Kate felt her heart accelerate and frowned at the response. “Sure,” she said. “I mean, I’m awfully busy right now and my guess is that I will be in September, too, but if you’d like to come out to Boulder some evening when you’re here, maybe that Friday the twenty-seventh, perhaps you could come up to the house and see Josh.”
“That would be great.”
They talked schedules and directions for a moment. O’Rourke would have the use of a car, so there was no problem with his driving from Denver to Boulder. When that was finished, there was a pause for a second.
“Well,” said the priest, “I’ll let you get some rest.”
“You too,” said Kate. She could hear the fatigue in his voice. There was an awkward moment when neither took the opportunity to end the conversation.
“Neuman,” he said at last, “you were lucky to get the baby out when you did. You’re aware that the government shut off new adoptions only a week or so after you left.”
“Yes.”
“Well…we were lucky.”
Kate tried to put a lightness in her tone. “I didn’t think that priests believed in luck, O’Rourke. Don’t you believe that everything is…pardon the expression…ordained?”
She heard a sigh. “Sometimes,” he said, his voice very weary, “I think that the only thing one can believe in and pray for is luck.” She heard him shake the exhaustion out of his voice. “Anyway, I look forward to seeing you and Joshua next week. I’ll call when I get into Denver and double-check our plans.”
They had said good-bye with as much energy as they could muster. Then Kate had sat in the dark house and listened to the midnight silence.
The RS-Project continued on several fronts and each area of investigation thrilled and terrified Kate.
While she was in charge of the overall project, Chandra was the actual boss of the retrovirus search, Bob Underhill and Alan Stevens had taken over the analysis of Joshua’s blood-absorbing “shadow organ,” and Kate herself was trying to unlock the mechanism by which Josh’s body liberated the donor RNA from blood and transcribed it to proviral DNA, ready to be distributed to cell nuclei throughout his body. Her second and more immediate goal was to devise a way for this same immune-repair mechanism to work without a massive transfusion of whole blood every three weeks.
Working with Chandra in the Class-VI lab was an education. The HIV specialist had taken less than forty-eight hours to get her “virus factory” up and running at RMR CDC. Kate had given her another three days of uninterrupted work before showing up for a briefing.
“You see,” Chandra had said while showing Kate around the innermost biolab, the two of them in pressurized anticontamination suits and trailing oxygen-hose umbilici, “ten years ago we would have had to start from scratch in an attempt to isolate the J-virus.”
“J-virus?” Kate had said through her intercom radio.
“Joshua virus,” said Chandra. “Anyway, even five years ago we would have had to cover a lot of ground before we could find a starting place. But with the HIV research of the last few years, we can take some shortcuts.”
Slightly distracted by the hiss of oxygen in the suit and the sight of technicians working with gloves and remote handlers through the clear plastic window behind them, Kate had concentrated on listening.
“You know that retroviruses are just RNA viruses that express their gene products after their RNA is transcribed to DNA by the reverse transcriptase enzyme, which has DNA polymerase and ribonuclease activities,” said Chandra.
Kate did not mind being lectured on the obvious, because she knew it was just the way that Chandra framed her explanations to everyone. She nodded through the clumsy headpiece.
“So,” continued Chandra, “the polymerase makes a single-stranded DNA copy of the viral RNA and then a second DNA copy using the first template. Ribonuclease eliminates the original viral RNA. Then this new invader DNA migrates to the cell nucleus and gets integrated into the host’s genome under the influence of the viral integrase enzyme and stays there as a provirus.”
Kate waited.
“Well, we assume that the J-virus behaves just like any other retrovirus,” said Chandra, lifting a culture dish and setting it closer to a technician’s gloved hand. “Only we’re guessing that it models itself after the HIV life cycle…or perhaps HIV mutated from the J-virus, we just don’t know. At any rate, we’re working on the assumption that J-virus follows the path of least resistance and binds gp120 glycoprotein to CD4 receptors in T-helper lymphocytes, mononuclear phagocytes, and Langerhans cells. Now my research has shown that our old friend HIV never infects cells without CD4, but we don’t know that about J. But CD4 is still the obvious place to start.”
