Food and Drug Chapter 6
Emily Prentiss never had dreams in which she morphed herself and her friends into adorable cartoon animals. In her dreams, she always played herself.
The only thing that varied was the age of the self. If Emily could have remembered and cataloged every dream she ever had, then she could have created a graph depicting the frequency with which each age dominated her subconscious mind. She would have found age 12 at the peak of the graph.
At age 12, Emily had been a student at the International School in Geneva, Switzerland. She had mingled with the children of diplomats, who, like her mother, worked at the many international organizations headquartered within the city. One day, during geography class, the teacher had given a pop quiz, and Emily had been the first to finish. The teacher had sent her down the hall to a kindergarten classroom to retrieve a giant rotating globe that he had hoped to use as a visual aid in his lesson plan. Emily had gotten as far as the doorway of the kindergarten classroom before she had been attacked by a group of masked gunmen. They had locked her, along with a dozen kindergartners, into the classroom and held them hostage for three days. They had thrown out the teacher, leaving 12-year-old Emily as the only caretaker for the 5-year-old kindergartners.
During the hostage crisis, Emily had developed a coping mechanism that she had used to take care of the younger children. She had taken her own fears and anxieties and shoved them into little boxes that she had cordoned off behind yellow caution tape. That was why she had been brave enough to demand food, water, and bathroom breaks from the masked gunmen. Providing physical security was the only way that she had thought of to keep the children calm, to prevent them from crying and screaming, to prevent the gunmen from shooting them in a fit of annoyance or rage, if only to shut off the ruckus.
For the first time in her life, Emily had felt strong and powerful. Her feelings had been in blatant contradiction with the actual situation, in which she was weak and powerless beneath the barrel of a machine gun. Psychological compartmentalization had offered a mental escape route. She was strong and powerful at the same time that she was weak and powerless, all because she had lucked out and chanced upon an effective defense mechanism.
After the crisis had ended, when the gunmen had abandoned their anti-globalization agenda in favor of their prolonged survival, Emily had not given up her new set of skills. Instead, she had incorporated them into her developing psyche, and they had become the default setting of her mind. Whenever she was faced with a serious problem or a dangerous situation, Emily simply compartmentalized her feelings into boxes, which she stacked, one upon another, to make room for analytical processes that were so much more useful during difficult times. During difficult times, Emily imagined that she could actually feel herself getting smarter.
Afterwards, she never dealt with the emotional fallout. She never unpiled the stacks or unpacked the boxes. She simply left them there to rot, over years and decades, and the voices trapped inside them never got a chance to tell their stories, not even in dreams. They spoke neither truth or un-truth, and as a consequence, Emily understood neither weakness or strength.
"New lists," Emily thumped a roll of paper over Reid's head, waking him up from a Thumper-Bambi-Flower dream, in which the three furry friends TP'd the gingerbread house of the evil cannibalistic witch from "Hansel and Gretel".
"New lists from Garcia?" Reid unleashed a jaw-unhinging yawn, "Including language linkage analysis?" he took a sip of coffee from The Book.
"If 'language linkage analysis' is what you told me to do last night," Emily replied.
"Do you like my terminology?" Reid asked hopefully. "I took inspiration from genetic linkage analysis. Genetic linkage occurs when genes located close to each other on the same chromosome are inherited together. The biological phenomenon isn't exactly analogous to our situation, but I thought that 'language linkage analysis' had a nice ring to it."
"This is all going into your book, isn't it?" Emily asked.
"This is all going into my book, of which you shall be the co-author," Reid offered magnanimously.
"Oh joy, I can't wait to write a book with you," Emily imagined the scenario, discovered that it was an attractive one, and compartmentalized the whole set of thoughts and feelings. "We can talk about that in the future. Right now, we have to make sense of these lists. Garcia went all informatics happy with the data. Let me explain her system," she shuffled the papers and split them into piles. "The same set of data is displayed in two different formats. In one format, the correlated terms are ranked by frequency in a list. In the other format, the correlated terms are shown in a table, with one term in the lefthand column and all the terms correlated with it in the righthand column. As you predicted, we've got Alzheimer's Disease on the left, correlated with amyloid beta, tau, and presenilin on the right, plus hundreds of other terms ranked by frequency."
