Monthly Archives: December 2012

Just a Passing Phage

by the BixoBrat

“No, but I can pay with my Bitcoin account,” Rupert said.

The hospital receptionist smiled for the first time. “That trumps insurance,” she said. “Go right down this hall, third door on the left.” Rupert barely heard over the screaming of infants and moaning of victims in the packed waiting room.

“Why didn’t I think of that two hours ago?” Rupert thought as he strode out of the waiting room. A heavy cough turned the stride into a hobble, and bounced him against the wall. A mule train of coughs poured out of his lungs. Hunched over, he fumbled and clutched for a doorknob. “Did I make it to door number three?” he thought as it opened. One last cough flung him inside and he sprawled across a bed just inside the doorway.

A perky young woman’s voice near his ear said, “Our first experiment shows up just in time.” Rupert moaned, rolled over, and looked up at a thin smiling woman in a lab coat who sat next to the bed. She said, “Time to give him the shotgun phages.”

A voice across the bed and out of Rupert’s field of vision laughed. “No, you just had the last patient. This one gets my nanobot.”

The young woman looked down at Rupert and said, “Too bad if you let this engineer at you. I could have saved your life. My phages are viruses that infect and kill every bacterium you could have. His little robots will just prolong your pain.”

The engineer said, “Not to worry, mister, I have a nanobot that will find and identify the bacterium, and kill that one type specifically. You’re as good as cured already.”

“What if he’s co-infected with several bacteria simultaneously?” the young woman asked.

The engineer repeated her words in a whiny high-pitched voice. “The nanobot stays on the job until they’re all cured.”

“It’s a virus,” Rupert says.

“What?” they both ask. “Like, how would you know?”

Rupert winced and said, “I know because I’ve taken every antibiotic on the shelf.”

The two lab coats looked at each other for a second, then burst out laughing. “Those old wives’ tales? They don’t work, never did.”

“Weird, my grandmother swears by them,” the engineer said. “Said it cured just about anything. Except cancer.”

“Except HIV. And we have mutant tuberculosis to cure lung cancer now,” the young woman said. “So what happened forty years ago? Did bugs get resistant, or did they stop making antibiotics when they fell off patent? Which happened first?”

The young man waved his fingers and clawed at the air. “I know,” he said. “Some sick genius let loose a mutant. Put it in the water supply and everybody died. You might have missed that story.” Rupert winced as the youngsters laughed.

Rupert squinted at the young woman and read “Grozny” on her lab coat. “Dr. Grozny, could I ask you something?”

She grinned shyly and said, “Susie. I’m not a Ph.D. yet, just a grad student. Jeremy and I might graduate about the same year soon.”

“Another two or three years oughta do it,” Jeremy said.

“You’re not even doctors?” Rupert asked. “I don’t even rate a real doctor?”

“Oh, no, they’re busy writing grants,” Jeremy said. “And the postdocs are monitoring hospital programs like this one.”

“Or do you mean an M.D.?” Susie asked. “They work on surgery, they don’t bother with the simple stuff like infectious diseases. A few rounds of treatment and you’re cured. That’s great for a graduate thesis, but the field changes so fast that they can’t teach anything in med school.”

Rupert thought, “I must call Betty again. Why doesn’t she answer?” He flicked his tongue over the GoldTooth and heard Betty’s phone ring. And ring.
Dr. Slaughter Enjoys Her Gig
I walked the familiar route from the secured parking lot into the hospital through my personal underground tunnel. I had a surgery scheduled in an hour for a Point-oh-one percenter, but first I had a consultation booked with a Point-oh-oh-one.

I went to my favorite consultation room and set the Sight/Sound for waterfall mood music and a flowing stream projected on the floor. I dialed up a faint mist of clary sage and coriander to reduce stress. Ms. Hamdan, the Point-oh-oh-one percent patient, arrived and eased back in the reclining chair.

