Genevieve Gervin greeted Dr. Brisling under the shade of CDC Building 18. It was all cold steel and green glass. She wore another of her flowery dresses, shorter and trimmer than before, her smooth, graceful arms bare from the shoulders down.
"What's wrong?" she said. "You look like hell."
Brisling stretched his lower back, wincing. "I spent the night there."
"Hotel bed?"
"No." The bed was fine. It was the thought of that poor girl that kept him awake all night. It all reminded him of internship back at Mass General, jolting awake every ten minutes to the beep of his pager, convinced he had prescribed the wrong dose of the wrong medicine to the wrong patient. Now, all these years later, he had actually done it. At least it felt that way, despite what the police were saying about Anna Jankowsky's death.
He stood straight and appraised the woman before him. "I don't know how you manage to look so lovely all the time."
She crossed her arms and frowned. "Was it that call from the Seattle Police?"
"I don't want to talk about it."
With a curt nod, she handed him a temporary ID badge and led him inside. They passed the security checkpoint and stepped into an elevator. Brisling stared up at the cold blue LED display. "I don't recognize a damn thing here."
"There isn't much of the original campus left."
"My old lab?"
"They tore it down. It's a daycare center now."
A daycare center. That pulled him back. He had wanted Judith to stay home with the baby. She had wanted to go back to school. They were arguing about it on their way home from Ansley Park the night of the accident.
With a chime, the elevator doors opened, and Genevieve stepped out into a bright hallway, beckoning Brisling to follow.
But he was still there in the dark, falling through that cold winter, sinking down to the bottom of the sea. And that was where Genevieve had found him, slumped behind his desk with a bottle of bourbon and handful of sleeping pills. She hauled him up but did not drag him ashore. Instead, she offered him a terrible choice: sink or swim. And he swam to her. Together, they flushed the sleeping pills down the toilet, but the bourbon they shared, blending it with her sweet iced tea until the liquor was gone and they both had cried themselves dry.
In the months that followed, Brisling poured himself back into his research. He published at a feverish pace. He won enormous grants. He hired so many technicians and post-docs that he scarcely knew their names. He lectured far and wideâanything to keep him from the home and bed he had shared with Judith.
Now, Brisling stepped out of the elevator, and Genevieve led him down the bright and airy corridor.
"Do you have the demographic data I asked for?" he said.
She stopped in the middle of the hallway and handed Brisling several sheets of printer paper stapled together. On the first page was a color pie chart showing the racial and ethnic breakdown of all recent PML cases being tracked by the CDC.
Brisling studied it. "There's something off here."
"You're right. Look at the green wedge, the one for Hispanics."
"It's just a tiny sliver." They stepped aside to make way for a janitor and his cart.
"There's something else."
"I don't see it," said Brisling.
"That's because you can't see what's not there."
In his mind, Brisling checked off all the racial and ethnic categories recognized by the US government. "What about our redskin friends?"
"Royal!"
"What?"
"That's a hateful slur. I won't tolerate that type of language, and you know it."
He held up his free hand. "Sorry. Let me rephrase. No cases in American Indians or Alaska Natives."
If Genevieve was satisfied, she did not show it.
"I said I was sorry."
She sighed. "We'll talk about this later."
"Fine." He wagged the paper in his hand. "But couldn't this just be sampling error? American Indians are only, what, one or two percent of the US population?"
"Right, but it's both Hispanic and American Indian people who are under-represented here. I don't think it's a coincidence. There's a genetic connection between the two groups."
"Go on."
"Many people in the US identifying as Hispanic have a genetic admixture from Indigenous populations in the US, Mexico, Mesoamerica and South America."
Brisling curled his lower lip and gave a little nod.
Then Genevieve reached over and flipped the page. "Now look at this."
Brisling scoffed. "Religion? Why would you analyze that?"
"I know. But my assistant simply ran all the demographic parameters available to her. But take a look. Again, there's a group that's conspicuously absent."
This time, Brisling noticed it right away. And this time, he chose his words carefully. "Ah, no Jews."
"Right. They're also only about two percent of the US population, and . . ."
The implications ricocheted in Brisling's mind, fusing together, breaking apart, recombining into dark thoughts, weird and terrifying.
". . . but Judaism is an ethno-religion, so there's a familialâ"
"Genotype." The word simply popped out of Brisling's mouth, like a gumball.
"Excuse me?"
"You're right. It is genetics. But not human genetics. It's viral genetics. JC virus genetics."
"I'm afraid you've lost me."
"Look, JC virus is ubiquitous. Nearly everyone gets infected early in life, often during infancy. It spreads through close family contacts. And it lies dormant inside us for the rest of our lives, unless our immune system fails. Then the virus reactivates in our brain and causesâ"
"PML."
"Right, but my point is that the JC virus is familial."
Genevieve nodded for Brisling to continue.
"The virus is also ancient. Our ancestors carried it out of Africa."
"Some stayed, you know."
"Of course. I'm sorry. But again, my point is this: as human populations migrated across the globe and became separated, they evolved independently. And so too did the JC virus they carried. As a result, you can trace your family's geographic ancestry based on the strain of JC virus you carry, its genotype. Anthropologists have used this to confirm human migration patterns across thousands of years."
Genevieve tilted her head. "So American Indians carry their own genotype?"
"Yes! A unique variant of genotype 2a. It's extremely common among Native people across the Americas, but found nowhere else."