"Perfect," Reid consumed the lists and tables with his eyes.
"We also ranked the articles and terms by importance," Emily organized additional piles of paper on the lab bench.
"What do you mean by importance?" Reid asked, "What's the criteria for importance?"
"I made a couple of assumptions, which may or may not be valid, to judge the importance of an article," Emily explained. "For electronic articles, I assumed that the most frequently accessed ones were the most important. Garcia was able to pull out the number of times that each article had been opened since it was first downloaded. For paper articles, I assumed that the ones at the tops of the piles were the most important. We split the articles into thirtiles - the top, the middle, and the bottom - based on frequency of access and location in the pile. We assigned multiplicative factors to the thirtiles - 1 for the middle, 2 for the top, and 0.5 for the bottom. That makes the top article twice as important as the middle article and four times as important as the bottom article."
"So you know which articles are from the top and which articles are from the bottom?"
"Yeah, I followed a specific protocol when I took the photos, so I can track down the locations of all the articles. First, I photographed the whole pile in its original location. Then, I flipped the pile over so all the articles were facing downwards, and I photographed each individual article as I turned it over to re-create the pile. The camera gives each photo a timestamp, so the most recent photo from each pile is the top article in the pile. I split the piles into three categories - on the desk near the computer, on the desk away from the computer, and anywhere else in the room, such as the bookcase or the floor. Piles received multiplicative factors based on their proximity to the computer. The terms in the articles at the tops of the piles closest to the computer received the highest scores for importance. Garcia generated a list of terms ranked by importance. Hopefully, this list gives us insight into which topics are foremost in the minds of our UnSubs. What do you think, Reid?"
"Basically, you converted everything into numbers," Reid remarked.
"Basically, I'm turning into you," Emily remarked.
"I knew that you'd see the light one day," Reid rubbed his hands together with a satisfied smirk on his face. "Let's see what we've got," he scanned through the papers depicting Lee's reading habits. "For Dr. Kenneth Lee, the most frequent set of correlated terms is 'statin' with 'cholesterol synthesis', followed by 'statin' with 'HMG-CoA reductase'. That's the enzyme that catalyzes the rate-limiting step in the cholesterol synthesis pathway. Not exactly surprising, considering that Lee's the administrator in charge of the clinical trial."
"But I don't think he's spending a lot of time thinking about statins," Emily circled the top item on a different list. "Most of the statin-related articles were accessed once on his computer, and most of the paper articles were nowhere near his computer. I don't see much relation between the clinical trial and the articles near his computer. The top set of correlated terms was 'human behavior' with 'Great Leap Forward'. I don't recognize the second term. I'd have to shoot myself if I didn't recognize the first term. What do you know about the Great Leap Forward?"
"The Great Leap Forward was the final step in human evolution," Reid recited. "It distinguished modern man from our archaic Homo sapiens ancestors. Prior to the Great Leap Forward, archaic humans looked just like us, but they thought very differently. Their cognitive functions were limited to the physical world, without our ability to engage in abstractions. They used a small set of simple tools in their daily lives. They didn't create art or music, none of the things that we recognize as culture. They didn't even bury their dead. Somehow, anytime between 50,000 and 100,000 years ago, humans developed imagination. It was the last cognitive function to evolve. Complex tools and cultural artifacts suddenly appeared in the archaeological record. The prime example is the Lascaux cave paintings in France, but much older rock art has been discovered in Africa in recent years. More and more anthrolopologists believe that the Great Leap Forward took place in Africa as early as 100,000 years ago. They would say that the Great Leap Forward gave rise to behaviorally modern humans. It made us us."
"Anthropologists would say that?" Emily connected the dots, "Anthropologists like Dr. Sandra Maynard?"
"Anthropologists like Dr. Sandra Maynard," Reid nodded.
"What the hell is going on here?" Emily threw up her hands. "Lee's wife is the recipient of a $50,000 check from PhenoPharm. Lee's wife is an anthropology professor at the University of Maryland. Lee spends all his time reading, and presumably thinking, about his wife's area of expertise rather than his own job."
"Well, we only know that Lee's wife is an anthropologist," Reid said, "We don't know her precise area of expertise," he walked towards a computer to look her up.
