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Chapter 1
Miri first noticed the baby's symptoms that morning, a wheezing sound when he exhaled. By afternoon Miri was worried enough to call the pediatrician.
A nurse set up an appointment for the next day and instructed Miri to keep Jack Jr. hydrated and his nasal passages clear, with a bulb syringe if necessary. She told Miri to take the baby to the emergency room if symptoms worsened before the appointment.
By the time Jack got home from the university that evening Jack Jr. seemed a little better. But Jack's usual cheerful smile evaporated as Miri told him about the baby's illness.
"What did the doctor say?" asked Jack, stroking his son's cheek.
"I set up an appointment for tomorrow. The nurse said to give him plenty of fluids and keep his nasal passages clear.”
She turned away and coughed as Jack tried to kiss her.
"You don't sound too good yourself. I hope you are taking something."
"Same thing as the baby."
They were preparing to turn in for the night when Miri's smartphone alerted. She took a look at the phone and started for the nursery.
Jack heard her yell for him to come quickly. When he walked into the nursery he saw Miri with Jack Jr. in her arms.
She turned and said, "We have to get him to the emergency room, his breathing is rapid and shallow and he's not waking up!"
Jack looked at his son and shuddered. He was sure the baby's lips had a bluish tinge.
"Okay honey. Wrap him up and bring him into our bedroom, I'm getting dressed."
Jack already had his pants and shirt on and was pulling on his socks when Miri walked into the room.
"Give him to me honey while you change.”
Miri handed over the baby and rushed into her closet.
Jack looked at his son and almost cried out, the baby's fingernails were turning blue. Jack knew his boy wasn't getting enough oxygen - they would have to hurry. He fought to maintain his composure. If he panicked Miri might also, but he couldn't wait another minute.
"Miri! Meet me at the car."
Jack placed his sleeping son on the passenger's seat and put the car in manual mode. He backed it out of the garage, his right hand never leaving his son's chest. The time he spent listening to the baby's labored breathing seemed like an eternity to Jack even though Miri arrived moments later.
“Please hurry,” she said as she took the baby in her arms.
“We'll be there soon,” said Jack placing his hand on her shoulder.
Miri was about to acknowledge but turned her head away to cough.
The emergency room was crowded. The admitting nurse was about to hand Jack and Miri paperwork to fill out when she saw the baby's face. She immediately stopped what she was doing and yelled to another nurse to take the Jackson's into an examination room while she called for a doctor.
Doctor Stilhs entered the examination room, took a quick look at Jack Jr. and said, “Mr. and Mrs. Jackson would you please step into the waiting room? I'll be there as soon as I've finished my examination, thank you.”
Jack and Miri looked at each other and turned to leave. Miri looked back at the doctor.
“As soon as possible doctor please,” she said.
The doctor nodded.
It was almost an hour before the doctor came into the waiting room.
“I was beginning to worry doctor, what have you found?” asked Jack.
“Mr. and Mrs. Jackson your son has a bronchial infection. I've ordered tests but it will be an hour or more before we have the results. Meanwhile I've also ordered that he be given fluids and oxygen to prevent dehydration and help him to breathe. We'll know more when we get the tests back.”
“He's going to be okay isn't he doctor?” asked Miri, coughing to clear her throat.
“Mrs. Jackson I'm afraid your son is very sick, but he seems strong and I think there is every reason to believe that he will recover. But it sounds like you may be coming down with something yourself, you should try to get some rest.”
“Thank you doctor,” said Jack.
After the doctor left Jack and Miri sat down.
“We should do as the doctor says honey. You need rest before you get any worse, and I think you could rest better at home.”
“Jack, I cannot leave this hospital as long as my son is in here. I'm staying.”
“Okay honey I understand. Let's try to make ourselves as comfortable as possible.”
He gently guided her head to his shoulder.
The morning light was flooding through the hospital window when Jack awoke. Miri was asleep beside him, her breathing labored. Jack got up carefully and went to ask the nurse for some coffee. By the time he returned with two cups Miri had awakened.
“Good morning honey, how are you feeling?”
Just then an orderly rushed up.
“Mr. and Mrs. Jackson?” he asked.
“Yes,” said Jack.
“The doctor wants to see you, follow me please.”