Kate had understood immediately. The HIV provirus had infected cells and obstructed the immune response; the J-virus, according to Chandra’s reasoning, broke down RNA the same way, transcribed it to DNA the same way, and invaded cell nuclei the same way, but enhanced rather than inhibited the cell’s immune system. “You’re assuming the same vector for proviral integration,” said Kate, “but trying to find its footprints after transcription.”
“Of course,” said Chandra. “We can compare the cells after reverse transcriptase to the control cultures and find out just how the little fucker operates.” She glanced at Kate. “The J-virus, I mean.”
Kate ran her gloved hand over the counter and stopped it next to a cultured specimen of Joshua’s blood. There were thirty-four similar cultures on this counter alone. Farther down the line were row upon row of HIV and SCID-cultured specimens sent from CDC Atlanta. “Where do these come in?” asked Kate, gesturing toward the infected cultures.
“Assuming that the J-virus doesn’t differentiate between your son’s SCID-infected cells and other SCID specimens—and there’s no reason it should, retroviruses don’t discriminate—then, theoretically, we can observe the action during the binding to CD4 cells in the precultured SCID templates.”
Kate looked at the other woman through their double layers of plastic. The experiments had been proceeding only a few days at this point, but she needed answers for her own work. “And have you witnessed what you expected to?” she asked, being careful to keep her voice steady.
“Shit,” said Chandra. She had started to rub her nose before remembering that she was in a pressure suit. She wiggled to scratch the tip of her nose against her gloved hand through the suit’s plastic window. “Sorry. Oh…yes, we’ve documented the J-binding to both the patient’s SCID cells and the precultured specimens. It’s close to the HIV model.” Chandra was one of those researchers who almost seemed to lose interest in the previous step of a project once that step was accomplished. But Kate had deliberately allowed the woman several days of work without the interruption of briefings or memoranda; now she needed answers.
“When HIV binds to CD4,” said Kate, looking at her adopted son’s culture as if she might see some activity there, “the infection of T-lymphocytes creates some cytopathic effects and obvious…footprints, I think you called them…such as formation of multinucleated synctia as the gp120 on the surface of infected cells fuse with the CD4 of other CD4-bearing cells. That’s at least part of the reason we see such a dramatic loss of helper T cells despite the fact that the HIV retrovirus is infecting just…oh, 1 in 105 CD4 cells in the blood.”
Chandra looked at her as if she had forgotten that Kate was a research hematologist. “Yes?”
Kate kept sharpness out of her voice. “So do you see the same synctia formation?”
Chandra shook her head. “I helped pioneer the treatment of injecting HIV-positive victims with recombinant soluble CD4 protein to slow the infection at that point by inhibiting synctium formation. But it wouldn’t work in the case of the J-virus.”
Kate’s heart sank. “Why not?”
“The J-viral integrase enzyme doesn’t transfer the invading transcribed DNA on the 1 in 104 or 1 in 105 of the blood cells that we’re used to here, Kate.” Chandra’s eyes through
the reflective plastic looked very intelligent and very bright.
“What is the ratio?” asked Kate. If it were too small, the chances of cloning an artificial J-virus would go down markedly.
“From the first few hundred samples checked,” said Chandra, her voice constrained, “we estimate 98.9 percent infection.”
Kate felt as if someone had hit her in the stomach. She checked to make sure that the counter behind her was empty and sat on it. “Ninety-eight point nine?”
“That is conservative.”
Kate shook her head. AIDS killed its host by infecting one out of every thousand or ten thousand white blood cells. The J-virus was so efficient that almost all of the cells in the host’s body were reprogrammed within hours of infection.
“Cytotoxicity?” said Kate. Such a rapid and universal infection of cell nuclei must have terrible side effects.