"Garcia looked her up already," Emily dug up another piece of paper. "Here's a list of her scientific publications," she handed the paper to Reid.
"Maynard is an expert on human evolution," Reid scanned the list, "She's a physical anthropologist, like the Leakeys."
"The ones who dug up all those hominid fossils in Africa?" Emily asked.
"Yeah, the Laetoli Footprints, Turkana Boy...You name it, the Leakeys discovered it," Reid replied. "Do you think that Lee is just taking an interest in his wife's field of research?"
"Are you really playing dumb, or have the fumes actually gotten to your brain?" Emily rolled up her papers and thumped them over Reid's head.
"I'm playing the skeptic," Reid explained. "Skeptics can be very annoying, especially if they disagree with your theories. I'm not a very good skeptic though. I actually agree with your theories. There's something fishy going on here. Lee and Maynard both appear to be involved."
"I'll have Garcia email you the anthropology articles and some of Maynard's publications so you can read them yourself," Emily suggested. "Maybe the specific information in the articles will point us in the right direction. Meanwhile, let's move on to Ames and Hawkins."
"Good thinking, I'll read the articles during the MALDI-TOF runs," Reid agreed. "Alright, Dr. Charlotte Ames, biochemist at PhenoPharm, lead scientist on the clinical trial," he grabbed a pile of papers. "Most frequent topic of interest...Alzheimer's Disease correlated with everything under the sun. Most important topic...Alzheimer's Disease as well. The top set of correlated terms is 'Alzheimer's' with 'acetylcholine'. I wonder if she subscribes to the cholinergic hypothesis of Alzheimer's Disease."
"I'm going to assume that the cholinergic hypothesis has something to do with acetylcholine," Emily said. "Doesn't this match up perfectly with your GC/MS results?"
"Not exactly," Reid frowned, "We found an excessive level of acetylcholine in your mother's CSF sample. Alzheimer's is associated with reduced production of acetylcholine. Three of the four drugs approved for Alzheimer's are acetylcholinesterase inhibitors, which, like nerve agents, prevent the breakdown of acetylcholine. They're only useful for treating mild cognitive impairments observed in the early stages of Alzheimer's Disease. None of them are effective for treating the dementia that accompanies advanced Alzheimer's, nor do they slow or stop the progression of the disease."
"That's comforting," Emily sighed. "The only thing I'm getting from Ames is that she's really invested in the Alzheimer's branch of the study. She doesn't seem to care about the cholesterol branch. I don't know how to interpret her behavior."
"I'm getting the same message from Ames," Reid concurred. "I'm not surprised that she's more interested in Alzheimer's than cholesterol. Statins and cholesterol are old news. Statins and Alzheimer's are far more exciting. So far, I'm not getting a suspicious vibe from Dr. Charlotte Ames."
"You're capable of getting vibes?" Emily widened her eyes in amazement. "Now I've seen everything!"
Reid rolled up his papers and thumped them over Emily's head. Emily stuck her tongue out at Reid, who blew up a latex glove, like a balloon, and released the air into her face.
"Hey, hey, hey! Watch it!" Emily grabbed the glove and blew it up herself. "Call it a truce and move on to Hawkins?"
"Call it a truce and move on to Hawkins," Reid drank from The Book.
"Dr. Stanley Hawkins," Emily sorted her papers. "Neurologist at Georgetown, on sabbatical for six months to oversee the clinical trial, highly respected in his field, has never been sued for medical malpractice. Interests include Alzheimer's Disease, Parkinson's Disease, Huntington's Disease. What would you call that, Reid? A neurodegenerative triad?"
"Pretty much," Reid replied. "Alzheimer's, Parkinson's, Huntington's - the three most well-known neurodegenerative diseases. Everyone's heard of them. No one wants to get them. Oh wait, we forgot one...Make it a neurodegenerative quartet...We forgot ALS."
"There's a bunch of other diseases on this list," Emily looked down the frequency list. "I haven't heard of any of them though. Where's the other list for Hawkins? The one ranked by importance?" she looked all over the lab bench without finding the list.