She told me she would not let a doctor in her country go poking around there, pointing below her abdomen. I told her this was routine, not any medical urgency involved. I said it nicely, since I was glad to get an ‘Oh-oh-one. I hated being crassly commercial but I knew the more zeros a patient has, the better chance of moving from their Bitcoin account to mine.

Ms. Hamdan told me my touch was so gentle she wouldn’t dream of going to anyone else, even if that meant I had no time to waste on any One Percenters. I sighed and admitted I no longer even had time to see any Point-Ones.

Soon enough, a bell chimed to indicate it was time for the scheduled surgery. I excused myself and left Ms. Hamdan to the mercy of the interns. I regretted spending so much time on a single Point-oh-oh-one, and vowed to cut the time to nine minutes max. I headed down my private corridor to the Fine Control Operating Room, and sat down in my favorite Fanatic Voyager chair. Technicians wordlessly attached the wired gloves to my hands. I watched the hologram cube in front of me until the patient’s outline appeared. I had no idea where the patient was physically, but the complete 3D image lay before me. With a tap of my feet on the chair pedals, I rotated the image to view the arterial occlusion.

I remarked to the techs how my grandmother had made do with the old fiber optic shape sensing and localization to track positions of the surgical tools inside the patient. I saw how they rolled their eyes as if I said that every time I came in to guide surgery. As my gloved fingers remotely manipulated the laser scalpel with its flexible whisker wire, I thought of Grandma and her primitive sensors on guide wires and catheters inside the patient for as long as three hours. My pinkie eased the flexible catheter down the artery as it stretched around intervening organs. I zeroed in on the occlusion and thought how far minimally invasive surgery had gone. I vaporized the occluding plaque without allowing it to dislodge. I retracted the flexible catheter and laser scalpel, each much thinner than a hair. I shuddered as I recalled the old cardiac catheters in the Mayo Museum, huge pipes up to 3 millimeters in diameter.

Sighing deeply, I thought that the surgery went smoothly without complications, as per our standard policy so my job was complete here. I eased my hands out of the wired gloves, wrote another tic mark on the chair with a marking pen, and stood up. After a total of five minutes, I stepped out of the Fine Control OR and wondered if I could have finished in four minutes. I hurried down the hall to my next appointment, that poor woman Betty Something who was hit by a falling piano. I knew Betty had so many zeros after the decimal that she rated a personal post-operation visit.
Betty in Her World of Hurt
Betty struggled to consciousness in a hospital bed somewhere, surrounded by confused visions. “I am Betty, hear me roar,” she thought but could not say. A perky nurse announced, “We must perform some Tests!” Betty’s ex-boyfriend from high school swam into view, with a large object just behind his ear. “You didn’t die of brain cancer after all!” Betty shouted telepathically. “Of course not,” he said, “and this magnet on my head keeps me alive and tells me what to do.”

“The Phase III drug trial is going well!” announced a suddenly appearing Rupert. “Tests!” said the perky nurse, holding out a urine collection cup. “How is the trial going?” Rupert asked. Betty faded away into oblivion.

Betty was awakened by the perky nurse, who promptly began drawing blood samples. “The hospital conducted several tests on you already prior to admitting you,” the nurse explained, “not just for MRSA but pneumonia and every infectious disease known. I’m sure we will give you a clean bill of health — and a bill for it all. You’ve already paid an arm and a leg. Tee hee.”

Betty found she could not move her left arm — or her leg. “What happened to me?” she asked.

“Whatever it was, it’s not the hospital’s fault!” said the perky nurse. “I think the ambulance report said you were hit by a falling
piano while shopping on Fifth Avenue.”

Betty gasped and sank back into the arms of Morpheus who treated her more gently. His arms of soft foam caressed her side and shoulder. He reached carefully to her knee and gently prodded. Wordlessly, he spun a gossamer web of comfort. Betty felt the pain and ache leach out of her. She reached her arms out and hugged her knees, then stretched full-length. Morpheus gave one last soft caress of her cheek and quietly ebbed away.

