Moonlight Medicine: Inoculation (11 page)

The other problem was that a Wolfkin’s bloodstream contained the highest levels of infectious virions during the five days around the full moon. These virions had a protective capsule that would make them immune to the enzyme that she would use to excise the viral DNA from the human cells, and therefore could infect the “cured” person again, given time. Because of these virions, a strict antiviral regime would have to be adhered to after the vaccine to prevent
Languorem luporum
from implanting itself into the host Wolfkin’s genome again. The virus was stubborn, but Evelyn predicted that with no new virions being produced, an infected person’s body would eventually be able to clear out the remaining virions.

Evelyn considered the latest sequencing results then wrote down a quick entry in her notebook about what she planned to do that night and what outcome her effort should have. Then she began to put on her PPE, personal protective equipment, to prepare for her actual work in the lab. As she was pulling on her gloves she noticed a sticky note on the negative-eighty-degree freezer. It read: “Confused blood sample LlDJ-5 with one of my own samples, hematocrit tube exploded in centrifuge and cut my finger. Dr. Jonson told me to contact you about possibility of infection. What zoonotic agent are you working with? Please contact Melissa.” There was a phone number and an e-mail address.

LlDJ-5:
Languorem luporum
, David Jenner, sample five. Evelyn dropped the glove that she had been about to put on her hand and reached over to grab the note. She read it over just to make sure that she hadn’t missed anything.

“Oh no.”

Evelyn didn’t bother to remove the gown and booties, but grabbed for the phone on the wall by the desk and then remembered that it was around two o’clock in the morning, so instead sat down at the desk again and logged on to the older desktop computer there. She clicked into her e-mail and wrote the girl an urgent message, telling her that Evelyn needed to see her and take a blood sample as soon as possible. She wrote that Melissa should try to come in before her classes the next day, and that Evelyn would meet her in the lab. Evelyn almost sent the message then, but after reading it over, she softened the wording slightly so that the girl didn’t panic and go to an emergency room.

After Evelyn sent the message she got up and paced within the unclean confines of the tape. She was horrified that she might have caused the infection of some poor vet student by sharing the lab with her, but how could she foresee such an event? She had clearly labeled all of her samples and tried to keep them separate from the other samples in the freezer, but the freezer was crowded with samples. Kim or Evelyn could have easily placed their box of samples where Melissa normally kept hers or accidentally placed a sample in the wrong box or someone may have spilled two boxes of samples and then placed samples back in the wrong box. Additionally, none of that should have mattered in the least, since no one in the lab should have been without PPE and therefore protected from infection, and not only that, but most of the test tubes used in the lab were plastic. For Melissa to have cut herself through her glove with the thin glass of the hematocrit tube while working with a sample of
Languorem luporum
that was not the mutant strain, a whole series of unfortunate events had to occur in tandem.

Evelyn stopped pacing.
Although
, she thought,
maybe there’s something that I can do in time to prevent Melissa from becoming infected
. It would require some amount of disclosure to the girl as to the sensitive and dangerous nature of the virus, and Evelyn prayed that the girl understood that working in a level three laboratory such as this was not without risk, although Brucellosis was a treatable disease. Evelyn dug through her backpack and pulled out her cellphone and dialed Roberto’s number. After six rings a very grumpy-sounding Roberto answered the phone.

“This better be important, Evelyn.”

“It is. I need you to get me a number of antiviral medications and I need them by tomorrow morning.”

“You are a doctor, yes? Can you not get them for yourself?”

Evelyn shook her head even though Roberto couldn’t see her over the phone. “Not by tomorrow morning.”

Roberto began sounding more awake. “Tell me why.”

“The short answer is: I think that one of the students working in Dr. Jonson’s lab may have accidentally exposed herself to
Languorem luporum
and I’m going to try to prevent the virus from incorporating itself into her DNA and turning her into a Wolfkin.”

She now had Roberto’s full attention. “E-mail me the list immediately and I will have a package dropped off by seven a.m. I cannot guarantee that it will have everything that you ask for, but I will do my best. Where should I send the package? I assume that a random courier will not be able to enter the building at that hour.”

