Syndrome - Thomas Hoover (best summer books .TXT) 📗

establish a general baseline of cognitive impairment as of now.”

“How long will that take?”

“Actually, Ellen can start in just a few minutes,” he said “Of course, we’ll need to hear about the usual danger signs everybody knows. Does Mrs. Hampton have recent-memory loss? Does she get confused about places and people? Does she have trouble handling money and paying her bills?”

“The short answer is yes.”

All of those things, Ally knew, had accelerated in the last six months. It was the tragic, recognizable onset of the latter stages of Alzheimer’s. Already more than once Maria had said there were times when she didn’t think Nina recognized her. More and more she seemed to be confused, unable some days to find her way around the apartment, and she’d started repeating herself. She often had trouble finding the right words, and she was increasingly paranoid and suspicious. Maria, who had worked with other Alzheimer’s patients, feared she might begin hallucinating soon, seeing things that weren’t there.

Ally turned to her. It felt obscene to talk about her when she was sitting right there with them.

“Mom, sweetie, do you understand what Dr. Van de Vliet is asking? Do you think you have trouble doing everyday things?”

She knew the answer but she was determined that her mother not be treated like a potted plant.

“Ally, you know that half the time I can’t remember a blessed thing. I’m getting crazy as a bloody coot.”

Then Nina turned and looked Van de Vliet in the eye.

“I don’t want to lose my mind, Doctor. I don’t want to see the shade closing in. I can’t do crosswords anymore. I used to do them all the time. And all the music I used to know. It was my love and now… now I can’t tell Scriabin from Strauss half the time. It wasn’t supposed to happen that way. I thought my mind would go on forever.”

“Mrs. Hampton, if you’ll let me, what I want to do is try to work on your recollection. I don’t know how much I can help you with crosswords, but then I’ve never been much good at them myself either. Your memory of music should improve, though. There are no guarantees, but—”

“Then I’m ready to try it, Doctor,” she cut in. “You’re all that stands between me and losing the only thing I have left, my past” Next came a burst of rationality. “Now, I hate to be a pest but could you explain what exactly it is you’re going to do. I want Ally to hear this too and then maybe she can go over it with me later and help me understand it.”

He smiled and reached over and stroked her slightly thinning hair. “I’d be happy to try, Mrs. Hampton. It’s actually pretty simple.”

Then he turned to Ally. “We touched on some of this on the phone. Do you want to hear it again?”

“Yes, I’m still trying to get it all into my simple mind.”

“Well,” he began, “to go back to the very beginning of my interest in stem cells the focus of our research has been directed toward challenging the notorious Hayflick limit. Back in the 1960s, Professor Leonard Hayflick discovered that when tissue cells are taken from the body and cultured in a laboratory dish, those cells grow and divide about fifty times, give or take, and then they stop. They have reached old age, senescence. The physical basis of the Hayflick limit is a section of DNA known as telomere, which gets shorter each time the cell divides. Eventually the telomeres become so short that all cell division stops. It’s like an internal clock telling them the game is over. They’ve had their innings.”

“And you’re saying you’ve found a way to beat the clock, to stop the telomeres from getting shorter?”

“All cells possess a gene known as the telomerase gene, which can restore the telomeres to their youthful length. But in most cells the gene is permanently repressed and inactive. It is only found in egg and sperm cells, and in cancer cells.” He gazed away for a moment as though collecting his thoughts. Then he turned back. “However, we’ve found that by isolating and inserting an active copy of the telomerase enzyme into adult stem cells, which can be found in minute quantities throughout the body, we can set their clock back to zero. We extract cells, ‘immortalize’ them with telomerase, and then return them to the body as a youthful infusion.”

“And is that what you’d be doing for Mom?”

“There’d be a series of injections, but given what appears to be her level of mental awareness right now, the procedure probably can be accelerated.” He patted Nina on the shoulder.

“All right,” Ally said “but can you use the same procedure for someone’s heart?”

“Well, yes and no,” he said. “Did you bring your medical records? I should have a look at them before making any pronouncements.”

To prepare for this moment, she’d printed off a copy of the medical files she’d scanned into her computer.

“There’re a lot of files,” she said, opening her bag. “I’ve got copies of my EKGs over the past eleven years. Dr. Ekelman, my cardiologist, says my condition is getting progressively worse.”

She took the folder out of her bag and handed it to him. He flipped through the files with what seemed an absent manner, almost as though he already knew what was in them and was just going through the motions. Then he looked up.

