Robin Cook - Fever

Dr. Wiley tossed the towel onto the counter by the sink and plucked out a pair of rubber gloves from a package Miss Hammersmith held open for him.

With growing dismay, Michelle watched him pull the gloves onto each hand, snapping the wrist portion into place and tugging on each finger in turn.

“I don’t want any more needles,” said Michelle, her eyes filling with tears. “I just want to go home.” She tried not to cry but the harder she tried, the less successful she was.

“Now, now,” soothed Miss Hammersmith as she began stroking Michelle’s hair.

Michelle parried Miss Hammersmith’s hand and tried to sit up, but she was restrained by a cinch about her waist. “Please,” she managed.

“Michelle!” called Dr. Wiley sharply, then his voice softened. “I know you don’t feel well, and I know this is hard for you, but we have to do it. It will be over in a moment if you help us.”

“No!” said Michelle defiantly. “I want my father.”

Dr. Wiley gestured to Miss Hammersmith: “Maybe Mrs. Levy could come in here for a moment and give us a hand.”

Miss Hammersmith lumbered out of the room.

“Okay, Michelle, just lie back and relax for a moment,” said Dr. Wiley. “I’m sure your dad will be real proud of you when I tell him how courageous you were. This is only going to take a moment. I promise.”

Michelle lay back and closed her eyes, feeling the tears run down the side of her face. Intuitively she knew that Charles would be disappointed if he heard that she’d acted like a baby. After all, it was going to be the last stick. But both her arms had been punctured and she wondered where they would do it.

The door opened again and Michelle propped herself up to see who it was. Miss Hammersmith came in followed by two other nurses, one of whom carried some leather straps.

“We won’t need restraints, I don’t think,” said Dr. Wiley. “Okay, Michelle, now just lie back quietly for a moment.”

“Come on, sweetheart,” cajoled Miss Hammersmith, coming up alongside Michelle. One of the other nurses went around to the opposite side while the nurse who had been carrying leather straps went down to the foot of the table. “Dr. Wiley is the best doctor in the world and you should be so thankful he’s taking care of you,” said Miss Hammersmith as she pulled Michelle’s sheet down over the child’s legs. Keeping her arms stiffly against her side, Michelle half-heartedly tried to resist when Miss Hammersmith pulled up the nightie to expose the child’s body from her nipples to her bony knees.

She watched while the nurse whisked the towel from the table with the wheels. Dr. Wiley busied himself with the instruments on it, his back to her. She could hear the tinkle of glass and the sound of fluid. When the doctor turned, he had a wet piece of cotton in each hand. “I’m just going to clean your skin a little,” he explained as he began scrubbing Michelle’s hipbone.

The water felt alarmingly cold to Michelle as it ran down her hip and pooled beneath her buttocks. This was a new experience, not like the previous needles. She strained to see what was happening, but the doctor gently urged her to lie back.

“It will be over in just a moment,” said Miss Hammersmith.

Michelle looked at the faces of the nurses. They were all smiling but they were fake smiles. Michelle began to feel panic. “Where are you going to stick me?” she shouted, trying again to sit up.

As soon as she moved, she felt strong arms grip her and force her back. Even her ankles were locked in an iron grasp. She was pressed firmly back onto the table, and the restriction inflamed her panic. She tried to struggle but felt the hold on her limbs tighten. “No!” cried Michelle.

“Easy now,” said Dr. Wiley as he floated a gun-metal colored drape with a hole in the center over Michelle’s pelvis and positioned it on her hipbone. Turning back to the small table, Dr. Wiley busied himself. When he reappeared in Michelle’s view he was holding a huge syringe with three stainless steel finger rings.

“No!” cried Michelle and with all her might she tried to break from the grasp of the nurses. Instantly she felt the crushing weight of Miss Hammersmith settle on her chest, making breathing difficult. Then she felt the sharp pain of a needle pierce her skin over her hipbone followed by a burning sensation.

Charles bit off the corner of his pastrami on white, catching a stray piece of meat with his fingers before it fell to the desktop. It was a mammoth sandwich, the only good thing put out by the institute cafeteria. Ellen had brought it back to the lab since Charles did not want to see anyone and, except for his brief foray to the First National Bank, he’d stayed at his desk poring over the Canceran experimental protocol. He’d been through all the lab books, and to his surprise, he found them well-organized. He began to feel optimistic that completing the study would not be as difficult as he had initially imagined; maybe they could get it done in six months. He swallowed what he had in his mouth and chased it down with a slug of lukewarm coffee.

“The one good thing about this project,” said Charles, wiping his mouth with the back of his hand, “is the size of the grants. For the first time we’ve got money to burn. I’ll bet we can get that new automatic counter we’ve wanted as well as a new ultra centrifuge.”

“I think we should get a new chromatography unit,” said Ellen.

“Why not?” said Charles. “Having been railroaded into this project, we owe it to ourselves.” He put the sandwich back down on the paper plate and picked up his pencil. “Here’s the way we’ll handle this thing. We’ll start out with a dose of 1/16 of the LD50.”

“Wait,” said Ellen. “Being in immunology, it’s been a while since I’ve done this kind of thing. Refresh me. The LD50 is the dose of a drug that causes 50 percent death in a large population of test animals. Right?”

“Right,” said Charles. “We have the LD50 for mice, rats, rabbits, and monkeys from the toxicity studies done on Canceran before they started the efficacy studies. Let’s start out with the mice. We’ll use the RX7 strain bred for mammary tumors because Brighton ordered them and they’re here.”

With his pencil, Charles began to make a flow diagram of the project. While he wrote, he spoke, explaining to Ellen each step, particularly how they would increase the dosage of the drug and how they would expand the study to include rats and rabbits as soon as they got some preliminary data from the mice. Because the monkeys were so expensive they would not be used until the very end when the information from the other animals could be extrapolated and applied to a statistically significant group. Then, assuming positive results, a method of randomization would be worked out with each species to ensure suitable controls. These fresh animals would then be treated with the optimum dosage level of Canceran determined from the first part of the study. This portion of the project would be carried out so that neither Charles nor Ellen would know which animals had been treated until after each had been sacrificed and studied and recorded.

“Whew,” sighed Ellen as she stretched her arms back. “I guess I didn’t know what was involved.”

“Unfortunately there’s more,” said Charles. “Each animal, after they’re autopsied, has to be studied not only microscopically, but also with the electron microscope. And…”

“All right already!” said Ellen. “I get the picture. But what about our own work? What are we going to do?”

“I’m not sure,” said Charles. He put down his pencil. “I guess that’s up to both of us.”

“I think it’s more up to you,” said Ellen. She was sitting on a high stool with her back against the slate-topped workbench. She was wearing a white laboratory coat which was unbuttoned, revealing a beige sweater and a single strand of small, natural pearls. Her soft hands were folded together and lay still in her lap.