Jack and Miri followed the man to a different exam room from before, there they found the doctor waiting. He looked like he hadn't slept.
“Mr. and Mrs. Jackson, I'm so sorry. Your son died just a few minutes ago.”
Miri fainted.
Chapter 2
As a young engineering student, Jack had been part of a research group that was developing an integrated circuit with the goal of running complex neural networks on a mobile platform. The platform would host a software-based Artificial Narrow Intelligence (ANI), commonly called an Annie.
Jack's specialty on the team was packing the necessary functions into a three-dimensional substrate while maintaining performance requirements. He developed what he called the Matryoshka (Russian nesting dolls) approach to help meet the requirements. Jack became famous on the team for writing the software that met packing and performance compliance.
He was still an undergraduate working with the Annie group when his son died. His wife succumbed a short time later. Jack thought Miri had lost her will to live after their son died. Both Miri and Jack Jr. had been early victims in a viral pandemic that took the lives of millions.
Jack vowed to not let it happen again.
He immediately changed majors to pursue biological research in infectious diseases. His single-minded focus enabled him to pack seven years into five, and he soon found himself the youngest researcher at a very prestigious university. He would find a cure for those like his son and wife who caught the virus early before the need for a vaccine was even apparent. Jack loved his research but even so, it was becoming a strain because of the pressure for results put upon him by his adviser.
It was late at night, and Jack was working alone in the lab as usual. He was working at the synthetic biology station. Jack had chosen to use synthetic biology because of its engineering approach which could be applied to biological systems. Synthetic biology held the promise of fast and easy design of biological systems instead of the usual trial and error method most biologists were familiar with. Well defined biological building blocks were used to assemble biological systems much as one could use electronic components to design a useful electronic circuit.
Jack was using synthetic biology to develop a synthetic gene circuit that could function outside a cell and could quickly identify viral agents. It would be embedded in paper for testing. He hoped by creating this paper-based detector it would serve as a proof of concept for his approach.
Suddenly, as he bent over the station he felt a hot flash of pain in his skull, like an explosion. The pain increased and lasted more than a minute before it subsided. By that time Jack found himself sitting on the floor.
When he recovered enough to stand he secured his experiment and closed up the lab. As he walked to the curb he took his Annie out of his pocket and unfolded it.
“Yes Jack,” said the Annie.
Jack explained his symptoms and asked the Annie what might have happened to him. The Annie took his vitals from his wrist band and ran its medical expert. It called for an Ark-car to take him to the hospital.
The self-navigating car arrived and as it drove him to the hospital he listened to the Annie conjecture about his health. At the hospital, he ended up being admitted for observation.
The next morning a doctor came into Jack's hospital room.
“Mr. Jackson?”
“Yes.”
“I have to tell you Mr. Jackson that was a reckless thing to do, driving by yourself to the hospital instead of calling for an ambulance. What if you had another attack with no medical personnel around?”
“Well sir, I guess I wasn't exactly thinking straight after such an episode, have you ever had such an attack?”
“I have not,” said the doctor, softening somewhat. “I guess I would be a bit confused myself under similar circumstances. By the way, I'm Doctor Greyson, I'll be your attending physician.”
“So, what do you think happened to me? I feel fine now.”
“I believe you had a transient ischemic attack. Sometimes called TIA or a mini-stroke.”
“My Annie suggested that was a possibility, but I thought that a stroke was something that usually happened to older people?”
“That is generally the case. But it can also happen to anybody at any time in their life. It could be caused by an inherited risk, it could be lifestyle choices, or it could be an imbalance of an amino acid, specifically homocysteine levels in your blood; or it could be all of the above. That is what we are going to find out. I've ordered the necessary tests and questionnaires for you to fill out.”
Dr. Greyson turned to leave but looked back to say, “Please be honest when filling out the forms, the diagnosis depends on it.”
Jack had answered the questionnaires as accurately as he could through the data diagnostics Annie. The results would be run through another ANI program and combined with his medical history to make a preliminary diagnosis for the doctor. Jack had also had an MRI and a complete blood workup. And now he was told that another test had been ordered and an intelligent gurney would be here any moment to take him to the exam room. The I-gurney finally showed up an hour later. He queried the robot about what test was scheduled next.
“Don't you know?” asked the I-gurney.
“No. No one has told me anything except that I had another test scheduled.”