"What about Jewish people?"
Brisling shook his head. "I'm not aware of any data there. But it's possible they also carry a unique genotype. I mean, they don't like to intermarry, right? That's why they're so prone to all those genetic conditions."
"Like Tay-Sachs disease in Ashkenazi Jews."
"Exactly."
Genevieve's brown eyes narrowed. "So, you're saying these unique genotypes are somehow different. They don't reactivate, or if they do, they don't cause PML."
"Maybe, but that wouldn't explain why every other genotype is suddenly reactivating, would it?"
She smiled knowingly and took him by the arm. "Come, let me show you what I told you about last night."
The lab was spacious, clean and modern. Floor-to-ceiling windows looked out over the variegated forests north of campus. The only thing Brisling recognized was the bready smell of bacterial growth agar brewing on a hotplate somewhere. At this early hour, most of the lab technicians were still in bed, but in the far corner, a Black girl in a white lab coat hunched over something on the work bench, a small polystyrene assay plate.
Genevieve laid her slender fingers on the girl's shoulder. "Good Morning, Lisa. I'd like you to meet Dr. R. K. Brisling, the one I told you about. He worked here during the early HIV days."
Deftly covering the assay plate with a sheet of adhesive plastic, Lisa removed her gloves, stood, and shook Brisling's hand. She had a sad, boyish face and pale brown eyes. Her big blond Afro wobbled as she spoke. "It's a pleasure to meet you, sir. It's not often we get to put a face on the history of this place."
Genevieve offered Brisling an apologetic shrug then said to Lisa, "Why don't you show Dr. Brisling what you found yesterday."
"Sure." As she spoke, she logged onto her desktop computer. "So, we've gotten about five hundred spinal fluid samples from these new PML cases all over the US. I've tested about three hundred so far and confirmed JC virus DNA in every single one of them."
Brisling grunted. "Which technique did you use?"
"PCR. That stands for polymerase chain reaction."
Brisling gritted his teeth, took a deep breath and counted silently to three. "I meant, what type of PCR, quantitative or semi-quantitative?"
"Oh, semiquant."
"So, you couldn't be bothered to do full quantitative PCR, is that what I'm hearing?"
Genevieve put her hands on her narrow hips. "Royal! I won't tolerate that, either."
Lisa held up her hand and said to Brisling, "No. He's not wrong. Normally I'd run quantitative PCR, but we needed a quick answer, so I just did semiquant. If I hadn't, I would have missed it."
Brisling turned to Genevieve for an explanation, but she simply nodded toward the image on Lisa's computer monitor.
"This is one of the gels I ran to resolve the PCR products."
Brisling leaned over for a closer look, glasses sliding down his nose. The gel itself looked like a shadowy rectangle set against a black background. About a third of the way down, a string of glowing orange dashesâor bands, as they were calledâstretched from side to side. Each band, Brisling knew, represented JC virus DNA that had been amplified from an individual patient's cerebrospinal fluid.
Lisa moved the pointer on the screen. "They're running right where we expect them, two hundred and fifty base pairs. But look here."
Brisling repositioned his glasses and leaned even closer. Just below each band was a second band, only much fainter. He jabbed his finger at the screen. "What are those?"
"I know, right? There should only be one PCR product per patient, not two."
"Well, what do you think?" said Genevieve to Brisling.
"I think you have a quality-control problem here. Something's wrong with your PCR primers. Did you run the proper controls?"
"Of course," said Lisa.
"Show me."
Lisa called up a second image, similar to the first. "I ran this gel at the same time. These are from PML samples the CDC archived during the AIDS epidemic, back in the eighties. See, there's only one PCR product, right at two-fifty base pairs. My primers are working just fine." With her mouse she clicked back to the original image with its double bands. "What I'm wondering is if this extra band is a mutant form of JCV."
"Is it present in every sample?" said Brisling.
"All three hundred I've run so far, but none of the historical controls."
"Then it's definitely not a mutation."
"Why not?" said Genevieve.
"Because that would mean the same mutation arose in multiple populations at the same time. Based on JCV biology, that's simply not possible."
"Well, then what is it?"
It was in his mind all along, over there in a dark corner, one of those weird and terrifying thoughts. "It's a second virus, close enough to JCV to be picked up by the primers, but different." He paused. "Yes, it could be a helper virus that's activating JCV in the brains of healthy people."
"Good Lord," said Genevieve.
Brisling turned to Lisa. "Can you sequence that second band?"
She nodded, her Afro bouncing again. "We can do more than that."
"What do you mean?"
"We can sequence every bit of DNA in these samples. If there's a second virus there, we'll find it."
Brisling turned to Genevieve for confirmation.
"We do have a high throughput sequencing core across the street. I'll bring all resources to bear on this if you want."
"What about your new boss?"
"De Soto? He doesn't need to know. Not yet."
"Then let's do it. Lisa, if you find somethingâanythingâI want you to design new PCR primers that will detect only the new virus but not regular JCV. Then overnight them to my lab in Seattle."
"Why?" said Genevieve.
"I'm going to have a lot of samples to analyze when I get back."
"What samples?" she said.
"The ones you and I are about to round up."
Senator Flaherty had called it right. Hindsight is twenty-twenty, but foresight is one in a million.
_______________
Thank you for reading Chapter 19!
The study of JCV genotypes has actually been used to supplement traditional knowledge about prehistoric human migration patterns.
All comments welcome.
-Frode