“Well, and how are we this evening – er, morning?” It took Betty a while to register that the voice came from a chrome box covered with flashing lights. “You would be Betty? You are our bionic patient, yes? I’m Dr. Patel, your roboteledoc.”
“What’s a roboteled . . .” Betty’s voice trailed off as she caught the implication. Dr. Patel was in India and visiting her bedside remotely.

A light on the box brightened, then dimmed. “Now while I think of it,” Patel’s roboteledoc said, “I’d like to prescribe some Botox. That should clear up all that severe underarm sweating.” Betty turned crimson with embarrassment. “And it should take care of that nasty cervical dystonia of yours.”

“But I don’t have any – ” Betty’s protest was cut off abruptly by a high-pitched screech from the roboteledoc.

“I don’t have time for uncooperative patients,” Patel roared in an overamplified voice. “Good thing this box has an amp left over from old heavy metal shows.” The windows behind Betty shattered from the noise. “Now we all know that cervical dystonia has chronically been underdiagnosed. Good thing I recognized the insidious symptoms. And there are positive side effects: it will cure headache, pain, spasticity and juvenile cerebral palsy.”

“What?” Betty gasped. “How could I have juvenile -?”

“Tut tut,” said the roaring robot, “you can never be too careful.”

“Just so,” Betty said as anger flowed out to her fingertips. “I’ll have my lawyers look into this! I’m sure I recall the Justice Department cracking down on this off-label Botox use decades ago.”

“Ah, you Americans have such a problem,” the Doc-in-a-Box said. “This is no problem here so as your doctor I say it’s OK.”

Betty flicked her tongue to trigger the GoldTooth and said, “Rupert? I need our legal staff.” The roboteledoc lights flicked off.

An hour later, Betty flicked off the connection to Rupert and pondered. She needed a good crossword puzzle to take her mind off of things. “How can anyone help Rupert?” she thought. “Who bothers with infectious diseases any more?” To the left of the bed was a nightstand with bottles of seltzer water and an issue of “More Puzzles That Humans Can’t Solve.” She reached over for it, and found a pen tucked into the pages. As she lifted the puzzle book, she noticed a strange crawling sensation running up and down her arm.
The door opened and someone in a lab coat walked in. Betty pondered a puzzle clue and looked up. “Yes, nurse?” she asked as she read ‘J.O. Slaughter’ stitched onto the lab coat.

The visitor stiffened visibly and said, “Doctor. I am not a nurse.” The last word sounded more like a sneeze than a word.

“My apologies,” Betty said. “Doctor. To what do I owe the pleasure?”

“I am your surgeon,” Dr. Slaughter said. “I performed the surgery to connect your prosthetic limbs.”

Betty looked at her arms. “Surgery?” she asked. “What surgery?” Her arms both looked perfectly normal. The crawling itch erupted in her left arm and she sucked in her breath sharply. “Is that why it feels there are worms crawling around inside my arm?” She flailed her arm and then scratched at it.

“Stop that,” Dr. Slaughter said. “You most certainly do not have Morgellons Disease. Those are the nanobots completing the job of connecting capillaries and rewiring your nerves. When you arrived there was nothing left of your left arm or leg, so we started from scratch.”

Betty looked at her left arm again. She tried to sort through the fragmented images of recent memory, but could not connect the pieces with Dr. Slaughter’s abrupt announcement. “You aren’t well practiced in the art of bedside manner, are you, Doctor?”

Dr. Slaughter sighed, shifted her weight awkwardly, and said, “I do very well in my consultations, thank you.” She fidgeted with hands in pockets. “I’m. I. I am not used to seeing patients actually ill.” She looked up quickly. “Oh. Or recovering,” she said. “I have never visited a recovering patient before. I find it fascinating. You did not even realize that you have a new arm and a bionic leg.”

“So I’ll need to learn how to walk again?” Betty asked. She remembered using her left hand to pick up the puzzle book.

“Do you think surgery is still done like it was fifty years ago?” Dr. Slaughter asked. “You can go run a Marathon tomorrow if you want. But first, wait for the nanobots to finish connecting your leg.”