“Oh dear, I thought you knew. You are scheduled for an angiogram of the carotid artery in your neck. Let me see here,” said the I-gurney accessing the hospital's database.
“Mr. Jackson, it says here that your carotid could have caused your attack. Therefore the test. This may take some time, you should try to visit the restroom now.”
Three hours later Jack was back in his room and starving. It was late in the day and because of the tests, he hadn't been allowed to eat any breakfast. He begged the floor nurse to bring him some food. The nurse agreed. The robotic food butler showed up with a small bowl of apple sauce and a slice of bread. Jack was just about to beg the food butler for more when Doctor Greyson came in.
“Well Mr. Jackson, I've reviewed the tests and questionnaires and data history from your wrist band and I believe you did have a transient ischemic attack as I said this morning. The levels of homocysteine in your blood are high. You also have other lifestyle risks that we need to address.”
“What do you mean, lifestyle risks?”
“You seem to have an all work and no play profession Mr. Jackson. It's widely believed that contributing factors to TIA are a sedentary lifestyle and high stress. All work and no play, you know. Also I suspect your diet is not as varied as it should be in fruits and vegetables. Would I be correct in that assumption?”
“I guess so. It's true that I have put my work above everything else in my life for the last five years. But I have my reasons.”
“I'm sure you do Mr. Jackson but this attack should be taken as a warning. You are at high risk for a stroke in the next six months; a stroke that would probably end whatever you are trying to accomplish at work. So we need to start now to reduce that risk.”
“What do you mean?”
“We will use gene therapy to repair any cell damage you may have suffered but I would still suggest that you plan a sabbatical from your work to reduce your stress level.”
Jack was quiet.
Finally he said, “That's quite a choice you are offering me doctor. My work means everything to me. But as you say I won't finish it if I have a stroke.”
He sighed, “I'll need some time to think. Would a month be a good rest interval?”
“I would suggest six months Mr. Jackson. At the end of that time if you've followed all my recommendations and the homocysteine level is in an acceptable range, then a reasonable work schedule could be resumed. A balanced work-life would be possible.”
“I see. Thank you doctor.”
“Okay Mr. Jackson, I'm going to recommend your release. I have ordered some prescriptions for you, the nurse will explain your treatment regimen. You should be ready to go home in about an hour.”
After the doctor closed the door Jack sighed.
Oh Miri, what now?
Chapter 3
Eleven hours on an airplane were more than enough but Wesley Williams still had nearly three hours before he landed at Addis Ababa International in Ethiopia. He had tried to sleep but he could only achieve an hour or two at a time. In between his naps, he studied the case book prepared for him.
Wesley was a researcher at the National Center for Emerging Infectious Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta, USA. He had been sent to Juba, South Sudan at the request of a doctor with the Doctors International Outreach (DIO) organization to investigate what seemed to be a new viral outbreak.
Wesley hadn't any idea where the state of South Sudan was until he was well on his way to Africa. The layover in Addis Ababa would allow Wesley to do some advance scouting. But for now, he went back to sleep.
Wesley awoke as the plane touched down. He was soon in the main concourse of Addis Ababa International. Except for the occasional sign a traveler might never know where he was in the world. The airport was as modern as any Wesley had ever seen. He queried his Annie as to the location of his hotel in Juba, where the Ministry of Health was located and where the DIO clinic was located. The clinic was his main objective while staying in the capital city. The Annie was slow to respond. Obviously, the cloud connection was limited. By the time it was finishing with his request Wesley was dozing off again.
He awoke in time to hear the call for his flight. The plane was an older prop model, and he had to walk across the tarmac and climb the boarding steps. By the time the plane was in the air, he had dozed off again to the sound of the propeller engines.
The bumpy landing which woke him was an immediate indication that things would be different in Juba. Departing the plane Wesley noticed that he was surrounded by United Nations, World Food Program, and Russian cargo jets parked in a close jumble because of the limited size of the apron. It was obvious that foreign aid and foreign influence was still important to South Sudan even after years of independence.
If Wesley thought the parking apron small the room he found himself in for visa check, baggage collection, customs and passport control was about the size of a large living room in the United States. It was crowded, hot and chaotic. Somewhere to the side, he saw his name on a sign. He motioned to the young man to meet him in the middle of the crush of people.
