The injections provide less balking than usual. We’re all too scared to react in much of any fashion.
Jimmy is there, and leaves the room for the procedure but comes back when we inform him that they’re all decent again. Anndie is with him. He’s got his arm over her shoulder. Her eyes are red from crying.
“Jimmy, you need to get her some new ID. And she needs to get out of Dodge, fast,” Mel reminds him. “We also need you to go to the safe and get all the stuff we prepared in case something ever happened that we needed to get out fast.”
Jimmy looks like a forlorn puppy. “Guess you guys can’t stick around.”
“And neither can you,” John informs him, as gently as possible.
“So where’re we going?” Jimmy asks.
“’We’ are not going anywhere,” Mel lets him know. “I think we’re going to have to split up and remain out of sight for a while.”
Jimmy seems astonished. “What? You guys not together? That seems...weird.”
“Everything is beyond weird, Jimmy. Or haven’t you figured that out?” Ringo is in a snarky mood. I’ve learned that’s how he gets when he’s really frightened.
“This is all my fault!” Anndie wails.
“Shut up,” Deborah orders. She slumps wearily in the chair next to Ringo’s bed. “One of the sucky things about my job is that you can do your best work and you can still have a horrible outcome. You wanna do the work you’re doing, that’s just the way it happens sometimes.” She’s initially harsh, but her voice turns sympathetic by the end. She stares at Anndie. “Look, you didn’t know for a long time, and you did quit, and you did try to help, and you know what? I’m gonna have to live with that. No matter what. You’re gonna have to as well.”
Jimmy pulls Anndie into a tight hug. “C’mon, let’s see what we can figure out, okay?”
As he and Anndie exit, Mel calls out, “Don’t strain your brain too hard.”
We all manage to laugh a little.
The first few hours are uneventful. We put on ‘Dr. Strangelove, or How I Learned to Stop Worrying and Love the Bomb,’ a favorite of everyone here. (Finally, TV we can agree upon. I’ve learned how rare that is). We laugh over the great lines, which have never lost their luster even nearly forty years later.
We’re in the middle of one of the scenes near the end where General Turgidson is screaming “We must not have a mine shaft gap!” when Ringo says, “I think I’m gonna be sick.”
I grab a plastic bucket and stick it near him. He looks weak and dizzy. I hope he doesn’t start vomiting--fluid loss in their condition could be really dreadful news--but my hopes are thwarted when he starts heaving in earnest.
“John? Mel? How about you?” Sari asks.
“I’m okay. Just really hot,” John says. Sari grabs some cool water and starts mopping him. He’s alternate flushed and ashen.
“I was gonna ask who turned up the heat in here, but I figured it was just Miss Foreign Affairs on the screen,” Mel winks at me, but there’s no smile in his eyes.
“Are you queasy?” I ask him.
“Not yet, but if Blondie keeps at it, I might eventually have a sympathetic reflex.”
This makes me edgy. Mel doesn’t have a weak stomach. He’s worked as a combat medic, and from what he has told me, cleaned up after plenty of Ringo’s hangovers and junk food binges in the past.
And so it begins. Let’s just pray it’s not the beginning of the end.
The next 14 hours seem more like 14 years. It’s like watching heroin addicts detox, on steroids. We’d cry but we’re too busy trying to keep them alive and hydrated and cleaning up after them. Devi comes down and helps us and we’re still overwhelmed by it all. Their readings are all over the map. They’re hot, they’re cold, they’re shaking so furiously that it could be dangerous, and they’re getting dehydrated from all the vomiting.
“This is worse than Saturday night,” Deborah comments wryly at one point as she’s cleaning up after Ringo and trying to feed him teaspoonfuls of gingerale.
They’re all in terrible pain. We try sending some pain meds through their lines, but to no avail--they just vomit it back. Compazine gives very little relief to them.
“I wish I’d thought to steal some Marinol,” I grumble. “But Oncology hangs on to that stuff like it’s their own personal party stash.”
“Uh, Mel? It IS their own personal party stash. I assume you know Marinol is the residents’ party drug of choice?” Deborah is trying to keep steady, but I’ve already caught her near tears.
“No wonder you can’t get any,” I mutter.
“Marinol. Oh man, that would be so good,” Ringo rasps. “Wish I had a joint, that’d keep me from tossing my cookies.”
“You didn’t happen to leave any at the HQ?” John asks, just before losing yet more. Sari cleans up after him.
“Didn’t have any. Ran out of cash gaming last time, used it as collateral.”
