Chapter 16: Playing God
Captain Brezinski along with the rest of her crew watched their destination unfold on the monitors in rapt silence. For over an hour Martha took them all on a journey, exploring the opening pages of the New World. Their destination was an earth-like planet that was about 10 percent smaller than Earth with much smaller oceans. It appeared to be very geologically active with well-defined mountain ranges and volcanic ridges. The atmosphere was somewhat thinner than the Earth's and with a significant reduction in oxygen content. It rotated along a somewhat tilted axis every 20.8 Earth hours and orbited its sun every 485 days. This produced a day-night cycle that was shorter than Earth's with seasons which were longer. The high altitude photographs revealed snow capped mountains with thick vegetation on the seaward facing lower elevations. The inter-mountain regions had sparse vegetation suggesting a desert climate. The tilting of the planet and the slightly elliptic orbit of the parent planet produced seasonal characteristics akin to those of the Earth. The moderating influence of the geologic activity from the planet produced an overall temperate climate with much smaller polar regions than on Earth. A near and a far moon lit up the night time sky.
The silence was broken by a general call from Doc Jules. "Eric-Peter, why can't I get my computer console to work?"
Eric-Peter responded, "The terminal in the emergency habitat is a single-user terminal and all input will have to be routed through Tom and Martha."
Doc Jules grumbled something about technology and said, "Captain Brezinski, I request that the general overview be deferred to an exploration of the micro-biology of this New World in order to assure the safety of our crew." Captain Brezinski agreed with his request and directed Martha to end the overview and begin searching for the information that Doc Jules required. When the monitors shifted from the panoramic views to the microscopic views of bacteria with arcane genetic and culture information, there was a general groan of disappointment from the crew.
Tom's response was more direct. "If this boring stuff gets me my shower sooner, then I can wait for the good stuff."
Doc Jules and Brother Simon worked for the next several hours reviewing the scientific classification and characteristics of the New World's micro-biology. The database contained not only the genetic code and physical characteristics of the bacteria and viruses but also detailed information on their surface antigens and modes of infection. There were significant parallelisms between the ecological niches that the organisms filled and their mechanisms of infection with the microorganisms of earth. The bacterial culture characteristics revealed a significant sensitivity to higher oxygen levels and the inhibition testing gave very specific information. Doc Jules was frustrated by his inability to recognize the inhibiting chemicals which he assumed were antibiotics. After a diligent search he did recognize a penicillin-like chemical to which the vast majority of the bacteria were sensitive. The viral information was much less complex. Brother Simon provided a significant insight when he identified a common genetic sequence for a capsid protein which appeared to offer the ability to produce a vaccine.
Captain Brezinski had allowed them to work uninterrupted for the majority of the work period but now stopped by to see how their progress was coming. Doc Jules explained, "We will have significant natural immunity because of our higher oxygen concentration, and it appears that the majority of the bacteria will be sensitive to our antibiotics. Brother Simon has identified a possible vaccine for the viral agents." Captain Brezinski thanked them for their work and asked if they could relax the isolation protocol for Tom and Martha. Doc Jules realized that in his zeal to analyze the micro-biology that he had forgotten Tom and Martha. He replied to Captain Brezinski, "Let me check the growth plates and if they do indeed show sensitivity to penicillin, I think relaxing the isolation protocol would be acceptable. I would recommend that the oxygen concentration in the emergency habitat be increased slightly to further suppress the risk of infection." Doc Jules called Martha and asked her to use her video camera to evaluate the culture plates. There was obvious suppression of growth surrounding the antibiotic disc documenting the sensitivity of the bacteria to antibiotics. Doc Jules advised them they could begin category 2 isolation protocols. Doc Jules could hear Tom cheering in the background and yelling something about his shower.
Captain Brezinski said, "I think that you have made our volunteers much happier."
Tom and Martha wasted no time in performing the final safety checklist and adjusting the oxygen concentration upward to 25 percent from the normal 20 percent concentration. While they waited for the atmosphere in the emergency habitat to adjust to the new settings, Tom suggested they arm wrestle to decide who got to take the first shower. Martha giggled and said, "For my benefit I would like you to take the first shower." As soon as the green safety light came on they began removing their suits.
Tom's jump suit was heavily stained from perspiration and as he took his first deep breath he said, "Phew, something smells terrible in here and then again it may be me."
Martha turned him and pointed him towards the shower and said, "Go get cleaned up." As Tom was stripping and removing the "waste collection devices" he said to Martha, "I bet the people who designed these waste devices never had to wear them for a two-day stint." He then climbed into the small shower cabinet and started singing as he finished his shower. Martha stored their suits and waited patiently for her turn in the shower. When he was finished, Tom dressed in a clean jump suit and came out of the wash room compartment stretching and exclaimed, "I feel like a free man again." He held the door for Martha and said, "You next, my dear." Martha enjoyed her shower but came out of the wash room wrapped only in her towel, her hair wrapped in a second towel. Tom whistled and said "Oh baby, Oh baby!" Martha smiled and said that she needed her personal pack which Tom handed to her. She then returned to the wash room and finished dressing.
Tom and Martha enjoyed an almost-real meal of emergency rations. They filed their evening report. Captain Brezinski extended their prescribed rest period to 10 hours. Martha and Eric-Peter had finally found a way for the new computer module to be controlled from the bridge, which freed Martha from the responsibility of performing all of the input functions. After signing off Martha turned to Tom and said, "It looks like we have the night off. Do you have any plans?"