Chandra shrugged. “Microbiologically…zip. Transfer and the transfection process require mucho energy, of course…but you’ve documented that with the baby’s temperature rise during the process. The child is a chemical and genetic crucible after this blood absorption and reconstruction. But the deed is essentially done after a few hours, although our preliminary research suggests that it would take a week or so for complete genetic assimilation.”
Kate gestured with a gloved hand toward the other cultures. “And the HIV specimens?”
Chandra blinked. “Because we’re so familiar with HIV diagnosis through viral detection, I’m using that as a second control. We take the patient’s blood—sorry, Joshua’s—and co-culture it with the template SCID’s and HIV, using a CD4 cell line or normal CD4 lymphocytes stimulated with phytohemagglutinin and IL-2. With the HIV virus we do an assay for reverse transcriptase on some of the cultures, the presence of p24 antigen on others. Then we cross-check that with the SCID and Joshua cultures that were done at the same time.”
“And the result?”
“Reverse transcriptase is quite visible in the J-virus cultures, although, as I said, without the cytotoxicity. The p24 antigen analysis doesn’t work with the J-virus, which is a shame because with HIV patients the antigen can sometimes be detected directly in a blood sample via an enzyme-linked immunosorbent assay.”
Kate nodded. She had also hoped that this relatively simple avenue of diagnosis would be available for them.
As if to reassure Kate, Chandra hurried on. “We’re still assuming that the J-virus creates a J-antibody, even though the results of the infection are immunoreconstructive rather than immunosuppressant. We should have that antibody for you today or tomorrow.”
Kate looked out at the dozen or so technicians working in the outer lab. Even though it was a shirtsleeve environment compared to the Class-VI inner lab, the technicians wore coats, surgical masks, cotton booties, and rubber gloves. Kate knew that the entire lab was pressurized, with the internal pressure lower than ambient pressure in the rest of the building. If the biolab leaked, it would leak inward. Even the apparently non-toxic J-virus was considered guilty until proven innocent.
“What techniques are you using to isolate the antibody?” asked Kate.
“The usual—enzyme immunoassay, Western blot, immunofluorescence, radioimmuno-precipitation assay.” Chandra’s voice revealed her eagerness to get back to work.
“Fine,” Kate said crisply. “From now on I’d like daily reports sent up—you can have Calvin follow you around and type them up if you want,” she added quickly to head off any protests. “But Bob’s blood absorption work and my hemoglobin studies will be piggybacking on your breakthroughs, so we need daily updates. And I’d like half an hour of personal briefing every Monday and Saturday.”
Kate saw Chandra’s eyes flare with anger—not at the thought of giving up her weekends, Kate was sure, since she worked weekends anyway, but at the idea of wasting time explaining her work. But the professional side conquered the researcher’s momentary pique and she merely nodded. Kate was, after all, in a position to take away all of Chandra’s toys and games if she wished.
By Friday, September 5, the J-virus antibody was isolated and tagged. By Wednesday the 11th, the J-retrovirus itself had been identified. Two days later Chandra began her attempts to clone the retrovirus. The same day, she revealed her hidden agenda for co-culturing the HIV specimens: Chandra was wasting no time in experimenting with the J-virus as a possible AIDS cure. Kate was not surprised; indeed, she would have been amazed if the dedicated HIV researcher had planned anything else. As long as it did not slow down the RS-Project, Kate had no objections.
Alan and Bob Underhill had completed a hypothetical schematic of the absorption organ by Thursday, September 19, and a full-team seminar was scheduled for Wednesday the 25th so that everyone could listen and comment. By this point, getting the entire team together was only slightly more difficult than assembling a dozen of the world’s political leaders, given everyone’s imperative to avoid interruptions.
Kate’s work on both the DNA transfer mechanism and the blood-substitute problem was also going well. Almost too well, she thought. Not only did she see a way effectively to cure Joshua of the SCID aspect of his disease, but she was confident that her work would help Chandra in the HIV breakthrough.
Things were going too well. Not in any way superstitious, Kate still had twinges of anxiety that the balance of pain in the universe would reassert itself soon.