“Great planning, Blondie. As always.” Mel is breathing hard and his vitals are terrible.
In between playing cleanup crew, we're trying to remember and review as much biochemistry as we've forgotten over the years. We're looking at the structures Maggie has sent to us, trying to determine what we can and cannot use for pharmaceuticals in the event the symptoms get worse.
After four hours of continuous vomiting by all three guys, they're becoming dangerously dehydrated and we can't push fluid fast enough.
"I think we can safely give them some Tebamide," Deborah tells me.
"Oh, they'll just love that," I roll my eyes. Tebamide is a suppository. "I'll do it." I've done it plenty. Get some latex gloves and get it over with.
"This is going to work, isn't it?" Mel eyes me skeptically, just before lurching again.
"Probably." This is the best I can offer right now.
There isn't much protest, and the good thing about Tebamide is that if it's going to work, it's going to work very rapidly. To our relief, the vomiting stops within 20 minutes all the way around.
Deborah's in several windows. "Okay, let's just hope it's not going to bind in some bizarro fashion to some membrane and do more harm than good."
They've all fallen asleep. Their vitals are still uneven, but as they rest, and don't lose any more electrolytes, they stabilize somewhat.
"From what Maggie's indicated here, it's not dopamine receptors being attacked, but serotonin ones," Sari is helping us piece this together.
"Okay, so not using L-Dopa was a good decision," Deborah looks immensely relieved. "We could've really made a mess out of that one."
"But you didn't," I remind her. She needs a little boost in confidence right now.
"Maggie says what she did was try to modify the gene so that serotonin can flow freely, as it should," Sari reads on. "I know that that's a problem in depression. Are antidepressants an option here?"
We're interrupted by Devi, who announces that Jimmy and Anndie have returned.
"Good, we've got a biochemist," Deborah wipes the back of her hand across her forehead. "Let's see what she can tell us about all this."
Jimmy's brought everything that's been requested. He's about to announce it loudly when I turn to him and put a finger to my lips. "Let's let them sleep. Keep your voice low, please. Anndie, we need some assistance here."
"Okay," she sits down next to Deborah.
"We were just wondering," Sari addresses Anndie, "since Maggie feels the virus is a serotonin inhibitor, if antidepressants would be helpful."
Anndie shakes her head. "Different mechanism. In depression, you have problems with reuptake. Here, it's a matter that the serotonin eventually stops traveling at all. You might get some temporary relief, but not enough to count, which is why Maggie made the serum the way she did. I actually did some assays with fluoxetine and paroxetine, and what really has to happen is, we have to open the gates so these chemicals can flow freely between the synapses."
"Those are both HCl based," Deborah states, not looking up. "What about HBr?"
"Has the same mechanism as the hydrochlorides," Anndie is clearly unhappy. "I didn't have time to assay it, and yeah, the hydrobromides bind better, but we have to get the ion channels open. From what we could tell, eventually, the channels would close off completely, and then all the drugs in the world wouldn't help. That's our best guess. Wish we'd had more time to do more testing."
"You and everyone else in here," I mutter, hoping to God the cure isn't going to be worse than the disease. But at least we have something of a clue here as to pharmacology at this point. A very vague clue at best, but it's the best we've gotten.
The guys seem to be resting more comfortably. They're still shocky and I'm sure they hurt like hell, but at least rest is a possibility now.
"One thing you need to probably avoid, based on what little we were able to do, is avoid anything that produces sulfide metabolites," Anndie says softly.
"Great. That just shot out about half the PDR," Deborah grumbles.
"I think you could use drugs that produce nitride metabolites safely, if you needed to use them," Anndie is more hesitant on this one.
I'm about to say I hope we won't have to contemplate that when there's a horrible sound from Ringo's bed.
"Shit, he's seizing," Deborah jumps up. I take his head, stuff a washcloth in his mouth. Sari and Anndie help to restrain him from falling off the bed.
"Clonazepam doesn't produce sulfide metabolites," I call to her. "At least not from what I read on line."
"Okay, I'm gonna titrate a little of that and hope to God it helps," Deborah is nearly in tears. I know that she can barely stand to watch. "Shit, Ringo, don't do this!"
The seizure is not long lived—they rarely are—but while she's getting ready to titrate, he has another one.
"This is not happening. This is not happening," I can hear Deborah whisper as she prepares the solution. "I'll start with 0.5." She injects it into his line. The seizure stops, but then there's a third one starting up.