Tom smiled and started playing his harmonica and said, "Why don't you turn the lights down and I'll play you some music. A bottle of good wine is in order, but I suppose we'll have to make do without." Martha turned down the lights and sat by Tom as he played a soulful song on his harmonica. Later that night, Doc Jules was awakened by an alarm. The vital sign monitors that Tom and Martha were wearing had both signaled a sudden jump in cardiac activity. He became fully awake and had the computer perform a system check. All systems checked out as being above minimums. He was about to make a status call to Tom when the realization hit him that he was probably about to interrupt them at a very inconvenient time. He smiled and had the monitors reset for a higher cardiac rate and went back to sleep.
Brother Simon had begun the laborious task of building a DNA vaccine against the viral antigen he had identified. Building the DNA molecule involved sequencing the four nucleotides, which are the basic building blocks of the entire genetic code, into a chain which represented the command structure for the viral antigen. During the short rest periods he allowed himself, he would day dream about the capability of the equipment aboard "The Egg." He would also hold theological arguments with himself, with one side arguing that he was "playing God" and the other side arguing that he was "doing God's work." He finally came to the conclusion that he would be doing "God's work" by playing God. He decided that he would simply do his best to accomplish the task he was assigned. He finished his work in a surprisingly short amount of time and then began producing the vaccine in the DNA replicator.
Doc Jules used the first batch to test for toxicity by ba
thing a cell culture with a dilute solution. After 24 hours no aberrant growth changes were noted and he decided to proceed with clinical testing. Captain Brezinski at first objected to his protocol, which involved injecting himself with the theoretical quantity which would produce immunity. She felt the risk was unacceptable. Doc Jules explained, "This protein is so dissimilar to our normal proteins, it is very unlikely to produce an allergic reaction."
Captain Brezinski replied, "You are a mission-critical individual and I cannot risk you."
Doc Jules replied, "Everyone is a mission-critical individual and I cannot ethically ask someone else to accept a risk I would not accept." Captain Brezinski understood this concept, because her personal code of conduct was similar, and reluctantly granted him permission to proceed.
Doc Jules had the auto analyzer obtain baseline lab data, then applied a tourniquet to his left arm and inserted an IV needle into his vein. This IV was connected to a mixture of steroids and adrenaline which would be used to treat anaphylaxis if it developed from the vaccine injection. Doc Jules then carefully filled a small syringe with .1 cc of the clear liquid from the vial that Brother Simon had given him. Brother Simon was continuing his argument that he should be the trial subject instead of Doc Jules; if he became ill from the injection Doc Jules would be available to treat him.
Doc Jules laughed and said, "When I went fishing along the Deschutes River, I always told my fishing buddy that he should go first. I figured if he disturbed a rattle snake and was bitten I, as a physician, could provide treatment. He never bought the argument and neither do I." Doc Jules began to absently clean the skin on his left arm with an alcohol wipe. He said, "Using this alcohol wipe before giving an injection has never been shown to have any value, but it is tradition and is expected by patients. I guess that I am reacting as a patient when I follow tradition on myself." He then inserted the needle into his left arm and injected the syringe contents. He winced with the sting of the needle, but was otherwise matter-of-fact about the injection. He monitored his vital signs and used voice recording to document his immediate response. Except for a slight increase in his heart rate which he felt was secondary to the pain and anxiety of the injection, nothing changed. After 20 minutes he felt the risk of anaphylaxis had passed and when he told Brother Simon this, the response was, "Thank the Lord." Doc Jules forwarded his initial response to Captain Brezinski and added that he would expect antibody formation to be detected within 72 hours. Captain Brezinski accepted the report and advised him to, "Carry on."
Doc Jules repeated his blood test after the 72- hour waiting period and was able to detect antibodies to the viral antigen. The mere presence of antibodies does not guarantee that the vaccination will be effective, but it is a very good indicator. Doc Jule's plan was to first vaccinate Tom and Martha prior to completion of their isolation period. He packed a medical kit which consisted of two syringes of vaccine, two blood specimen vials, and an anaphylaxis treatment kit. Following approval from Captain Brezinski, he had the Chief deliver this package to Tom and Martha using the delivery wire they had stretched along the access tunnel and a self-breaking sliding mechanism.
Tom was obviously "over-joyed" at the thought of having his blood drawn and receiving the injection. When Martha finally told him to, "Quit acting like a big baby" he grudgingly allowed her to apply the tourniquet and draw his blood. Tom teased Martha about waiting for her turn. When it came time for him to insert the needle, he began to perspire heavily and had to force himself to draw her blood. When it came time for the vaccination, Tom told Martha, "I think I would rather have another meeting with the Chief and his cat-o'nine- tails than get a shot." Martha just shook her head and, when Tom was not looking, stuck the needle into his arm and injected the vaccine. He yelped but otherwise tolerated the vaccination well. Martha did not even ask Tom to give her the injection; simply doing it herself. Following a two-hour observation period, Doc Jules allowed them to return to their work.
Doc Jules now began vaccinating the remaining crew members after first performing a physical examination. Most of the crew accepted the examination and the injection without complaint. Mike, as expected, complained of the inconvenience and the loss of time which the examination required. When he found out it was going to be a complete examination which included a screening rectal exam his complaints became much louder. Doc Jules asked him if he would like to discuss the issue with Captain Brezinski, but Mike mumbled, "Just get the damn thing over with."
