Najid nodded. “That is why you give him the anticoagulant, to stop that process?”
“Exactly right.” Kassis said. “If we can stop the clotting, we have a chance when we reach the next phase of the disease.”
“The bleeding?” Najid asked.
“Yes. The bleeding occurs because the blood has run out of coagulants. That coincides with tissue death all over the body. Where the tissue has died, eventually it bleeds.”
“Everywhere,” Najid concluded.
“Yes. Everywhere. It flows from every orifice, catastrophically. However, if we can use the anticoagulants to limit the damage from the clotting, we can later use coagulants to limit the bleeding. We keep him hydrated in the mean time and hope what we are doing helps.”
“So, anticoagulants to reduce the damage, and later coagulants to keep him from dying,” Najid summarized, more to get it straight in his own mind than to let Dr. Kassis know he understood.
“Yes,” replied Kassis.
“How do you know when to stop using one and start using the other?”
“That is my job, Najid.”
“I trust your judgment.” Najid looked down for a long time at his brother, imagining the sorrow his father would feel to lose him. It would be worse because his father was the one who had forced Rashid to spend his summer in Africa, seeing what life looked like from the other side.
“When Ebola has spread the world over, do you have a plan for how we will survive?” Dr. Kassis asked.
Najid looked up at the doctor. “The Western countries will develop a vaccine or an effective treatment. They have the technology and the experience. As we discussed, it is only a matter of time. When that time comes, we will buy enough for ourselves.”
Dr. Kassis raised an eyebrow, hidden under his goggles. “And if the Americans won’t sell it?”
“The Americans likely won’t, but I am converting my father’s fortune to gold. There will never be a time in this world when I won’t be able to find a man willing to sell his soul for a handful of gold.”
“Gold? How so?”
“I have instructed our man in Switzerland to sell everything, purchase gold bullion, and have it shipped to my father’s compound within the next few days. Gold will be the only currency with value when the world economies fall apart. My family may come out of this as the wealthiest on the planet. I have little doubt that I can pay corrupt Americans for all we need.”
Dr. Kassis adjusted his mask. It was becoming a habit, along with the fear of not knowing which was worse, an ill fitting mask, or a snug mask being touched by contaminated hands. “It is possible that gold will be worthless? It may be that only bullets, water, and food will have value.”
Najid laughed out loud. “Your faith in men runs deeper than mine, doctor. In all of man’s history, except for the age of electronics, gold has never had any intrinsic value. At best it was made into trinkets that didn’t rust. But men have always traded weapons, water, food, even their lives to possess it. It will be so in the future. The value men place on gold has never been rational. So it will continue.”
“Wiser than proceeding down this road with only a hope for a cure would be to have a backup plan.” Dr. Kassis laid a gloved palm across Rashid’s forehead. “I will speak candidly.”
“Of course.”
Dr. Kassis turned to face Najid. “In case I fall ill and am unable to offer it at a later date, I wish to tell you now?”
Najid scrutinized the doctor. “Do you think you might fall ill?”
“I don’t know. The risk is great. Our clean room is not so clean. I don’t know whether every man follows the procedures as required. It only takes one lazy man failing to remove a bit of contaminated protective gear for all of us to become infected.”
Najid’s anger rose. “Have you seen someone do this?”
“No,” Dr. Kassis shook his head slowly, showing his fatigue. “When men get tired, they make mistakes. That is all I am saying.”
“If one has made a mistake and we become infected, or if we simply aren’t protected well enough and we fall ill, what is this alternative?”
“I know you educated yourself a great deal about this disease before we came here. Did you read about the outbreak in Kikwit in 1995?”
“I am not familiar with that outbreak,” replied Najid.
“More than three hundred fell ill. Eighty percent died.”
“Not as bad as some outbreaks.”
“No.” Dr. Kassis stood up and stretched. “Let’s walk a bit.”
Najid stood up and the two men waded through the prone townsfolk, with their distant, empty faces and near-lifeless bodies. They followed the center aisle to the front doors and went out to stand on the patio.
The doctor leaned on the porch railing. “Near the end of the outbreak, one of the nurses fell ill, a Zairian woman. This disturbed the Zairian doctors greatly. They had all been taking precautions, including this nurse. They wore goggles, masks, gloves, and suits. They disinfected themselves with bleach, sprayed it on the suits, and waded through pools of bleach on the way out of the sick wards. All procedures were followed, but still, she fell ill.”
“That is a frightening prospect,” said Najid.
“For one thing, it tells us how dangerous this disease is. It takes a dozen or fewer virions—”
“Virion? I do not know this word.”
“It is an individual virus—a strand of RNA or DNA wrapped in a shell of proteins. An individual package—the infectious particle designed for transmission of any virus is called a virion.”
“Interesting that you don’t talk as though it is alive.”
Dr. Kassis nodded, “Yes, it is good that you caught that. Viruses exist somewhere between living and nonliving things, as we traditionally think of them. The point I’m making, though, is that given the unimaginably tiny amount of material it takes to make up a dozen virions, it takes only the imperceptibly smallest of mistakes to become infected.”
“That is not encouraging, Dr. Kassis.”
The doctor shook his head. “That is exactly what the Zairian doctors thought. And after seeing one of their own—the nurse—contract the virus, they knew that any one of them might be next. Who can say if it was that, or pure altruism motivating their subsequent choices? Regardless, they took a risk on an experimental treatment.”
Najid gave Dr. Kassis his full attention. “What do you know of this experimental treatment?”
“Some of the Ebola patients survived. Indeed, some were on the road to full recovery. They clearly had the antibodies in their blood to fight off the virus. That is how immunity works in humans.”
Seemed pretty basic to Najid. “I understand that.”
“The risk they took—against the wishes and objections from the American and European doctors—was to transfuse a measure of blood from one of the healthy survivors to the sick nurse.”
“What happened?”
“The nurse got better.”
Najid stood up straight and couldn’t hide the surprise in his voice. “That sounds miraculous.”
Nodding, Dr. Kassis said, “The Zairian doctors then tried the same treatment on seven other patients.”
“Against the wishes of the Westerners?” Najid asked.
“Yes.”
Najid thought for a moment. “Did they survive?”
“All but one of them did.”
“In seven out of eight, the treatment worked?” Najid confirmed.
“It appeared to have worked,” replied Kassis.
“What do you mean by that?”
“The decision to test the new treatment occurred at the end of the outbreak. There was no way to know whether or not the virus had mutated to a less lethal form of itself.”
“So no one knew for sure if it was the treatment that cured them.”
“No.” Dr. Kassis looked at Najid. “There may come a time when we are desperate enough to try this same treatment to save our lives. There may come a time when it is the only hope we have.”