“But you ain’t gonna check my nuts to see if I’m nuts, are you?”
“Seabury!” Ruth scolded.
Blauw laughed. “It’s okay, Mrs. Campbell. I can assure you that it’s nothing compared to surgeon talk in an operating room. No, you should still see your family doctor for all your annual physicals. My nurse will draw some blood so we can rule out thyroid disorders or vitamin deficiencies. If you’re okay with all that, then I’d like to get started with a 10-minute ‘mental status test.’ Colonel Raines, you’re welcome to stay for the mental test but only family members during the physical portion.”
“She’s our daughter-in-law,” Ruth blurted out before Raines could speak. “She is family.”
“Look who’s nuts now, woman!” Seabury quipped.
“I understand, Dr. Blauw,” Raines answered amid subtle embarrassment.
“Okay, this should take 10 minutes. You can use the clipboard for the written answers. Are you ready?”
Sea Bee nodded.
“Number one; draw the face of a clock with the hands showing four-thirty.”
Sea Bee looked over at Ruth and rolled his eyes.
“Two, what’s today’s date, and where are you right now?”
Sea Bee answered but couldn’t hide his contempt. Blauw held up a laminated sheet of paper with a picture on it.
“Three, here is a picture of two pentagon shapes intersecting. On your paper draw the same thing, or as close as you can come.”
Sea Bee looked at the picture and reproduced it on his clipboard.
“Number four, Mr. Campbell; I’m going to hand you a note card with instructions on it. Please read the card silently and then follow the instructions written on the note card.”
Blauw handed him the card. Sea Bee stood up and walked over to the door. He knocked on the door two times quickly.
“I have 40 cows in the field,” Sea Bee announced to the room then knocked on the door two more times, turned around in a circle and sat down.
“Number five, Mr. Campbell, here is a blank note card. Write down one complete sentence that tells me about your family.”
“Can’t do it in one.”
“Please, try to limit your thoughts to one complete sentence.”
Sea Bee looked at Ruth for inspiration, but she refused to make eye contact with him. He started to write fast and furiously then handed the note card back to Dr. Blauw who read it to himself.
“Okay, two more and we’re done. Mr. Campbell, count backwards from 100 by sevens, out loud.”
A strange gaze grew over Sea Bee’s face.
“I’m not following you.”
“Start with 100 and count backwards by sevens. For example, take 100 and subtract seven, which would give you 93, then keep subtracting sevens.”
Sea Bee didn’t speak. His breathing became more pronounced. He started to panic.
“Seabury, you’ve always been a math whiz. Just count backwards,” Ruth said trying to encourage him.
“Mrs. Campbell, please,” Blauw stopped her as the intensity with Sea Bee started to ramp up.
“Well he is,” Ruth whispered to Raines. “He was the one who always helped the children with their math problems.”
Leslie held up her hand to help quiet Ruth who was starting to panic more than Seabury.
“Mr. Campbell? Can you count backwards from 100 for me… by sevens? I’ve already given you the first answer.”
Sea Bee looked down at the floor in defeat. He said nothing.
“Okay, number seven, the seventh and final question, Mr. Campbell. Are you up for one more?”
Sea Bee nodded his head.
“I’m going to say three words out loud with a pause between each word. Once I’ve said all three words, simply say them back to me. Okay?”
He nodded again.
“Sliding… slippery… sidewalk…”
Sea Bee moved his lips. He was trying to say the words. Both Ruth and Raines could see the anguish on his face as he struggled to recall the pattern that flashed through his brain but quickly disappeared.
Sea Bee was lost.
“That’s okay… I understand that you are a farmer so let’s try these three words instead. Cow… barn… pasture.”
Sea Bee smiled as he searched for the words. Finally it came.
“Junior… my boy. He used to help me on the farm. He was a good boy, Dr. Blauw, a good boy.”
The room was silent. Dr. Blauw recorded some notes and then stood. “Mr. Campbell, I’ll give you a couple of minutes to change into this hospital gown for your physical exam.”
“And I really need to get back to Fort Detrick,” Raines said as she gathered up her things.
Blauw walked over to Raines as Ruth tended to Sea Bee.
“Colonel Raines, I’ll walk you out. You must have gotten a very high level referral. It’s not often that we can take new patients on such short notice.”
Raines and Blauw emerged in the corridor away from the exam room.
“Actually my boss, Dr. Ernst Groenwald, said you were the best on the East Coast.”
“Ernie? He’s a great guy. I haven’t seen him in years.”
“He said you two once worked together.”
“A hundred years ago in The Netherlands. Ernie was one of many brilliant minds who rotated in and out of Rotterdam. I worked for a few years in the Daniel den Hoed Clinic, part of the Dijkzigt Hospital, while Ernie researched infectious diseases and pandemics. Once you get accustomed to the American way of life, even an impressive place like the Brezden University Medical Center can’t keep you.”
“Well, I hope you can do something for Mr. Campbell.”
“Hard to say, colonel, we’ll see how the tests come back.”
“I presume you’ll do the standard battery: CT, MRI, and PET?”
“Colonel, the best hope we have for AD is early diagnosis and prevention. By the time we cinch the diagnosis of AD we’re already in trouble. Too late. Think of the fireman holding the hose, spraying water into your living room, and yelling ‘fire’ while you’re sitting on the couch reading a book. It’s kinda too late to be at the bedside when the fire department shows up. That’s why I work on the bench as well. We’ve got to find better diagnostic tests, biomarkers, vaccines, early detection and prevention.”
“I work with infectious diseases and bioterrorism. Prevention is the name of the game.”
Blauw pulled the note card out of his lab coat and handed it to Raines.
“Colonel, hang on to this. Guess his son must be a Navy SEAL. The family will appreciate it one day, but probably sooner than they would like to admit.”
8
Datta Khel, Miran Shah District
North Waziristan, Pakistan
The table next to the woman’s bed was set. Ether, surgical sutures, a scalpel and two industrial grade silicone breast implants were staged for the operation.
“Why were these taken out of their packages? It’s hardly a sterile environment in the first place,” Banks said with full irritation as he pointed to the silicone implants just lying on the wood surface of the dirty table.
“They are fine, Dr. Banks. The commander wanted them modified,” Kazi defended as he turned on two more lights, all powered by an outdoor generator. “I want to introduce you to Dr. Ja’far. He will be assisting you.”
Ja’far had arrived the night before. He was an older man, bespeckled, and of slight build. He wore the traditional salwar kameez.
“What kind of a doctor are you, Ja’far?” Banks asked as the old man looked back puzzled.
“He does not speak English. Dr. Ja’far is a professor, a scientist by trade,” Kazi said. “Tell me what you’re doing, how you’re doing it, and I will translate everything for Dr. Ja’far. Perhaps he can learn to do the procedure himself in the future.”