All of the female members of the crew also underwent a mammogram. Everything was proceeding well until Kate received her mammogram. There was a small tumor visible in the left breast. When Doc Jules showed her the images she started crying. Doc Jules simply stood beside her with his hand on her shoulder and let her cry. After she settled down, she told Doc Jules, "I want you to remove both breasts."
He objected, saying, "I do not think that a bilateral mastectomy is needed and you should not need to undergo that much surgical mutilation."
She replied, "I watched my mother die of breast cancer and if living flat-chested will save me that fate, then I would prefer being flat-chested. Besides if the horny bastards aboard this ship do not like me flat-chested, then it is their loss."
Doc Jules sat quietly for a few minutes thinking about the alternatives. He finally told Kate, "Before we make our decision let me do some research and see what other treatments might be possible." He then asked Kate's permission to perform a simple needle biopsy. She agreed, and using the MRI unit to guide placement of his needle he performed an aspiration biopsy of the tumor. Doc Jules placed some of the fluid on microscopic slides for staining and evaluation. The remaining fluid he placed in a cellular growth chamber. He told Kate he would have results available the next day. She asked him not to inform anyone else until they were sure. Doc Jules agreed with the exception that he thought Captain Brezinski should know. Kate nodded and thanked Doc Jules for his kindness and understanding.
After Kate left the clinic, Doc Jules processed the microscopic slides and with some dread looked at them under the microscope. He was not a pathologist but the cellular changes were so obviously cancer that he did not doubt the diagnosis. He called Captain Brezinski and asked her to join him in the infirmary. When she arrived Doc Jules gave his report in a scientific fashion and when he was done, Captain Brezinski asked him, "What does all that mean?"
Tears welled up in his eyes and he said, "Unless we can find a better treatment for breast cancer, Kate's chances of dying from the tumor are pretty high."
Captain Brezinski began speaking Russian and when Doc Jules interrupted her, she apologized, "I swear much better in Russian." She continued, "The safety of the crew as a whole is paramount so I would like you to complete the vaccination program and then use whatever resources you need in your search for a treatment."
Doc Jules nodded and related Kate's wish for privacy. Captain Brezinski responded, "Of course." She left the infirmary with a heavy heart. Doc Jules finished his schedule of physicals and vaccinations, but his thought processes kept returning to that small tumor in Kate's breast and the prognosis it held.
When Kate returned the next day, Doc Jules was just finishing his last physical and vaccination. As soon as Kate looked at Doc Jules' face she knew the biopsy was positive. She did not even ask him if it was cancer but asked, "What's the plan, Doc?"
Doc Jules responded, "Standard treatment would be to remove the tumor with a lumpectomy followed by local radiation therapy and chemotherapy."
"You have the facilities to perform the radiation therapy and chemotherapy?" Doc Jules shook his head no and said nothing. Kate was silent for a while then said "I suggest we get on with removing my breasts then."
Doc Jules responded, "It may well come to that, but before we proceed with radical surgery I need to complete my research for new alternatives. Captain Brezinski has given me permission to utilize all of our resources in a quest for
a better therapy. A delay of a week should be irrelevant to your outcome and I ask your permission to delay therapy for one week."
Kate said, "I would rather get it over with, but I guess that I can wait one week." Doc Jules asked her if she wanted him to notify the rest of the crew or if she wanted to do it herself. She replied, "I think it would be best if I told them myself." Her green eyes then flashed mischievously and she said, "Maybe I should go topless and tatoo a sign across my breast saying enjoy the view because in a week these will be gone."
Doc Jules smiled and said that may be something less dramatic would be more appropriate. Kate said, "I suppose so, but I might as well enjoy them while I can."
Doc Jules called Eric-Peter and Brother Simon and asked them to join him in the infirmary. When they arrived Doc Jules briefed them on Kate's diagnosis and Captain Brezinski's commitment of the ship's resources. They both immediately offered their assistance. Doc Jules asked Eric-Peter to begin a computer search for specific information on breast cancer and its therapy. Eric-Peter nodded and said a search through the new computer module would be relatively slow and he would require at least a day to complete his task. Doc Jules thanked him and Eric-Peter left. Brother Simon asked what he could do and Doc Jules responded, "If prayers actually work, now would be a good time to use them, but I was hoping we could somehow isolate the breast cells from the remainder of the breast tissue and destroy these cells only."
Brother Simon asked, "How much of the breast tissue is composed of actual breast cells?"
Doc Jules said, "Except during pregnancy and breast feeding, only a small portion of the breast tissue maybe 10 to 15 percent is composed of breasts cells and the rest is connective and fatty tissue."
Brother Simon wanted to know how these breast cells differed from the remaining tissue cells. Doc Jules informed him that the breast cells were all epithelial in origin and connected to the ducal system of the breast. They responded to prolactin stimulation to produce the breast milk.
Brother Simon said, "So all of the cells are physically connected and have a distinct origin and a distinct reaction to this prolactin hormone?"
Doc Jules nodded in the affirmative.
Brother Simon began to pace around the infirmary obviously in deep thought, mumbling to himself. He stopped pacing and said, "It would seem that if we could engineer a virus to activate the ‘suicide gene' in the breasts cells so they went into apoptosis (programmed cell death), we could selectively remove the breast cells without damaging the remainder of the breast."
Doc Jules was still digesting this idea when Brother Simon started down yet another thought path. He said, "It might be easier to design a bacterium which attached specifically to the prolactin receptor on the surface of the breast cells and produced an infection which would be fatal to those specific breast cells."