“Well, your physical condition looks pretty good. You clearly exercise. And I don’t see anything here that would suggest a complication. As to how your procedure might differ from your mother’s, I guess the main area of concern is simply the scale.” He laid her files on the steel table. “Your heart has reached the stage of aortic valve stenosis where cardiac output no longer can keep up proportionately with vigorous exercise. And that has put an even larger strain on an already weakened condition. What we are about to undertake here corresponds to what might almost be considered an aortic valve replacement, though it is done at the cellular level. We call it regenerative medicine. Millions of cells will be involved We’ll attempt to reverse the calcification and also to develop new blood vessels that supply the heart muscle.”

“You know, this is so risky. I remember that not long ago they tried to use fetal cell injections into the brain for treating Parkinson’s disease. And it turned out that the side effects were horrendous. Why should I assume that this is any safer?”

He looked pained. “I assure you we don’t do anything here that is remotely like that particular, unfortunate procedure.”

She stared at the ceiling trying to grasp what he’d just said. “So how risky do you think this is?” she asked finally. “Truth time.”

He looked away again and sighed. There was a long silence in which he seemed to be pondering some extremely troubling thoughts. Finally he turned back.

“In medicine there Is always something that can go wrong. Even the most innocuous procedure can end up being lethal if that’s what the gods want that day.” He looked at her intently and seemed to try to measure his words. “But I wouldn’t recommend we proceed if I didn’t feel that the potential benefits far outweigh the risks.”

She listened wondering. Something in his voice is sounding cagey. What is he leaving out?

“I still want to think about it”

“Of course, but we can make some preparations in the meantime,” Van de Vliet said turning back to Nina. “Mrs. Hampton, do you understand anything of what I’ve said? Nothing is risk free.”

“Young man, if you’d lived as long as I have, and then felt it all slipping away, you’d be willing to take a chance with anything.”

“Mrs. Hampton, Alzheimer’s is one of the more promising areas of stem cell research. We’ve already had successes here. I truly think we can help you. In fact, Ellen can start your preliminaries right now, if you like. A lot of it you may have done before. For example, there’s a game where you have to memorize the names of three unrelated objects, and you have to count backwards from one hundred by sevens. Finally there’s a test where you copy sentences and symbols.” He chuckled and there was a warmth but also a distant sadness. “Some days I’m not sure I could even do it all myself. In any case, it’s not something you pass or fail. But if we do enter you into the trials, you’ll have to stay here for the duration. That’s absolutely essential. We’d also like a caregiver to be here with you, as long as it’s necessary.”

Ally looked at Maria. “Do you think you want to stay here with Mom?”

Maria’s eyes were very sad “I could stay for a day or two. But… maybe we should talk.”

“We can arrange for someone,” Van de Vliet interjected “We routinely provide caregivers from our staff when called for. And because we’re still in clinical trials, there is no charge.”

Ally watched Nina brighten and turn to Maria. “You can bring some things from my closet when you go back. I want to start right away. I just know he can help me. I’ve got a feeling and you know my feelings are always right.”

Ellen reached and took Nina’s hand. “Come, dear, we have a special office where we handle all the paperwork for admissions. We can do the tests there.”

Ally leaned over and kissed her mother. “I love you, Mom. And I love your spirit. You taught me how to be a fighter a long time ago. And I guess you’re still teaching me.”

Tuesday, April 7

12:03 P.M.

Karl Van de Vliet watched the three women leave. Now he was alone with Alexa. So far, so good, he thought. With her mother checked in, we’re partway there. Now what is it going to take to get her with the program? I’m not sensing commitment. She’s asking too damned many questions.

It looks like we may have to go to Plan B tomorrow. Too bad.

After the door was closed, he turned back.

“Your mother is quite an inspiration,” he said with a smile. “I’ll need those tests to create a baseline, but already I can tell she’ll almost certainly respond to the treatment. She fits our success profile. I’d say the odds are heavily on her side.” Then he darkened his look, for effect. Better let her know I don’t have to do this, he reasoned.

“The truth is, we already have enough data on Alzheimers that I don’t really need any further clinical trials. I know the parameters of what the procedure can do and what it can’t. But when Grant told me about his mother’s condition, I saw no reason not to work her into the trials. We’re winding down now and we have some empty beds.”

“Don’t think I’m not grateful,” she said, “even though I may ask a lot of questions.”

She got the message, he thought. Good.

“Alexa, I’m now going to tell you something I’ve never told anyone else,” he went on, feeling a tinge of sadness arise in his chest. He hadn’t planned to say this, but for some reason he now wanted to. Perhaps because it was true. “My late wife, Camille, was a brilliant medical researcher. We worked together for many years, first at Johns Hopkins and then at Harvard. What took her from me was a heart condition very similar to your own. That was over a decade ago and I vowed I would dedicate my work to her. I wanted the final clinical trial in this program to be on a young person with advanced valvular stenosis, but I could never find