Робин Кук - Mutation

“Do you remember back when you were three and suddenly couldn’t read?” Marsha asked.

“Of course,” VJ said.

“We’ve never talked much about that period,” Marsha said.

VJ turned away from Marsha and looked out the window.

“Were you very upset?” Marsha asked.

VJ turned to her and said, “Mother, please don’t play psychiatrist with me. Of course it bothered me. It was frustrating not being able to do things that I’d been able to do. But I relearned them and I’m fine.”

“If you ever want to talk about it, I’m available,” Marsha said. “Just because I’ve never brought it up doesn’t mean I don’t care. You have to understand that it was a stressful time for me too. As a mother I was terrified that you were ill. Once it was clear you were all right, I guess I tried not to think about it.”

VJ just nodded.

They all met in the waiting room of Dr. Clifford Ruddock, Chief of the Department of Neurology. Victor had beat them by fifteen minutes. As soon as VJ sat down with a magazine, Victor took Marsha aside. “I spoke with Dr. Ruddock as soon as I arrived. He’s agreed to compare VJ’s current neurological status with what he found at the time VJ’s IQ dropped. But he is a little suspicious about why we brought him in today. Obviously, he knows nothing about the NGF gene, and I do not plan to tell him.”

“Naturally,” said Marsha.

Victor shot her a look. “I hope you are planning to be cooperative.”

“I’m going to be more than cooperative,” Marsha said. “As soon as VJ is finished here, I’m planning to take him to my office and have him go through a battery of psychological tests.”

“What on earth for?” Victor asked.

“The fact that you have to ask means that I probably couldn’t explain it to you.”

Dr. Ruddock, a tall, slender man with salt and pepper hair, called all the Franks into his office for a few minutes before the examination. He asked if the boy remembered him. VJ told the man that he did, particularly his smell.

Victor and Marsha chuckled nervously.

“It was your cologne,” VJ said. “You were wearing Hermès after-shave.”

Somewhat taken aback by this personal reference, Dr. Ruddock introduced everyone to Dr. Chris Stevens, his current fellow in pediatric neurology.

It was Dr. Stevens who examined VJ. In deference to the fact that both parents were physicians, Dr. Stevens allowed Victor and Marsha to remain in the room. It was as complete a neurological exam as either had ever witnessed. After an hour just about every facet of VJ’s nervous system had been evaluated and found to be entirely normal.

Then Stevens started the lab work. He drew blood for routine chemistries, and Victor had several tubes iced and put aside for him to take back to Chimera. Afterward, VJ was subjected to both PET and NMR scanning.

The PET scanning involved injecting harmless radioactive substances which emitted positrons into VJ’s arm while his head was positioned inside a large doughnut-shaped apparatus. The positrons collided with electrons in VJ’s brain, releasing a burst of energy with each collision in the form of two gamma rays. Crystals in the PET scanner recorded the gamma rays, and a computer tracked the course of the radiation, creating an image.

For the second test, the NMR scanning, VJ was placed inside a six-foot-long cylinder surrounded by huge magnets supercooled with liquid helium. The resultant magnetic field, which was sixty thousand times greater than the earth’s magnetic field, aligned the nuclei of the hydrogen atoms in the water molecules of VJ’s body. When a radio wave of a specific frequency knocked these nuclei out of alignment, they sprang back, emitting a faint radio signal of their own which was picked up in radio sensors in the scanner and transformed by computer into an image.

When all the tests were done, Dr. Ruddock summoned Victor and Marsha back to his office. VJ was left outside in the waiting room. Victor was plainly nervous, crossing and uncrossing his legs and running his hand through his hair. Throughout the testing neither Dr. Stevens nor the technician made any comment. By the end, Victor was almost paralyzed with tension.

“Well,” Dr. Ruddock began, fingering some of the print-outs and images from the tests, “not all the results are back, specifically the blood work, but we do have several positive findings here.”

Marsha’s heart sank.

“Both the PET and the NMR scans are abnormal,” Dr. Ruddock explained. He held up one of the multicolored PET scan images with his left hand. In his right hand he held a Mont Blanc pen. Carefully pointing to different areas, he said, “There is a markedly elevated but diffuse uptake of glucose in the cerebral hemispheres.” He dropped the paper and picked up another colored image. “In this NMR scan we can see the ventricles quite clearly.”

With her heart pounding, Marsha leaned forward to get a better look.

“It’s quite obvious,” Dr. Ruddock continued, “that these ventricles are significantly smaller than normal.”

“What does this mean?” Marsha asked hesitantly.

Dr. Ruddock shrugged. “Probably nothing. The child’s neurological exam is entirely normal according to Dr. Stevens. And these findings, although interesting, most likely have no effect on function. The only thing I can think of is that if his brain is using that much glucose, maybe you should feed him candy whenever he’s doing much thinking.” Dr. Ruddock laughed heartily at his own attempt at humor.

For a moment both Victor and Marsha sat there numbly, trying to make the transition from the bad news they’d expected to the good news they’d received. Victor was the first to recover. “We’ll certainly take your advice,” he said with a chuckle. “Any candy in particular?”

Dr. Ruddock laughed anew, enjoying that his humor was so well received. “Peter Paul Mounds is the therapy I recommend!”

Marsha thanked the doctor and ran out the door. Catching VJ unaware, she had him in a bear hug before he could move away. “Everything is fine,” she whispered in his ear. “You’re okay.”

VJ extracted himself from her grasp. “I knew I was fine before we came. Can we go now?”

Victor tapped Marsha on the shoulder. “I’ve got some other business here and then I’ll go directly to work. I’ll see you at home, okay?” Victor said.

“We’ll have a special dinner,” Marsha said, turning back to VJ. “We can leave but you, young man, are not finished. We are going to my office. I have a few more tests for you.”

“Oh, Mom!” whined VJ.

Marsha smiled. He sounded just like any other ten-year-old.

“Humor your mother,” Victor said. “I’ll see you both later.” He gave Marsha a peck on the cheek and tousled VJ’s hair.

Victor crossed from the professional building to the hospital proper and took the elevator to Pathology. He found Dr. Burghofen’s office. The man’s secretary was nowhere to be seen so Victor looked inside. Burghofen was typing with his two index fingers. Victor knocked on the doorjamb.

“Come in, come in!” Burghofen said with a wave. He continued to peck at the typewriter for a few moments, then gave up. “I don’t know why I’m doing this except my secretary calls in sick every other day, and I’m constrained from firing her. Administering this department is going to be the death of me.”

Victor smiled, reminding himself to remember that academia had its own limitations the next time he got fed up with office problems at Chimera.

“I was wondering if you had finished the autopsies on the two children who died of cerebral edema,” Victor said.

Dr. Burghofen scanned the surface of his cluttered desk. “Where’s that clipboard?” he asked rhetorically. He spun around in his chair, finding what he was searching for on the shelf directly behind him. “Let’s see,” he said, flipping over the pages. “Here we are: Maurice Hobbs and Mark Murray. Are those the ones?”