The young man had been sent by DIO and was to take Wesley to his motel but first, they had to get him through customs. He led Wesley to the visa window where there didn't seem to be a queue. Passport, entry permit and a crisp American hundred dollar note and they were off to retrieve the luggage. After some shoving, loud arguing in English, Dinka and Nuer with a smattering of Arabic pidgin, the luggage was retrieved.
Wesley by now was impressed with the young man's skills and followed him to the customs area. There both bags were opened, actually spilled onto a table, searched and then chalked, apparently meeting with the custom officer's approval, Wesley was allowed to repack his bags after another hundred dollar bill exchanged hands.
Now it was a fight to get to the immigration official who checked Wesley's passport and the chalked luggage again and accepted a hundred dollar “tip,” before allowing him to move into the arrivals area. Once Wesley found his baggage tag from Addis Ababa he was allowed to leave the one-room terminal.
Outside the terminal, the young man found his motorbike where he had left it chained. He looked relieved to find the bike in order. As they had a moment the young man introduced himself.
"I am Kamal Cham Dr. Williams, I will be your guide during your stay here in Juba," he said in almost perfect English.
"I am very glad to meet you Kamal," said Wesley. "I really am impressed with your expertise in guiding me through that ordeal."
"I have done it many times."
"I have to ask though, to whom do I owe the three hundred dollars?"
"Do not worry Dr. Williams. It is the cost of doing business here. Dr. Petiot will charge it against expenses. Shall we go now?"
"Yes," said Wesley.
They put Wesley's bags in the small cart attached to the back of the motorbike. Wesley climbed on to the rear of the extra-long seat. The seat was long enough for several people as Wesley confirmed by noticing other boda-bodas with three to four people climbing onto them. The ride to the Panorama Hotel was just over a mile distant.
Kamal left Wesley at the front desk after making arrangements to pick him up early in the morning for the trip to the Ministry of Health where Wesley would present himself as a courtesy to the authorities. Wesley had a quick bite to eat in the hotel's restaurant and retired to his room, which unlike the ordeal of the flight and Juba airport, wasn't that bad.
Wesley took out his Annie and unfolded it. He asked for the weather for tomorrow in Juba. The Annie cautioned that connections to the cloud were very tenuous, it might take a while for it to fulfill his request. Wesley told his Annie that it could go offline, and he would check in the morning for the answer. He quickly washed and went to bed.
The following morning, after leaving the Ministry of Health, Kamal and Wesley were on their way to the DIO clinic. So far Juba, except for it's awful connection to the cloud, had not been too far out of the ordinary for Wesley. The streets were paved, trees though not plentiful lined some blocks, but this was about to change.
Kamal turned onto a side street west of the Ministry and headed south. The character of the buildings began to change. They looked older and worse kept than what Wesley had previously seen. Then as Kamal turned west again the pavement ended and the street became dusty red dirt. The bike kicked at the ruts and Wesley held on to the seat. They finally arrived at the clinic which was not much different than the surrounding buildings except for the sign and the fresh coat of white-wash which was quickly becoming red-tinged from the ground up.
Dr. Petiot, a small man in a white smock, came out to greet them.
"Welcome Dr. Williams," he said with a slight French accent. "And thank you Kamal, for bringing our guest safely. How are you Dr. Williams? Is there anything I can get for you, such as food?"
"No thank you Dr. Petiot," said Wesley. "And please call me Wesley."
"And you shall call me Jacques."
"Very good. As you know I have only a day to investigate your request and obtain any samples I might need. Are we prepared to tour the facilities?"
"Of course, follow me please."
The clinic was well maintained and seemed to be properly supplied, though it would have been considered primitive in Europe or the States. Dr. Petiot took Wesley immediately to the corridor that housed the suspect patients.
"At this time we have about a dozen patients with the same symptoms," said Dr. Petiot. "As I stated in my request to the CDC the symptoms start with a headache and burning eyes. This gives way to fever and disturbed sleep. In the worse cases, they begin to drift in and out of consciousness, complaining of muscle aches and their head throbbing. If we are unable to stop the disease's progression their face will start to change color to a darkish purple-brown. Soon they begin coughing up blood and eventually gasp for air as they drown, their lungs overwhelmed with bloody fluid. We have lost eleven out of the twenty-six patients we've treated."