"Go to 1.0." 0.5 is a low dose. Normally, she could go to 2.0 and be considered in the safe range, but we have no idea what the interaction is going to be. Mel and John, thank God, are not seizing—yet. This is, however, like Anything Can Happen Day on the Mickey Mouse Club. It may be a while before I can tolerate surprises of any kind again.
The next seizure is less severe but the fact that the seizures are continuing at all indicates we need to go higher.
"I'm doing 1.5," Deborah adds more.
We wait several minutes. There seem to be no more seizures. At least not for know. The bad part is that Mel and John are naturally awake and alarmed.
"Maybe we should be taking the drug prophylactically," John comments.
"The thing is, I've been treating Ringo with albuterol, which other than for tissue samples, the only other person who got any is John. So I don't know if it's related to that," Deborah shakes her head, stroking Ringo's greasy hair with one hand.
"I'd recommend it," is my opinion.
"I'm not so sure," Anndie says softly, but then we hear the same guttural, frightening lurching from John.
"I am," Deborah tells Anndie. Sari is helping to restrain John, softly telling him he'll be all right.
"He can't hear you," Deborah snaps as she instructs me to start titrating at 1.0.
"How the hell would you know?" Sari snaps back at her.
"Kids, kids, just play nice, this isn't the time for it." And I'm most assuredly not in the mood for it, either. They can take it out to the parking lot another time.
The 1.0 keeps John from having another seizure. I immediately go to Mel and insert 1.0 into his line. If I need more, I'll put more in, but considering the shape his heart's in, if he seizes, it will kill him.
I'm not in the mood for that, either.
The next 12 hours are critical. We monitor constantly. Even Jimmy assists. We had kicked him upstairs to visit with Devi when he first came in, but when he comes back down, we tell him what went on and what we're up against.
"I figured it was a bad time to say that everything got taken from the offices. Everything but the safe," Jimmy says very softly. "They'd never know where to look for that."
"So you have everything," Sari says.
"Think so. They back up most stuff. I just took it all."
"You do know that you have to get out of Dodge," Sari tells him. "We all do." She looks over to Anndie. "You too."
Anndie is sitting close to Jimmy. He has his arm draped over the back of the sofa, not quite hugging her, but definitely wanting to. Sort of reminds me of guys in high school trying to cop a feel in a dark theater. I'm so punchy I nearly giggle.
"Where would I go?" Anndie asks, frantic.
"When you figure it out, let me know." Deborah's tone is dry and tired. She's still clasping Ringo's hand. "I'm sure I don't have a job anymore. I was thinking Doctors Without Borders, but what about my credentials? I can't get in without my credentials."
"Mula might be able to help you there," Devi offers quietly. "He has a lot of connections."
"What exactly does a consul do? Forgive me here, I'm a doctor and we're all stupid," Deborah groans.
Devi laughs. "Deals with trade agreements, prisoners in foreign countries, just about any matters of state. Actually, what he really does is know people."
"And we have to get out, whether or not…" I trail off. I don't want to say it. I check Mel's vitals again. On the low side, but stable. If it stays that way, we have a chance of going together.
"How do you think your husband will react to all of this?" I'm curious. And a bit nervous.
"Muladharma would do whatever he could to help," Sari says simply.
Devi nods in agreement. "Although this is not quite in the same class as my clearing out the racks at the Nordstrom's half-yearly sale." We all laugh.
"Devi, you do that every year. Muladharma might check for a pulse if you didn't." Sari teases her younger sister, who has been nothing short of a godsend to us.
"My question is, what about the finances to get wherever we need to go?" I have no money to speak of. I don't know how to play cloak and dagger very well. I'm strictly a novice here.
"Don't worry about that," Devi waves her hand in dismissal.
"We can't ask you to do that," Deborah protests.
"You didn't. I offered," Devi shrugs.
"Let's get through the night first," I say, yawning. Things are looking all right for the moment.
"I'll stay up," Jimmy offers.
"You've been awake as long as the rest of us," I remind him.
"Nah. Get some sleep. Anything looks the least little bit hinky, I'll wake you up, right away."
"If anything changes at all, no matter how trivial it might seem, it's important." I emphasize this.
"Anndie, why don't you get some sleep?" Jimmy pats her on the shoulder.
"If it's okay, I'll stay with you."
When they're out of earshot, the four of us just look at each other. Devi giggles.
"He's sweet on her, that's for sure."
"Oh, Devi, when are you going to stop being 13?" Sari teases her sister back.
"When I have a good reason not to. So far I haven't found one."
Time to try and rest for the journey ahead.
Go To Chapter 11