Evelyn was grateful that he didn’t ask any further questions. “Have them drop it off at the front desk of the veterinary clinic. It’s open twenty-four hours a day for emergencies. I’ll pick it up from there.”

“And Evelyn.”

“Yes, Roberto?”

“Do I have to tell you to be more cautious in the future?”

Evelyn wanted desperately to describe the whole improbable situation to Roberto and explain to him how she never could have anticipated something like this happening, but she knew that time was of the essence. “No, Roberto.”

“Good.”

18

Evelyn sent over the list of drugs to Roberto and then reluctantly made a new entry into her notebook transcribing the note, laying out the facts of the event as she understood them, and communicating her strategy to deal with the problem. This was a decent test for the efficacy of the antivirals in preventing integration of the virus into human DNA and in helping the body to clear the virions from the bloodstream. She couldn’t test the antivirals on a Wolfkin because the intermingled viral DNA would be constantly producing new virions. She hated to think of the poor girl as a test subject, but as of now, that was an apt description.

Evelyn sneaked upstairs into one of the unoccupied wards and nicked a couple of vacutainers, needles, and blood collection tubes along with a tourniquet, cotton balls, and cloth medical tape. With such a quick incubation, she would need to draw blood from the possibly infected girl to look for virions in the plasma and check for viral DNA integration within the human DNA of the white blood cells. Evelyn hadn’t drawn blood from a human for a very long time and didn’t cherish the experience, so she fervently hoped that Melissa had good veins.

The rest of the early morning Evelyn tried to concentrate on her work in the lab, but she spent a good deal of time going through the boxes of samples in the freezer and making sure that her and Kim’s samples were all accounted for in the proper boxes. She relabeled all the boxes in red sharpie and taped them shut with brightly-colored tape. She also managed to use a stray piece of cardboard and a lot of freezer sample Tetris to split off half of one shelf only for their samples. When she had finished, her fingers were freezer-burned and sore from the cold, but she was confident that a second accident was impossible. She also checked the offending centrifuge for any missed particles of glass and cleaned and disinfected it.

Progress in the lab was additionally stymied by Evelyn’s overwhelming desire to check her e-mail constantly for a reply from Melissa, which was silly given that it was the wee hours of morning. Around six thirty, Evelyn cleaned up the lab and sterilized the areas she was working in then she secured the lab and went up to the front desk of the clinic to ask if a package had been dropped off for her. The tired and frumpy woman working there seemed very surprised to see her coming from the depths of the building and even more surprised when Evelyn told her that she was there to pick up the package that had been left at the desk mere moments before Evelyn’s arrival.

Evelyn feared that the whole exchange was going to foster a juicy hunk of gossip that was certainly going to gallop to the far corners of the veterinary school before the day was out. She just hoped that it wouldn’t be linked to Dr. Jonson’s laboratory and his mysterious lab-sharing program, and that people who heard the rumors would be far too lazy to follow up on finding out who this unfamiliar doctor receiving peculiar packages at seven o’clock in the morning was. Smiling broadly, Evelyn tried to act like the whole exchange was perfectly natural, even humming to herself as she walked away with the box under her arm.

Once out of sight of the front desk, Evelyn glanced around for other observers and, seeing none, ran for the stairwell. She rushed down the stairs and back to the lab where she used scissors to cut the tape and tore the box open. Inside was a bottle of every single antiviral drug on her list. Roberto’s funds and connections had come through again, and Evelyn felt profound relief although there was still a great deal to be anxious about. Evelyn quickly composed an instruction sheet describing the dosage and frequency of the medications for Melissa. Then she tried to go over in her head exactly what she was going to say to the girl. She contemplated lying about which virus it was, maybe telling the girl that it was a strain of influenza or measles or herpes, but again that risked Melissa going to another doctor.

Evelyn didn’t have much time to debate with herself before the door to the lab opened and a short, freckled girl in her early twenties with straight brown hair entered and looked around expectantly. She looked groggy and had a large heavy book bag slung over one shoulder. Upon spotting Evelyn, she ambled over and held out her hand.

“I’m Melissa, you must be Dr. Eisenhart?”