And then, late on Sunday the 22nd of September—just another workday as far as she was concerned—the calendar in her Wizard electronic organizer told her that the next day was the autumnal equinox, that Tuesday was Joshua’s birthday—or at least the day they had chosen to celebrate his birthday—and that Father Michael O’Rourke would be visiting before the end of the week.
Kate knew that—even without compromising the details of the project—she would have wonderful things to tell him. What she did not know was that within the week her life would be changed forever.
Chapter Eighteen
KATE came home early on Tuesday to celebrate Joshua’s eleven-month “birthday.” These monthly celebrations had been Julie’s idea: at a time when she was not sure that the baby would survive another week, much less another month, it seemed important to mark every milestone. Kate had chosen the twenty-fourth at random, although she did like the evenness of the number.
“The CBS Evening News” carried a story of miners running amok in Romania, commandeering trains to take them to Bucharest, where the rioting continued in some sort of unfocused protest against the government. Kate remembered that the current regime had used “miners”—many of whom were Securitate agents in miners’ coveralls—to brutalize their own people the year before. She watched the video images of men smashing windows, tossing Molotov cocktails at buildings, using crowbars against doors, and she wondered what was really going on in that miserable country. She was glad that she and O’Rourke were out of there and hoped that Lucian and his family were lying low.
Joshua loved his cake. Not waiting for the slow spoonsful offered by Kate or Julie, he tore into his piece of cake with his hands, soon smearing enough on his face to equal the amount still on his high-chair tray. Later, cleaning his face with a washcloth and then setting him down on the floor so he could play with his wooden-penguin toy, Kate looked at her adopted son with a clinical, if not critical, eye.
On the surface, Josh was the picture of health: chubby, rosy-cheeked, bright-eyed, and beginning to show real hair rather than just a nimbus of dark fuzz. But Kate knew that this was a manifestation of the last segment of what she thought of as his “healthy-manic” swing; in a week or less, the diarrhea and listlessness would return, followed by more serious lethargy and infection. Until the next transfusion.
Kate watched her baby lie on his back and wrestle with the wooden toy—two penguins on a wooden dolly, their rubbery flippers moving and beaks clacking as the wheels turned. Not a sophisticated toy in an age when Nintendo ruled, but one which fascinated Joshua for some reason.
; Kate knew from her baby books and conversations with other mothers that an eleven-month-old should be sitting and standing by himself, perhaps even walking. Joshua was just mastering crawling. She knew that “normal” eleven-month-olds could pull on some of their own clothes, lift a spoon, say several words including “Mama,” and understand the word “No.” Joshua could not handle clothing or a spoon, did not speak other than the occasional gibberish and rarely had to be told “no.” He was a hesitant child, physically and socially. While obviously comfortable and happy with Kate and Julie, it had taken him weeks before he would relax with Tom.
Joshua dropped the penguin toy, rolled over onto his stomach, and began half-creeping, half-crawling toward the dining room.
“He’s been exploring more,” said Julie, her mouth half-full of cake. “This morning he headed for the front door when I let him out of his crib.”
Kate smiled. Neither she nor Julie thought that Joshua suffered from mental retardation as a result of his deprived infancy, merely delayed development. Kate had sought out opinions from at least three childhood development specialist friends, and each had different opinions on the long-term effects that five months in a Romanian orphanage or hospital would have on a child. Two of the specialists had seen Joshua, and both agreed that the boy seemed normal and healthy enough, merely small for his age and slow in development. So now, watching her son creep across the living room carpet and make noises rather similar to an airplane, Kate saw the behavior of a happy eight- or nine-month-old rather than the eleven-month-old whose “birthday” they were celebrating.
Later, tucking him in his bed in her own bedroom, Kate lifted Joshua one final time and patted his back, smelling the talcum-and-baby scent of him, feeling the fuzz of his hair against her cheek. His tiny hand curled against her face. His breathing showed that he was already asleep, drifting into whatever dreams eleven-month-olds dreamt.