"Certainly sounds like a virus," said Wesley. "In the terminal cases, how long does it take to run its course?"
"Anywhere from twenty-four to thirty-six hours."
"Really! That fast?"
"Yes, and it is usually the young healthy patients that go quickly. That should sound familiar."
"Yes it does. Just like the last viral outbreak a few years ago. Except the time from contracting the illness to death has been compressed."
"Yes, and this viral outbreak doesn't seem as contagious, thank goodness," said Dr. Petiot.
Wesley spent the rest of the day visiting with patients and the other doctors and nurses at the clinic. He used his Annie and sensor attachments to make a preliminary investigation of blood, tissue and fluids from the infected patients. The difficulty of getting a good cloud connection prevented the Annie from making a quick diagnosis but a virus was definitely the main suspect. The clinic's technicians, under Wesley's supervision, prepared further samples for him to take back to the CDC for testing.
Chapter 4
The day after Jack was released from the hospital, he called his thesis adviser to arrange a few days off and to schedule a meeting with him for the following week to further discuss his situation. He hadn't been off the call very long when his Annie alerted him to an incoming call from Phylicia Hastings. Phylicia was a fellow grad student in his lab.
"Hi Jack, its Phylicia, I just heard that you won't be coming to work for a while. Is something wrong?"
A first-year doctoral candidate, Phylicia Hastings' specialty was DNA sequencing and gene expression. She was short, quick-witted and had a knack for knowing who to call to solve a problem.
“Doing okay at the moment,” said Jack. “But a couple of days ago I was working late in the lab and suddenly got a bad headache, the next thing I know I'm on the floor. It turned out to be a mini-stroke.”
"Oh no! That must have been a terrible ordeal, so unexpected at your age. Is there anything I can do for you?"
"No, nothing that I can think of. I'm just supposed to rest. I'll be in next week to speak with Professor Camble about what I need to do to recover.”
"Well please be sure to look me up while you're here. I'll probably be in my office, if not, look in the lab. Will you promise to call if you need anything in the meantime?"
"Alright I'll stop by, and thanks.”
Jack had always found Phylicia helpful and upbeat, but he had never considered her a close friend, so it was a little surprising but somehow comforting to hear from her. He had no one else.
Jack spent the next several days thinking about how he could follow the doctor’s orders while still pursuing his research. He soon settled into his new routine with his Annie providing scheduling and diet support. He reviewed his finances and found that if he was careful he should have enough savings to last for several months. He hadn't made much as a researcher but he hadn't spent much either.
In reviewing his past Jack came to realize that he had gotten caught up in the business of doing science. He had become so engrossed in grant proposals, publishing, conference presentations and team building, that the core of science, theory and experimentation, was something he did almost as an aside. All that activity had the appearance of progress but in fact, it was no more than a cycle of busyness. He had gotten caught up in that cycle and he now realized that many of his fellow researchers were also.
If only he had applied some of the engineering discipline he had learned as an undergraduate. He might have more to show for his efforts.
Miri had been right about him always rushing through everything without looking back. 'A roller coaster ride', she called his approach to life, always looking for the next thrill. He had dismissed her concerns as unfounded worry. Hadn't she understood that all the hard work was just a means to an end? To hurry the coming of the day when he could slow down and spend more time with her and little Jack. Now his health had imposed upon him the necessity of slowing down and reviewing his days and planning his tomorrows.
Jack's eyes watered.
Miri, without you and little Jack what do I have to plan for?
Chapter 5
After his day at the clinic, Wesley prepared to depart.
"Thank you and your staff Jacques. You've been most accommodating. I have to say I'm impressed with the work you are doing here for the Sudanese people."
"You are welcome Wesley. You will keep me informed of the findings of the CDC?"
"Absolutely, and thanks again."
His sample bag already secured to the motorbike by Kamal, Wesley climbed aboard and they were off to the hotel.
Juba was located close to tropical forests along the White Nile. But this section of Juba, with its dirt roads and few trees and small scrub bushes, reminded Wesley very much of the western part of America, only with a lot more red dirt which was everywhere, even in the air. As he looked at the bare concrete buildings they passed he noticed for the first time a military presence. Soldiers standing guard at each intersection. Soldiers gathered at the entrance to commercial buildings. He didn't remember seeing them on the way out that morning.