Evelyn noticed a small but deep wound on the girl’s proffered hand, so she held it gently while she shook it. “Yes, thank you for coming in this morning. With accidents such as these we like to start the antiviral protocol as soon as possible.” Evelyn tried to sound as cool and professional as possible to alleviate some of Melissa’s probable fear regarding the infection, and to hopefully curtail some of her questions. The girl didn’t appear overly nervous and nodded to Evelyn, but was not completely dissuaded from asking more questions.

“What virus are you working with?”

Evelyn decided that a very vague truth gave the best chance of her pulling off the overall lie. “It’s a novel virus very distantly related to rabies. If you want to put your bag down, I’ve set up an area over here to draw your blood.”

Evelyn pointed to another desk which she had cleared and set up the blood drawing materials on. She had even precut a piece of tape to use as a bandage. Melissa glanced over at the desk and then back at Evelyn. She raised her eyebrows. “I don’t mean to be rude, but are you, um, qualified to do that?”

“Of course. I also have an M.D.”

Evelyn bustled over to the desk as if there was no further need for discussion and pulled the chair out for Melissa to sit in. Melissa set her bag on the floor, followed Evelyn over and sat down in the chair. She started to roll up her sleeve. “I’ve been vaccinated for rabies if you think that will help. Will I need injections?”

Evelyn smiled cheerily in what she hoped was a comforting way as she slid the tourniquet up Melissa’s arm and tightened the rubber straps. “Unfortunately there is no current evidence that having rabies titers will prevent possible infection, but the good news is that all of the antivirals are oral medications, so no injections.”

“Oh. Okay. Good.”

Evelyn swabbed Melissa’s bare arm at the crook of her elbow with rubbing alcohol and picked up the vacutainer and blood tube, willing her hand not to shake. She felt the moisture of sweat on her forehead and under her arms as she uncapped the needle and prepared to puncture the girl’s vein. Knowing that hesitation only made things worse, she speedily poked the turgid bump of the blood vessel and tried to hold the vacutainer steady as she attached the blood tube, watched it fill with blood, and then swapped it out for another. She filled three tubes, then loosened the tourniquet and grabbed a cotton ball to press to the needle hole as she removed the needle from Melissa’s arm. Evelyn set the vacutainer aside and secured the cotton ball with the tape strip hanging from the desk.

Evelyn felt light-headed and realized that she’d been holding her breath. She exhaled shakily and tried to return to a more natural breathing rhythm while she was labeling the tubes with her back to Melissa. When she turned around the girl had rolled her sleeve back down and was looking at her expectantly. Evelyn guessed that she was waiting for Evelyn to tell her when she would get the results of the blood testing. Evelyn hedged.

“It may take some time to get results. Like I said it’s a novel virus and a little hard to isolate. Also I will need another blood sample in about a week. We can set it up by e-mail again.” Evelyn walked back over to the desk with the medication on it and picked up the four bottles and instruction sheet. She walked back over and handed them to Melissa. “Here are the antivirals and instructions. Please follow them as closely as possible. I’ve included my phone number in case you have any problems. I don’t expect you to manifest any symptoms, but if you think that you might be please call me immediately.”

“What kind of symptoms?”

“Oh, upset stomach, nausea, vomiting, headache, fever, runny nose, things like that.”

Melissa scrutinized each bottle in turn. “But this is all just a precaution right?”

Evelyn couldn’t quite meet Melissa’s eye. “Right.”

19

The alarm went off at eight a.m. like a jackhammer in David’s temple. He slammed his fist down on the snooze bar, but pried himself out of bed and stumbled blindly down the hall to the bathroom. As he splashed cool water on his face he thought that this was one of the worst hangovers in a long, sad history of hangovers that he’d been unfortunate enough and stupid enough to experience. What he really wanted was a long, hot shower, but he wanted to give Kim the opportunity to take one first, so instead he headed downstairs. He started up the coffee maker while he popped some bread in the toaster and tried to choke down some orange juice. David was nibbling on the dry toast when the front door opened. Surprised, he stepped out into the dining room and turned into the living-room in time to see Evelyn slide off her shoes and set her backpack down. She was the picture of exhaustion.