Doc Jules instinctively liked this approach and said, "We want to create a severe case of mastitis which would prove lethal to all of the breast cells but not infect any of the other tissue cells."
Brother Simon and Doc Jules continued to banter back and forth defining the characteristics of the custom-designed bacteria they needed. Doc Jules suggested they use a form of Staphylococcus because that was the common bacteria which produced mastitis in women who were breast feeding. Brother Simon said he would need some normal breast cells and some tumor cells to make sure they had a common receptor for the prolactin hormone. Doc Jules said he had some tumor cells growing in a cell culture and he was sure Kate would allow him to repeat the biopsy to obtain some normal breast cells. Doc Jules asked Brother Simon if he would need any of the equipment aboard "The Egg." Brother Simon replied, "No. Without the DNA auto analyzer and the DNA sequencer, it would require several years or decades of work to accomplish the task."
Doc Jules said, "Kate has given us only one week to develop this alternative. Is it possible?" Brother Simon said that with the grace of the Lord and some hard work they could meet that deadline.
When Mike heard about Kate's tumor his concern was transformed into anger and he stormed into the clinic and demanded that Doc Jules help Kate. It took Doc Jules several minutes to settle Mike down to the point where he could reason with him. He explained they were not ignoring the problem, but were trying to design a treatment which would make a cure more likely and cause Kate less pain and disfigurement. Doc Jules could sense the despair in Mike's eyes when Mike asked if there was anything he could do to help. When Doc Jules told him Brother Simon would need some of the equipment from "The Egg." Mike responded, "The Chief and I will carry that equipment up on our backs if we need to, as soon as you cancel that damn isolation protocol of yours!"
Doc Jules replied, "The isolation protocol will be complete in 12 hours and if you could expedite the transfer of the equipment after that, it would be a great help."
Mike found the Chief in the Long Branch Saloon and they began working immediately on a plan to transfer the equipment from "The Egg" up the 2 kilometer tunnel that connected the docking port with the ship's interior. Their initial plan had involved the use of a crane to simply lift the individual containers up the tunnel, but even with the use of the auto supplier's manufacturing capabilities it would be several more days before the equipment would be ready. They argued about the feasibility of using explosives and rockets to lift the payload, but the control issues made these unacceptable. The Chief recommended using one of the plasma lasers to create a more controllable explosion for the lifting process. This concept was quickly adapted by Mike who was scribbling furiously on his scratch paper. His design quickly became a large parachute connected to a simple platform that the equipment was loaded onto. The center of the parachute had an opening through which the laser could vaporize a small quantity of water creating a miniature steam bomb which would force the parachute upward. The laser itself would be stationed at the inner airlock and by carefully controlling the firing rate of the laser, the rate of ascent would be controlled. The Chief raised the issue of controlling the water supply especially with the frigid temperatures in the tunnel. Mike's solution was to use a block of ice which would be gradually melted by a limited energy laser. The water produced would be collected into a funnel and discharged out the narrow end into the focal point of the plasma laser. Three small mirrors would have to be positioned equidistant from the focal point to utilize the existing aiming lasers on the plasma laser.
Mike told the Chief to begin the fabrication process. When the Chief objected that the Captain had not even seen much less approved their plan, Mike replied, "I will work out the acceleration issues and the energy transfer formulas with Eric-Peter and present the completed package for the Captain's approval."
The Chief responded with a simple, "Yes, Sir." and left to begin working with the autosupplier and the computer design program.
Mike called Eric-Peter and asked him to meet him in the Long Branch to work on a propulsion problem. Eric-Peter obliged and met Mike in the Long Branch. When Mike explained the reason for the urgency in moving the equipment, Eric-Peter was more than eager to help. He did question Mike's choice of the Long Branch as a workstation. Mike replied, "When I worked for Boeing, we did most of our protocol development and original thinking at one of the local watering holes, so I figured that maybe we would be more productive here."
Eric-Peter nodded and took out his personal computer and began creating a large spreadsheet to compute the energy requirements for different load weights and rates of acceleration. Mike was unable to provide actual weights. Eric-Peter recalled that on the "bill of lading" there had been a column which may have been the mass calculations of the individual containers. He used the infrared sending unit on his personal computer to access the main computer data bank. He then had the central computer translate the characters in the column he had previously noticed. The translation produced very large numbers which seemed meaningless. Mike had an insight when he noticed how much smaller the number was for the "keys"
and called Tom to ask him what he thought the weight of the key was.
Tom responded "I am not sure but I can weigh it if you want me to." Mike asked him how he could weigh it and Tom explained they had access to a small medical scale.
Mike responded, "Of course I want you to weigh it and hurry up." Tom placed the key on the scale and told Mike that it weighed 115 grams. Eric-Peter used this information to convert the number that was listed and developed a conversion formula for the remaining containers. The containers that Mike had been told were needed weighed between 200 and 300 kg each. Using the energy released from the small steam explosions they decided that the maximum lift would be calculated for 700 kg. The plasma laser had very well known energy output and it was relatively easy to calculate the amount of water which would be required to produce sufficient acceleration to lift their required load.
After several hours of work the chief rejoined them. He said, "Production is proceeding fairly well and I expect we can begin assembling the unit in about six hours."
Mike thanked him and asked for some input on the fail-safe mode to prevent a catastrophic loss. They decided that simply using multiple balloons on the bottom of the platform would significantly limit the potential for damage if there was a catastrophic loss to the parachute. One issue led to another issue and before any of them could leave to catch some sleep the Long Branch began to fill up with crew members for breakfast.