Kamal dropped Wesley off at the Panorama and confirmed that he would pick him up the next morning for the trip to the airport.
As a backup to his Annie, Wesley asked the desk clerk for a wake-up call at six the following morning and went to his room. He placed the samples in the small fridge and once secured he went to the dining room for dinner before emailing the CDC and turning in for the night.
Wesley awoke to what sounded like thunder. He asked his Annie for the time. It was a few minutes after five. He snapped awake when he heard the unmistakeable sharp crack of gunfire. A more distant thunder made him sit up, he jumped at the knock on the door.
Wesley went to the door and demanded, "Who's there?"
"It's me Kamal."
Kamal entered the room. "Hurry Dr. Williams. We must get you out of here and to the airport before the roads are blocked."
"Okay Kamal, while I get dressed tell me what's happening?"
"The Dinkas are attacking the Nuers. The government forces are trying to stay neutral."
"Why? Why doesn't the government maintain order?"
"The government is caught in the middle. It is a coalition with no side having a clear majority. So they cannot generate a consensus and they do nothing. It's tribal, I have seen it many times."
Wesley had his clothes on and, having packed before bed last night, was almost ready. All he had to do was get the samples from the room fridge. When finished he turned to Kamal and said, "I'm ready."
They climbed aboard the motorbike for the short trip up Airport Road. But Kamal immediately turned onto a side street. He yelled back at Wesley, "The main roads are probably already blocked we will take a less direct route."
"You know best," yelled Wesley over the roar of the motorbike.
Only gone a couple of blocks had passed when they almost crashed into a military convoy which blew through the crossroads. The last jeep in the convoy slid to a stop. Two soldiers jumped out with their guns trained on Kamal and Wesley.
"Halt!" they yelled in Dinka. "Who are you, where are you going?"
Kamal answered in Dinka, "I am Kamal Cham, and this is Dr. Wesley Williams from America. I am taking the doctor to the airport to catch his plane."
The soldiers approached the pair. "Why then are you going this way? It is quicker and shorter by Airport Road."
"We were worried that the road might be blocked," said Kamal.
"Maybe," said one of the soldiers. "Get off the bike we need to search."
One of the soldiers was inspecting Wesley's passport and identification. The other had taken Wesley's bags back to the jeep to search. Just as he reached the jeep a shot rang out. The soldier dropped. The bags hit the ground. Then the concussion of an explosion launched the jeep into the air and made Wesley hit the ground and scramble for his papers which the remaining soldier had thrown down when he started running.
Kamal had mounted and started the motorbike and was yelling at Wesley to get on. Wesley struggled to his feet and climbed behind Kamal.
"My bags, Kamal my bags!" he yelled.
"Sorry doctor," yelled Kamal as he gunned the motorbike. "I'm afraid they have been destroyed, we must go."
Kamal slid the bike around the corner of the street as the remains of the jeep were blocking the intersection. He righted the cycle and opened the throttle. Wesley was too shocked at what had just happened to be afraid of the speeding, careening motorbike.
Wesley noticed all the lights on the streets and the buildings were out. In the distance, he could see the orange-red glow of fire. He still heard a loud boom occasionally, but thankfully in the distance. Kamal pitched the bike over as he made another turn without slowing. Wesley had no idea where he was or which way led to the airport.
It was just then that they turned onto Airport Road and Wesley saw the airport entrance. Kamal had succeeded.
Kamal had to stop at the makeshift checkpoint that had been set up. The guard challenged him. Kamal, speaking in Nuer answered back. The guard looked at Wesley and asked in English for his papers. Finally, they were allowed to pass.
Wesley was still stunned when Kamal pulled up to the entrance and stopped.
"Sorry Dr. Williams about your bags. I'm afraid there was nothing I could do."
"You did everything you could Kamal," said Wesley somewhat in shock. Artillery boomed nearby.
"I want to thank you for getting me here safe, it's unfortunate about the bags but it's not your fault."
"Goodbye Doctor," said Kamal as he started his motorbike and roared away.
Wesley stared in disbelief at the back of the disappearing Kamal, riding away almost as if nothing had happened.
He walked up to the guard at the entrance to the airport lobby. He pulled his papers and identification from his coat pocket. The guard allowed him to pass.
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