian eased into the chair again. She reached into the pocket of her white coat and extracted a small notebook with a pen stuck into the ring binding.

"I'm going to do some investigating of my own. Do you happen to know the original name of the compound? Not Jandramycin. What they called it in the beginning." "Not really. Why do you ask?" "Because I may be able to backtrack from there and get information about the mode of action of the drug. There's usually a reason for the names investigators give these compounds." She put the notebook back into her pocket. "Besides, unless you have a better idea, it looks like we don't have anywhere else to go short of holding Ingersoll or Resnick at gunpoint until they give up their secrets." John said something, but Lillian only half-heard it. Her mind pictured the scenario she'd mentioned so off-handedly, and wondered if it just might work. After all, her late husband's gun was still at home in the back of a drawer under her winter sweaters. And how difficult could it be to use it?

"Does anyone there speak English?" Sara realized she was shouting into the phone and made an effort to moderate her tone.

Although reason told her that talking louder didn't increase the chance the person on the other end of the line would understand her despite the language barrier, the longer she talked the more frustrated she became and the louder she spoke. The woman seemed calm enough, not at all flustered by the conversation or lack thereof.

Neither her tone of voice nor her answer changed. " Bitte, Ich verstehe nicht." By now, the phrase was familiar to Sara. The woman didn't understand. This was the end of a tedious process, and it looked like it would be wasted effort. Sara had dug deep on the Internet to find that Drs. Gruber and Rohde were internal medicine specialists on the faculty of a medical school in Ulm, Germany. Then it was a matter of finding the contact information for that medical center, looking up the process for making an international call, calculating the time difference between Texas and Germany, and finally placing the call from her home phone because Southwestern Medical Center would undoubtedly look askance at an unauthorized transatlantic phone call from her office phone. Completing the call was only half the battle, though. She was transferred from person to person until she finally reached the proper department. Now, for the first time in the series of exchanges, she encountered someone who apparently spoke no English. For the past five minutes, a calculator in Sara's mind toted up the charges for the call. This must be costing her a fortune, and she was getting nowhere. She was about to hang up when a new voice came on the phone. "Yes, may I help you?" "Oh, thank you. This is Dr.

Sara Miles at Southwestern Medical Center in Dallas, Texas. Who is this?" "I am Frau Schilder. I am the Chefsekretarin… the head secretary for the Medizinklinik." "And you speak English?" "I speak a little, yes." Sara rolled her shoulders to relax the tension there.

Maybe this would work after all. "I'm a doctor, calling from the United States. I need to speak with Dr. Gruber or Dr. Rohde." "I am very sorry, but the doctors are both with patients today. Shall I give them a message?" Would they really call back? It was a transatlantic call, and they had no idea who she was. Then it occurred to Sara that the mention of one word in her message might get a response. "Yes. My name is Dr. Sara Miles. And we need to discuss some important information about Jandramycin." "Yes, and your phone number please?"

Sara gave it and rang off. She found it interesting that the woman hadn't asked to confirm the spelling of Jandramycin. Apparently the word was familiar to her. Perhaps she'd even been called upon to type reports and collate data. Maybe the work of Gruber and Rohde wasn't shrouded in as much secrecy in Ulm, Germany, as Jack's was here in Dallas. Sara permitted herself a bit of hope. Funny. She couldn't get the information she needed from her ex-husband whose office was less than two hundred feet from her own, but she might be able to get it from two perfect strangers who carried out their medical practice and research five thousand miles away. She'd done what she could. Now there was nothing to do except wait, hope, and pray.