When Captain Brezinski arrived, she could not help but noticed the stack of papers both on the table and on the floor. She said, "It appears that some of us spent the night working."
Mike replied, "Well, we did not mean to work all night, it just sort of happened, but we did accomplish our goal."
Captain Brezinski began looking at the sketches and recognized that they had been developing the lift mechanism for the equipment that Brother Simon needed.
She said, "When I told Doc Jules he could utilize all of the resources of the ship I had assumed that normal channels would still be utilized." The Chief began to blush at the reprimand, but Mike did not even seem to realize that he had been reprimanded.
He simply said, "I figured we would complete the design and protocols before bothering you with the plan, and I think we're ready to present it now." Captain Brezinski suggested they enjoy their breakfast and present the plan during the morning report.
Captain Brezinski opened morning report by asking for the standard daily reports first. Then she asked Doc Jules to summarize the progress they had made working on a treatment for Kate's cancer. Doc Jules explained their proposed treatment utilizing the genetically engineered staphylococcal bacteria which would selectively kill only the actual breast cells leaving the remaining breast tissue.
Captain Brezinski asked, "Has Kate agreed to this experimental therapy?"
Doc Jules had to admit they had proceeded only with Kate's agreement to defer the surgery for one week while they explored the alternatives. She asked what other alternatives they had found. Doc Jules responded, "We cannot provide the traditional post-surgical radiation therapy and chemotherapy. Eric-Peter has been performing a review of the new computer's database looking for other treatment modalities."
Captain Brezinski turned to Eric-Peter, who was looking quite tired, and asked him what success he had in his computer search. He responded, "Captain, my initial effort produced no new information, but I have had the computer performing an automated detailed review which should be complete this morning."
Captain Brezinski asked Doc Jules, "How likely is it that you'll be able to develop these new genetically engineered bacteria in time to meet the deadline that Kate has given you?"
Doc Jules turned to Brother Simon who also appeared somewhat short on sleep and asked him to respond. Brother Simon said he had analyzed the genetic code of the proposed staphylococcal bacteria and was successful in identifying the genes which control the surface proteins which were used to bind to cell walls. He said, "My ability to accomplish the actual genetic manipulation will be dependent upon the grace of God and the ability of the machinery that has been delivered to us."
Captain Brezinski summarized the situation by saying, "I have an essential crew member with a potentially fatal cancer. You're trying to develop this bacterium to assist in destroying both the existing tumor and the remaining breast tissue, but to develop this treatment you need the equipment in the New Beginnings." She then turned to Mike and asked him to review his proposal.
Mike began by explaining they had been developing a specialized crane to lift the equipment from "The Egg" but that the auto supplier would require 11 more days to manufacture the filament cable which would be capable of lifting a payload of several hundred kilograms. They had developed an alternative plan utilizing existing equipment and modifying it to produce the required lifting capability. He then explained the principal of using the laser energy to vaporize water. This would produce a rocket propulsion that would act against the parachute and lift the required payload in a very well-controlled manner. Brother Simon, who was obviously visualizing his irreplaceable equipment crashing to the bottom of the cylinder, asked him what would happen if the equipment failed. Mike looked very annoyed and said, "We trust you to do your work properly to help save Kate; you need to trust me to do my part properly."
Captain Brezinski interrupted the discussion and said. "Gentleman, we are all working towards a common goal and to succeed we must all work together." Mike mumbled something about "damn mystics" under his breath, but explained to the group that the bottom of the platform would be covered with multiple balloons which would cushion the fall in the event of a complete system failure. A detailed exploration of the safety protocols was followed by a review of the propulsion requirements. The plan appeared to be complete and practical and Captain Brezinski complimented Mike and his team for the work. She reminded everyone that for the teamwork to be effective that the normal chain of command needed to be followed. Captain Brezinski closed the meeting by approving Mike's plan and telling Doc Jules to make sure he had Kate's approval before proceeding any further.
Doc Jules called Kate and asked her to meet him in his clinic. When she arrived he began explaining the plan they had arrived at. Kate astutely asked him if these specialized bacteria would be capable of destroying any cancer cells that had already spread from the tumor. Doc Jules admitted they were not sure but that theoretically it should work. Kate then asked how they were going to create this bacteria and Doc Jules explained in general terms what Brother Simon intended on doing.
When Kate heard about using the equipment from "The Egg" she said, "So that was what Mike and the Chief were doing all night at the Long Branch? They can be so sweet."
Doc Jules was not sure what Kate was talking about and decided it was none of his business. Kate was quiet for only a few moments and told Doc Jules, "I would rather keep my breast if possible. I trust you and the rest of the crew so I approve the plan as long as we can accomplish it quickly."
Doc Jules began to explain the risk of a systemic infection or allergic response, but Kate responded, "I already feel like I am living on borrowed time. I have lived with the fear of dying like my mother for so long that I am more than willing to take this chance."
Doc Jules nodded and said he would inform the Captain of Kate's decision. He then performed a biopsy of the right breast to obtain normal breast glandular cells. Kate tolerated the biopsy without difficulty and quickly dressed. Doc Jules asked if she was done dressing and when she said yes, he walked back into the procedure room. Kate smiled and thanked him for his help and caring. Before Doc Jules could respond she turned and gave him a big hug and a kiss. Doc Jules was not only surprised but somewhat embarrassed. He could feel the redness rising from his neck onto his face. Kate smiled again as she left the clinic.
