Hollis Sinclair was not the only doctor at Southeastern State with a network of sympathetic informers. When Jack saw Helen Morales walk into the waiting room, he nudged Madison. They both stood up. Fifteen minutes earlier, she had phoned Madison, informing her she’d like to meet with them as soon as possible.
With a blend of circumspection and worry etched on her face, Helen walked straight over.
“Perhaps we should speak in one of the consultation rooms. I suspect it will afford the privacy we’re going to need.” Jack and Madison came to their feet and followed Helen into the largest of the three family consultation rooms. “Please sit,” she told them. She did not, electing instead to pace as she spoke. “I’m sure you two can imagine my surprise to learn that Tess Ryan’s C-section had been canceled and that she was being operated on by Amy Willwade, who, the last time I checked, was a neck surgeon.” She turned back around, folded her arms. “I know both of you are highly skilled and thoughtful physicians, so I’m going to assume there’s a logical explanation for why Tess Ryan is having her thyroid gland urgently removed. I was also informed that Mike’s pulled the plug on Vitracide therapy too.” She paused for a few seconds, and then, after a few measured shakes of her head, she continued, “It seems you two have had a rather busy morning. I’ve had at least ten phone calls already, most of them from frantic board members and administrators wanting to know what the devil’s going on around here.” Her focus on each of them intensified. “I’ve been informed…no, make that warned, that Hollis Sinclair’s in a volcanic uproar. He’s already awakened every living soul of authority connected with Southeastern State University, the State Health Department and the Surgeon General’s Office. If he had the president’s cell phone number, I’m sure he would have called him as well.” She paused for a few seconds and then walked over to the coffeemaker but didn’t reach for a cup. Jack was accustomed to prickly political situations, but at the moment he felt like an intern on his first day trying to stay out of trouble.
“Something unexpected happened this morning,” Madison explained. “I was making rounds when Jack called to fill me in. We had to move quickly. The bottom line is we think we’ve figured out what’s causing GNS and how to cure it.”
Helen took a seat and in a calm voice said, “I’m all ears, but could you be a little more explicit than that?”
Jack’s eyes shifted to Madison. From her expression, it was obvious she wanted him to take the lead.
“One of our GNS patients, Sherry Rosenfelt, has an identical twin sister who is also pregnant. We did some checking and she received the same flu vaccine at the same time Sherry did. So, for all intents and purposes, they’re genetically identical in every way.”
“Except that she’s fine and Sherry has GNS,” Madison said. “So there has to be some critical difference between the two of them that gave Lisa immunity to the disease.”
With her lips pressed together, Helen shook her head slowly. “I still don’t see how all of this leads to Tess having her thyroid gland removed.”
“We believe it’s the chimera cells,” Jack explained, “which are in part responsible for GNS. When Lisa was a teenager she was diagnosed with severe Graves’ hyperthyroidism. She was given radioactive iodine, which destroyed all of her thyroid tissue. We’ve recently come across some convincing evidence that GNS may be an autoimmune disease like rheumatoid arthritis or lupus.”
“I haven’t heard anything about that. How did you happen to come across that information?”
“I asked another pathologist to have a look at the slides from Sherry’s brain biopsy,” Jack explained, with the full knowledge his judgment would be called into question. “His opinion was that GNS was likely to be a new, never-before-seen autoimmune disease. He also asked a colleague who’s an expert in the area to look at the slides and he agreed.”
Her eyes squinting, Helen asked, “Would it be safe to assume that this pathologist is not affiliated with Southeastern State?” When neither of them responded, she added, “I thought so. For now, I’ll reserve whatever comments I might have regarding the wisdom of that decision for another time,” she said. “So, what’s your theory, Jack? What’s really causing GNS?”
“If GNS is a new autoimmune disease, then we have to assume the patient’s antibodies are the problem. We believe the chimera cells of the GNS patients are interacting with their normal antibodies. This interaction somehow makes these antibodies defective.”
“In what way? How are they defective?”
“They mistakenly recognize normal brain tissue as foreign and react by attacking it. We believe this…this faulty interaction is the cause of GNS.”
“The antibodies only form in the presence of chimera cells,” Madison said. “So, if we can eliminate the chimera cells…well, we eliminate these destructive antibodies, which should result in a cure.”
“But my understanding is that chimera cells are found in several different areas of the body, not just the thyroid gland. What about these other cells that aren’t in the thyroid?”
“Based on our tests, and for reasons we don’t totally understand, women with GNS have almost all of their chimera cells in their thyroid gland.”
Helen’s eyebrows lifted. “So you ’re saying no thyroid gland—no GNS.” They both nodded at the same time. “Theoretically, what you’re saying might make some sense, but that’s still a pretty thin limb you two have climbed out on.”
“It’s the only limb we have,” Madison said.
“And I assume Mike Ryan has been fully briefed and has given…”
“He understood everything and gave his consent for the thyroidectomy,” Jack assured her.
“Since Tess is already in surgery, I guess there’s not much I can do to unring this bell,” she said coming to her feet. “I better get going. I have a lot of phone calls to make. I can’t decide if the first one should be to the surgeon general to inform or Hollis Sinclair, to try and calm him down.” Gazing upward, she added, “The rumors are already flying. We have to figure out some way to keep a lid on this thing. If any of this becomes public knowledge before we know if the surgery’s been successful…well, it could cause a national frenzy.”
“Do you think Hollis will talk to the press?” Madison inquired.
Helen shook her head. “He’d have to be crazy. That would be a serious breach of professional ethics with significant consequences. I don’t think he’d risk it.” She paused and after an audible sigh that faded to an edgy smile, she added, “I’m going to set up a meeting with him right away. I’d prefer to find him before he finds me.”