Betty’s left leg began to itch. “Must not think of little buggie monsters crawling up my leg,” she thought. Her mind raced over the hour-long talk with Rupert. “Doctor,” she said. “Is it true you have no Infectious Disease department any more?”

Dr. Slaughter put her hands on her hips. “Nonsense,” she said. “We have the finest department on earth. Our tuberculosis clinic wrote the book on treating lung cancer with mutated TB.”

“What about bugs that only cause harm?” Betty asked. “The old-fashioned kind?”

“Oh, those old things.” Dr. Slaughter waved away the thought. “We have graduate students who work on those. No respectable pharmaceutical company will consider working on new treatments that cannot be financially viable. And all the old generics no longer seem to work.”

“Does every disease have its drug-resistant mutants?” Betty asked.

Dr. Slaughter pondered for a second. “Not my field. But as I recall, most antibiotics are now made in places with no regulatory oversight. They may have been selling sugar pills for the last twenty years. Why, do you feel sick?” She pulled a clipboard from the wall and peered at it. “It looks like you were tested for every possible infection.”

“It’s not me, it’s Rupert,” Betty said. “He is somewhere in the hospital trapped in experiments by some graduate students.” Betty closed her eyes and inhaled. “They aren’t even real doctors.”

“Oh, but they will be some day,” Dr. Slaughter said. “Do you want me to check in on them? Just let me know if it is an engineering department or the virologists.”

“Both,” Betty said. “They argue over what experiment to do as if he were a lab rat or, or, or someone on a GenRx policy.”

Dr. Slaughter sucked her breath in. “Generics Only? He may as well be de-” She stopped before saying the dreaded D-word.

Betty looked up with wide eyes. “No, certainly not. He has a Bitcoin account that mines itself. He can afford to fund this entire hospital. But …”

“Money, or even Bitcoin, can’t buy everything,” Dr. Slaughter said.
The Kids Have a Plan
“We got a call from some Dr. Slaughter,” Susie said as she helped Rupert sit up in bed. “Jeremy and I still aren’t sure how we want to treat you today. Either my shotgun phages or his latest nanobot. Or set up a whole new foundation with your name on it to sponsor a research program.”

Rupert coughed once. He coughed again. Then he coughed several times in rapid succession. He gasped for air and waited for his head to clear. “What’s that about a new foundation?” he asked.

“We’ll need financial support of course,” Susie said. “Once I wrap up my thesis on using phages to cure bacterial infections, I want to do a postdoc on developing virophages. You know, like, engineer a virus that destroys other viruses.

“Talk about wishful thinking,” said Jeremy the engineer. “We also need an approach that could actually work. My nanobots are a bit large to deal with viruses, so I’ll need a clean room facility to develop something smaller than nanobots. I call them femtobots.”

“I call them fembots,” Susie said.

Rupert scratched his chin. “Catchy name,” he said. He realized that his cough had faded into the background and his head cleared. “You two go get the paperwork to start this foundation and I’ll see what I can do.” He waved cheerfully as they left the room.

After they closed the door, he stood up and stretched. His tongue flicked the GoldTooth and he said, “Betty, I’m getting out of here now. And I promise I will never ever touch another one of George’s cheap cigars. Virus indeed, huh.”

Copyright ©2012 Bixogen, Inc. All rights reserved. Used by permission.  No part of this work may be reproduced or transmitted in any form or by any process without prior written permission.

Soap Opera Drama in the Biotech Industry

Every society has its drama, and the Biotech Industry is no exception. There was the online soap opera “All My Clones” that documented the craziness for over 4 years at BioWorld. Is there no end to it all?

No, of course not.

We have engaged the BixoBrat, one of the “All My Clones” authors, to take time away from laughing aloud in public libraries while reading the Business section and update us on things we’d rather not think about while undergoing surgery. While inspired by the news, the stories are in fact fiction – er, are lies with a kernel of truth. But not necessarily wisdom.

So keep an eye out for the BixoBrat and find out what the executives don’t want you to know.