Mike and the Chief were connecting the monitor and power supplies for the laser system which would be installed outside of the airlock. Mike asked the Chie
f why the Captain was so sensitive about them doing their job. The Chief responded by reminding Mike that he always wanted to know what was going on with the equipment and whether or not maintenance was up-to-date. Mike acknowledged he felt personally responsible for making sure his department performed well. The Chief replied, "The Captain feels the same about everything that happens on this ship and to its crew. She does not want to interfere with your work, but she needs to be able to integrate the operation as a whole."
Mike grumbled, "I suppose that makes sense."
When they had completed the electrical connections they moved the laser into the airlock and suited up. After cycling the airlock they slid the laser onto the platform inside the access tunnel and secured it to the platform with the tube aimed down the tunnel. The computer then performed a systems check on the laser and documented proper functioning. They moved back into the airlock and with the help of other crew members moved the lifting platform and parachute into the airlock. They again cycled the airlock and moved the platform out and slowly lowered it on its tether down the tunnel. They attached the parachute and lowered the entire apparatus further down the tunnel. The restraining strap was disengaged and the parachute opened, almost filling the tunnel.
Testing was begun using the laser to produce enough lift to take the tension off of the support cables. Only a minimal adjustment of the aiming mirrors was required to keep the laser centered on the vaporization point. Following completion of the safety checklist and the checkout, Mike reported their readiness to Captain Brezinski. She ordered Tom and Martha to maintain their position in the emergency habitat with their EVA suits on and ready. She then authorized Mike to proceed with the lowering of the lift device. They increased the laser power enough to remove all tension from the tether lines and removed them. They gradually decreased the laser power and the lifting device descended. They were able to control the velocity very accurately. They slowed the rate of descent as the device reached touchdown and brought it to a stop just above the outer loading platform. Tom and Martha were then allowed to leave the emergency habitat and secure the device. They had previously maneuvered the critical containers into the airlock. Tom used the miniature fork lift Mike had sent to move the containers onto the platform of the lifting device. They secured the first two containers using the key in addition to straps. Then they released the hold-down cables and returned to the safety of the emergency habitat.
The power of the laser was gradually increased until the lifting device began to ascend. They kept the speed of ascent low and slowed it even more as the lifting device approached the inner loading platform. The suspension cables were attached and the laser power was shut off. A mechanical winch was then used to raise the load the last few feet. Mike and the Chief released the containers individually and moved them through the airlock. Captain Brezinski ordered a brief rest and then the lifting device was again lowered to raise the remaining critical containers.
Following their safe unloading Captain Brezinski ordered a general rest period. Tom acknowledged the order but asked, "Could I get a ride on the lifting device before starting my rest period."
Captain Brezinski replied, "If Mike approves the device for crew transport you'll be given the choice between riding or ascending the stairway which you regard so highly."
Tom responded with his usual, "Aye, aye, Captain." and added, "I am not in a hurry to leave except that I keep thinking about the beer that Kate is saving for me."
The equipment was brought to Brother Simon's lab but nobody knew how to open the crates. Mike and the Chief examined them for the better part of an hour without finding an obvious opening. Brother Simon sat quietly watching them, but when Mike jokingly said, "Chief, we may need the cutting torch." He got up and walked over to the closest crate. He asked Mike if he could try opening the crate with the key.
Mike groaned and said, "Just don't break anything." Brother Simon inserted the key and rotated it counter clockwise locking the base to the floor. Instead of removing the key he tried pushing it in further, which it did do. He then rotated the key clockwise and everyone heard a distinct click.
Mike and the Chief said simultaneously, "What did you do?"
Brother Simon said quietly, "I think that I have released the cover."
When they tried to lift the crate cover it actually moved and the three of them were able to remove it. Mike was obviously surprised and said, "How in hell did you know how to do that?"
Brother Simon shrugged his shoulders and said, "It just seemed logical that the base would need to be secured before the cover could be removed. We used a double position lock to secure our most sensitive equipment at the monastery."
Mike responded with a simple, "Oh."
The machine was the size of a large desk and had a central computer console with small doors on either side of the bench space. There were symbols similar to the crates themselves but no recognizable instructions. The Chief asked, "What do you think this machine does?"
Brother Simon responded, "I would expect this is the DNA auto analyzer and we will use it to sequence the four nucleotides that make up the entire genetic code."
The Chief looked at Brother Simon and said, "But how are you going to learn how to operate it?"
Brother Simon smiled and said, "Hopefully the machine has been built so that I can use it intuitively."
The remaining machinery was positioned in a cluster at one end of the lab and Mike began the process of deciphering the wiring schematic. All of the equipment used a standard computer interface cable which was connected to the input terminal for the central computer. The power requirements varied with the individual pieces of equipment. Mike and the Chief were able to adapt the standard power cords relatively easily to fit to requirements of the individual units. By the end of the work period the equipment was positioned, interconnected with the main computer, and had power established. Brother Simon sat at the auto analyzer and began to push buttons until the unit came on. Once the computer screen became active he had the central computer translate the characters into English and he began scrolling rapidly through the screens. Mike was watching over his shoulder and interrupted him by asking how he could read that rapidly.
Brother Simon responded, "I began speed reading as a teenager without knowing I was doing it and have always enjoyed the gift."
Mike asked him, "How good is your recall?"
Brother Simon replied, "I have a near photographic memory which unfortunately does decay over the period of several months."
Mike's only response was, "Holy shit!" Brother Simon continued his rapid review of the manual the computer was translating for him. Within an hour he had completed his review and began setting up the equipment.
