By the time Jack and Madison reached Isabella’s room, Marc had already powered up the ultrasound machine and applied a generous layer of jelly to her lower abdomen.
“I’m all set,” he said, selecting one of the probes that hung from the side of the machine. “It might help if I knew what I was I looking for.”
“I want to see her ovaries,” Madison said, looking over her shoulder at Jack. “What side did you say her pain was on?”
“Her right.”
She looked back at Marc. “Start on the left.”
“She’s very thin. We should get a pretty good view,” he said, using a practiced touch to tilt the probe in various directions and angles across her abdomen. “There,” he said, gesturing at the screen. “There’s the left ovary. Size and appearance seem fine. Looks like a normal ovary to me.”
“I agree,” Madison said. “Let’s have a look at the uterus and then the right ovary.”
Marc eased the probe toward the right. “The uterus appears normal.”
To Jack’s untrained eye, the blending of the gray, black and white shades and shadows looked more like a complex weather map than the female reproductive organs.
It took Marc only a few seconds to locate the right ovary. He was still making the final adjustments to sharpen the image when Madison jumped forward. “There it is,” she said, pointing to the central portion of the screen. “It’s not the biggest ovarian tumor I’ve ever seen, but it’s real and it’s right there.”
Marc held the probe perfectly still. “I’d say it’s about two centimeters.”
“Three,” she stated with certainty “Make sure you get some good pictures.”
“Have I ever let you down before?” he responded with a broad smile.
Feeling invisible, Jack asked, “What are you guys talking about?”
“Isabella has a tumor on her ovary,” Madison explained. “Some of these tumors produce large amounts of hormones, which are the exact same hormones that normal pregnant women produce. So, it would seem likely from a hormonal standpoint that there’s no difference between Isabella and every woman in the country with GNS”
Marc’s grin widened. “So, if we measure the hormone levels in Isabella’s blood…”
“We might be able figure out exactly which one made her and the other women susceptible to GNS. Let’s get a gynecologist down here right now. I want this tumor out as soon as possible.”
“Anybody in particular or whoever’s on call?” Marc asked, reaching for his phone.
“See if Schiller’s available. If he doesn’t answer, leave a message for him to call me on my cell.”
Jack tapped his chin a few times, and then, with a note of caution in his voice, said, “I’d agree this is an important discovery, but I’m not sure it means we’ve hit the mother lode.” Marc and Madison stopped what they were doing and then shifted their collective gaze to Jack. “Well, even if your hormone theory’s correct, it just means that GNS is associated with a high level of some hormone. It doesn’t mean it’s the cause.”
“I don’t think you’re getting this,” Madison said. “If we remove this tumor and Isabella recovers, it will mean that the other women with GNS don’t need Vitracide or any other dangerous drug Hollis Sinclair might suggest. They’ll get better on their own once their hormone levels are back to normal.”
“But that wouldn’t happen until their pregnancies come to an end…in one way or another.”
“Obviously,” Madison said.
“But…for those women who haven’t reached their twenty-sixth week…well, aren’t those babies too small to survive?”
“I know where you’re going with this, Jack. I don’t think now’s the best time for us to enter into a moral debate on the pros and cons of termination. Every physician in the country who’s trying to cure this disease believes we’re going to start seeing a lot more deaths in the days to come.”
“I understand that, but don’t you think we should at least think about the—”
“When we encounter the moral bridges, well…we’ll just have to jump off them then. Right now all I care about is getting this tumor out of Isabella.”
Jack took a steady look at Madison. It was clear to him she had nothing more to say regarding his concerns. It was at that moment that her cell phone rang.
“Hi, Jeff. Thanks for calling back. I was hoping you had a few minutes to come over to the ICU. I’m taking care of a pretty sick fourteen-year-old with GNS. We just discovered she has an ovarian tumor, which I’d like to have removed as soon as possible.” A few seconds passed and she said, “That’s great. No, I consider this urgent. I’ll wait for you.” She quickly tapped in another number. She covered the mouthpiece and looked over at Jack and Marc. “Schiller’s on his way. I’m going to call Helen Morales and fill her in.”
Jack wondered if in her excitement, Madison had overlooked one obvious reality: If removing Isabella’s tumor didn’t work, Hollis Sinclair’s theory that Vitracide therapy, even with its dangerous side effects, was the only way to cure GNS would dramatically gain credibility.