SE was caused by germs known as prions — infectious protein particles capable of reproducing themselves without DNA or RNA. One of the characteristics of SE was that despite an often spectacular clinical picture, the brain looked grossly normal until sections of it were examined under the microscope, where diffuse, sponge-like holes could be seen. Another characteristic was that the incubation period of the disease was often a decade or more, during which time the victim might well be infectious to others.
'Did these cases of yours also have neurofibromas?' Keller asked.
Matt was awake now, pawing sleep from his eyes and looking over at her quizzically. She put a finger to her lips and motioned that she would fill him in momentarily.
'Yes, both of them. From what I have been told, there was nothing unusual about them on microscopic.'
'Well, maybe and maybe not,' Keller said. 'I tried a number of stains and stain combinations on them, and found an approach that clearly distinguishes these lesions from the reference neurofibromas in my library.'
Keller the ever-curious, Keller the intellectual. Nikki smiled just picturing her boss. He was forever playing with stains and with his department's powerful electron microscope. His library, in addition to the hundreds of texts, included hundreds, probably even thousands, of unstained specimens from every organ and countless disease states, each carefully catalogued. Evidently, among those unstained tissues were some run-of-the-mill neurofibromas — the reference specimens.
Spongiform encephalopathy with unusual neurofibromas. The Belinda syndrome, Nikki speculated… Or maybe Rutledge-Solari disease.
'Joe, listen, we'll be home between ten and twelve tonight.'
'I should be here then.'
'If you are, great. But if not, we'll see you tomorrow morning.'
'We?'
'A doctor from down here saved my life two or three times recently. He's got more than a passing interest in this syndrome. He thinks it's due to a secret industrial dump spilling toxic waste into his town's groundwater.'
'Given what we know about prion infections,' Keller said, 'I really don't see how.'
'Well, we'll talk about it when we get there. Thanks, Joe.'
'I'm so relieved you are okay,' Keller said. 'Oh, by the way, the police had no trouble finding the man who killed your drowning victim, Roger Belanger. His name was Halliday. That was what the 'H' was for. They were friends and business associates. The police believe they fought about money. Halliday invited him over to his place to make up. He wrote a check and the two of them had a few drinks. Once Halliday got him into his pool, he got his hands around Belanger's throat and dragged him to the bottom.'
'Process,' Nikki said.
'Exactly,' Keller concurred.
By the time Nikki set the receiver down, Matt had pulled on a new, blue sweatshirt with YALE block-printed on the front.
'Mornin',' she said.
'Mornin', yourself.'
She motioned at the sweatshirt.
'Did you go there?'
'No, but while you were trying on things in that Target store last night, I bought some stuff for me. This was one they had in my size.'
'Believe it or not, I remember. Well, sort of. Where did you go to school?'
'Good ol' WVU. The Mountaineers. That was the only college we could afford. Turned out to be a great place.'
Nikki felt certain she recalled a nurse telling her that Matt had gone to Harvard Med, yet he didn't feel that minor factoid was worth tossing in. She gave him high marks for modesty, as if he needed any more high marks after what he had done for her.
'You sleep soundly,' she said.
'People have noticed that from time to time, yes.'
'If you have trouble walking today, it's from me kicking you to wake you up.'
'The nurses at the hospital quiz me when they call, to be certain I'm awake. They don't know that I've mutated so that I can now answer most of their questions, even the complex mathematical ones, in my sleep. Do you remember much of last night?'
'Unfortunately, I think I do. I hope I thanked you enough for rescuing me the way you did.'
'I have a thing against losing patients. So, what was that call all about?'
'I phoned my boss, Joe Keller, to tell him I was alive and well, and to see if anything had turned up in Kathy's microscopic.'
'And?'
'You're not going to believe this, Matt. Kathy had spongiform encephalopathy. Joe's absolutely certain of that, and believe me, he's, like, never wrong.'
Matt sank back onto the bed, incredulous. He was hardly an expert on the various versions, but he was keeping up on the condition in the medical literature — at least as much as his cramped schedule would allow.
'Prion disease?'
'Yes,' Nikki said. 'Quick point of interest — most people pronounce it pry-on, the way you do, but Stanley Prusiner, who won the Nobel prize for describing the beasties, pronounces it pree-on. I heard him speak a year or so ago.'
'Pree-on it is. This is incredible. Do you think my two cases had SE as well?'
'How can I not?'
'Well, what in the hell?… What about the neurofibromas? Anything special about those?'
'Apparently there was. Joe Keller is sort of a stain freak. He might try a dozen different staining techniques on a piece of tissue just to see what shows up. He tells me Kathy's facial lesions take up this one obscure stain differently from the usual Elephant Man type of fibromas.'
'I just don't get it.'
'Neither do I. But listen, Matt, the way I see it, maybe you're still on the right track. Before we jump to any conclusions, let's go up to Boston and see what Joe has to show us.'
'Give me a few minutes to get put together and we're off.'
'Only as far as the nearest IHOP, though. I have this sudden, insatiable craving for pancakes drenched with maple syrup.'
'IHOP, she wants,' Matt mumbled as he headed to the bathroom. 'First she lays prions on me, then she wants IHOP. What kind of a woman is this, anyway?'
Nikki was impressed with his attempt at cheeriness, but she knew Joe Keller's revelation had stung. From what Matt had told her last night, he was determined to expose the directors of the Belinda mining corporation for all the shortcuts they had taken over the years, and all the people they had harmed along the way. The bizarre cases were just the catalyst he had been looking for to bring them down — proof that mishandling of organic toxins was causing serious biologic injury. But it was going to be hard connecting the mine with prion infection. Well, she reminded herself, nothing was decided yet.
If there were answers, though, Joe Keller would have them.
Matt returned to the room scrubbed and shaved and looking very good. He had stripped off the Yale sweatshirt and replaced it with a black T and the denim jacket he had been wearing when he rode to the cabin in the woods and rescued her. Nikki liked the change. He was much more denim than Ivy League.
'Ready to go?' he asked.
She stood and set her hands on his shoulders. His eyes immediately found hers.
'You were very cool and very brave last night,' she said.
'If I had thought about what I was doing, I probably would have fainted.'
'I doubt it.'
There was much more that she had planned to say, much more she wanted to know about him, but suddenly she was on her tiptoes, her arms around his neck.
'Thank you, Matthew Rutledge,' she whispered. 'Thank you for saving my life.'
Maybe she had known all along that she was going to kiss him. Maybe she had promised herself, clinging to