Doc Jules brought the Staph culture they had planned on using for the basis of their new bacteria. Using a sterile wire, he transferred a small sample of the culture to the input port of the auto analyzer. This sample was diluted and individual bacteria were separated out for analysis. The computer monitor displayed a highly magnified view of the process. The bacteria cell membranes were dissolved, freeing the DNA. After several attempts an intact chromosome ring was seen and Brother Simon with great enthusiasm accepted the sample for analysis. While the equipment was analyzing the sample, Brother Simon had the computer display the genome (the entire genetic code) of the bacteria. When the analysis was complete a picture of the circular chromosome was displayed and the genetic code was highlighted. He then explained, "Because all bacteria in a culture are genetically identical we will be able to treat the culture with a combination of chemicals and bacteriophages (viral type agents) which will selectively remove those genes which we want deleted and add those components we need. The fact that bacteria have a single circular gene instead of 26 pairs like humans makes them much easier to work with."
Doc Jules then suggested they could improve the therapy if Brother Simon could manipulate the bacteria to produce
a viral-type antigen that the killer T-cells would recognize and allow them to assist in the destruction of all of the breast cells. Brother Simon thought he could easily add the antigen. If Doc Jules would vaccinate Kate ahead of time with the antigen, then her killer T-cells would be activated and more likely to succeed in helping destroying the breast cells.
Brother Simon and Doc Jules worked with only minimal rest periods growing and analyzing subsequent generations of the bacteria, checking for the essential characteristics. The machinery provided ideal growth characteristics and the bacteria colonies would double every 20 minutes. The micro manipulator would allow for sterile sampling of each colony and automatically store the remaining cells in a sterile chamber for further work. A second type of bacteria, E.coli, was developed without a cell wall which incorporated the human prolactin receptor on its surface. The bacteria were mixed in a micro chamber and the electron microscope was used to detect clumping of the two types of bacteria. The tighter the clumping the more active and selective was the attachment of the Staph to their targeted receptor. Each generation produced additional changes in the genetic code, manipulating the bacteria for their special use. Doc Jules complained to Brother Simon, "There must be a better way to quantify the effectiveness of the bacterial attachment than the laborious methods we are using."
Brother Simon thought about it for a few minutes and replied, "We could add the gene for luciferin to the Staph bacteria and the gene for luciferase to the E. coli and simply measure the bioluminescence of the mixed culture."
Doc Jules said, "If the genetics would not be too difficult, this technique would improve our ability to quantify our results and save my eyes."
Brother Simon nodded and said, "With the equipment that we now have, the genetic manipulation will be very simple and I will add the appropriate genetic material to each of the bacteria for our next culture."
On the fifth day their efforts had produced a dramatic improvement in the engineered bacteria. Captain Brezinski stopped by to check on their progress and add her encouragement. Doc Jules excitedly held up two test tubes, one of which glowed with a soft green light and the other which only contained a slightly cloudy mixture. He explained, "The tube that is glowing shows that our bacteria strongly attaches to the prolactin receptor. The other tube because it is not glowing shows that the bacteria no longer attach to the regular cell receptors."
Captain Brezinski smiled and asked, "Does this mean you're going to turn Kate into a giant fire fly or that this new bacteria is working like you planned?"
Brother Simon replied from behind some equipment, "Captain, the thought of Kate glowing like a giant fire fly is very intriguing, but I had planned on removing the genes that produced this bioluminescence before Doc Jules uses our new bacteria."
Doc Jules added, "We have made dramatic progress and have accomplished in a few days what would have been all but impossible without the equipment from ‘The Egg'."
After six days of intense work, their test showed they had achieved their goal and the time came for Kate's treatment. She presented to the clinic looking somewhat tired and admitted that she had spent the last few days enjoying life as much as she could, doing without much sleep.
Doc Jules smiled and said, "I expect during the next few days you will not feel like doing much more than resting."
He then reviewed again the risk that Kate was taking, but Kate just nodded and said, "It is time we got on with this so we can all move forward and accomplish what we have been sent to accomplish."
Doc Jules began his preparation by inserting an IV catheter into her arm vein and connecting it to a bottle of fluids. He administered a large dose of cortisone to temporarily weaken her immune system. Giving the bacteria a chance to establish themselves and spread to all the breast tissue cells. After the infection was well-established he would stop the cortisone and inject an immune stimulus to reverse the effect. The large dose of cortisone acted as a mild stimulant and Kate began talking incessantly. Doc Jules continued working and just kept nodding as if he was listening to Kate. The next step involved using a microscope to recognize the small ducal openings in the nipple. The hormonal manipulations Doc Jules had performed had caused the breast tissue to become active and the ducts more evident. He used a small blunt needle to inject a microscopic amount of the modified bacteria into each duct that he could recognize. He stained each duct with a small amount of ink after he treated it in order to identify the untreated ducts. It was very tedious, demanding work and Doc Jules would go several minutes without responding to Kate's chatter.
Finally Kate interrupted him by saying, "Either you are working too hard and need to take a break or you're having way too much fun and should stop playing around."
Doc Jules had to laugh at the impertinent remark and sat back and stretched his tense shoulders.
Kate had been asking him why she needed to stay in the clinic during the treatment since she felt so good. Doc Jules explained again, "These bacteria have been designed to be super-responsive to antibiotics. There is a chance they could mutate and become difficult to treat, especially if they had the chance to share genetic material with other bacteria." He admitted the risk to the other female crew members was very small, but it was a risk he did not think was necessary.
Kate remembered he had already explained this to her and apologized for her absent-mindedness. Doc Jules smiled and accepted her apology. He reminded her that the medicine tended to disrupt her short-term memory and things would return to normal shortly. He then finished treating all of the visible ducts. He placed a small gauze pad saturated with a solution of the bacteria over each nipple and applied a dressing over each breast.
Kate spent most of the next 24 hours sleeping. Doc Jules had given her a mild sedative which, combined with her fatigue, allowed her an excellent rest period. When Doc Jules began his morning examination Kate was fully alert and already complaining of her isolation. Doc Jules responded with a hearty, "Good morning, Kate!" and began to prepare the MRI machine using the settings which were designed to detect their special bacteria.
As the images appeared on the monitor it was obvious their therapeutic infection was spreading throughout both breasts.
Kate asked, "Why is it that I cannot feel the infection in my breasts?"
Doc Jules explained, "The medicine has prevented your body from reacting to the infection. It is the inflammation the body produces while fighting an infection that causes the pain and swelling that we associate with an infection. When we stimulate your immune system, you'll be able to feel the infection."
Kate responded, "I have a feeling you are understating the experience that I am about to have."
Doc Jules just shrugged his shoulders and then told Kate, "There seems to be a long list of crew members who would like to visit you. Would you mind if I allowed them to stop by and visit for a little while?"
Kate brightened immediately and said. "Of course, let them in."
Doc Jules was smiling and said, "Unfortunately, the isolation protocol limits you to one male visitor at a time. They must wear masks and gowns just like I am wearing to prevent you from catching some other illness while your immune system is being blocked."
Kate frowned but replied, "Well, even that would be a lot better than sitting here by myself." During the next 48 hours Kate had a steady stream of visitors. If Doc Jules had not required mandatory rest periods the visitors would have been continuous.
At 72 hours Doc Jules repeated the MRI scan which revealed extensive activity in both breasts and to his surprise an area of activity in the left axilla (arm pit). When Kate looked at the images she immediately recognized that there was an activity outside of her normal breast and she asked Doc Jules what it meant. He could not hide his concern, and before he could even explain that it appeared that the cancer had metastasized. Kate said, "It has already spread, hasn't it?"
Doc Jules responded in a very subdued voice, "It would appear s
o, but it also appears that the bacteria are attacking the metastasis. Hopefully it will destroy it along with all other breast tissue."
Kate visibly slumped down into the chair she was sitting in and Doc Jules began massaging her shoulders, offering his support in a nonverbal way. After several moments Kate said, "I have put my faith in you and Brother Simon. I guess we will have to wait-and-see how things turnout."
Doc Jules then administered the immune stimulant and connected a pain relieving narcotic solution to her IV. He instructed her on the use of the auto inject pump. He told her she would soon begin feeling her body reacting against the bacteria. He said, "I do not want you to fight the pain. When you hurt, press this button and a small amount of pain medication will be injected automatically."
Kate looked a little scared and replied, "You make it sound like this is going to be a big deal."
Doc Jules gave her a small smile and said, "I learned a long time ago that female patients tend to tolerate pain better than men, which is why men are not allowed to get pregnant. I see no reason for you to suffer."
Within a few hours Kate's immune system began attacking the bacteria and both breasts began to swell to the point they became painful. The inflammation became significant enough that Kate began to run a high fever. She complained of being severely chilled to the point where she was actually shaking. Doc Jules explained, "The fever is part of your body's response and will help it destroy the bacteria and the tumor, but if you get too uncomfortable I can control the fever with medication."
Kate shook her head and said, "If this is as bad as it gets, I can handle it." After 24 hours both of Kate's breasts were swollen to at least three times their normal size and purulent secretions were draining from both nipples. The area under her left arm was also very red and swollen. When Kate complained about this area Doc Jules just smiled and said, "The strong reaction you're having means the bacteria apparently attached to the tissue there and your body is now attacking it." Kate's fever had begun to decrease and her thinking was more coherent.
She said, "This is one hell of a way to get a breast augmentation, but if those germs of yours are working then I can put up with the discomfort." She then asked how much longer she would have to be in isolation. Doc Jules said. "You can probably start having visitors again tomorrow, but I will not allow any female visitors for several more days."
Kate responded, "I'll take any visitors that I can get. Not that I do not enjoy your company, Doc, but you are so busy being a doctor that we do not have any time for fun."
Doc Jules laughed and said, "I always figured that when patients began to complain about being bored they were on their way to recovery."
Tom was one of Kate's first visitors and he immediately apologized for not stopping by sooner to get the beer that Kate was saving for him.
Kate said, "That's okay Tom. The good doctor has been keeping me quite occupied producing this temporary breast augmentation. At least he's given me one of the biggest sets of knockers that I have ever seen."
Tom smiled his shy smile and said, "I always liked them just the way they were."
Over the next few days the inflammation began to decrease and Kate's fever was almost gone. Doc Jules decided the treatment was complete and gave Kate some antibiotics to completely rid her system of any remaining bacteria. He then performed a second needle biopsy of the tumor using the MRI guidance. He again placed the material onto a culture plate and microscopic slides. He stained the slides and with high expectations examined them under the microscope. Instead of tumor cells he now saw mostly inflammatory cells and cellular debris. He excitedly showed Kate the changes that were evident.
Kate said very quietly, "You mean it worked?"
His response was simply, "Yes". This time when Kate bestowed upon Doc Jules one of her famous hugs, he was able to return it.