"I don't know," Reid said, crumpling up the list and stuffing it into a pocket of his lab coat. "We can look for it later. Right now, I've got to seed some cells for tomorrow's experiments."
"Oh, so you have more official work to do tonight?" Emily asked, "You won't have time to run the MALDI-TOF?"
"No, unfortunately not," Reid replied, "I won't be able to run the MALDI-TOF until tomorrow. Sorry, Emily."
"Sorry for what? You've done so much already," Emily stood up to leave the lab. "Anything I can help you with here?"
"Nah," Reid replied, "I'm going to do my menial job now. It'll be boring, but it'll give me time to mull over the LLA data."
"Oh God, you're abbreviating your made-up terminology," Emily shook her head. "You're hopeless, Reid. Absolutely hopeless. What am I going to do with you?"
"Of course I'm abbreviating," Reid defended himself. "Language linkage analysis is quite a mouthful. LLA is so much easier to say."
"Whatever you say, Genius," Emily backed into the door. "I'll leave you with your acronyms and abbreviations and terminology. I've still got my own menial job to do," she shuddered her way out the door.
"Bye, Emily," Reid waved.
He plopped into a chair, waited for five minutes to make sure that Emily wouldn't come back, and called Garcia at 2:30 AM.
"Office of Earth-Shattering Exemplitude!" Garcia answered brightly, "What can I do ya for?"
"You're still up at this hour?" Reid asked.
"Yes, dear," Garcia replied sweetly, "I've adjusted my sleep schedule to match your nocturnal pursuits. I'm like a NASA scientist during a Mars rover mission, timing my life to the Martian day and slowly falling out of sync with the terrestrials."
"That's a good idea, Garcia," Reid said, "This way, I won't have to feel bad about waking you up in the middle of the night."
"Indeed not," Garcia said, "I'm all ears."
"You know the language analysis you've been running for Emily?" Reid went ahead with his request. "Can you run it again right now and email me the results right away? This time, rank the articles by date of download. I want to build a historical record of reading habits. I'm especially interested in the past month."
"Got it! I shall email you and your partner forthwith!"
"Um...Can you email me and not Emily?" Reid whispered cautiously.
"Why would I do that?" Garcia asked, "Doesn't Emily want to see the list?"
"Uh...I don't think so," Reid stammered. "Emily and I..." he prepared a lie, "We had a little argument about the language analysis," he lied. "It was all my fault. I started babbling about the proper way to do a language linkage analysis, and I made light of some of her work during the past couple of days. She was right to be angry, but it's all over now. She's not mad at me anymore. Still, I'd prefer it if you didn't email her the list."
"No problem, Disgraced One!" Garcia said. "The Office of Earth-Shattering Exemplitude promotes harmony in all human interactions. It shouldn't take more than ten minutes for me to email you the list."
"Thanks, Garcia," Reid cringed at his lies. "I've got a new name for your office, if you wanna hear it."
"You know I do!"
"What about the Office of Extraterrestrial Sagacity?" Reid offered timidly.
"Oooooooh, I like, I like," Garcia clapped in approval. "It makes me sound like a wise old alien watching over the humans from my undetectable orbiting mothership. The humans have no idea that I was the one who originally seeded their planet with proto-intelligent life. Nor do they realize that I've been controlling every step in their evolution ever since."
"I'm glad you like the name," Reid said. "I'll be even gladder when I get the list in my inbox."
"On it, Taskmaster! Office of Extraterrestrial Sagacity, out!" Garcia hung up.
Reid put his head down on the lab bench, his heart pounding from all the lies that he had told in the past ten minutes. He apologized silently to Garcia for lying to her about the non-existent argument with Emily. He apologized silently to Emily for lying to her about the non-existent cells that had to be seeded. He grabbed the crumpled piece of paper out of his lab coat and tossed it into the garbage. He didn't need to read it, because he had already memorized it.
The piece of paper showed a list of topics at the forefront of Dr. Stanley Hawkins's mind. Topping the list was a set of abbreviations - CJD, FFI, TSE. They were all diseases. They were all essentially the same disease, caused by the same agent, progressing through the same steps, ending with the same result. They shared the same mortality rate. It was 100%, without exception.
Reid remained with his head on the lab bench until Garcia texted him to check his email. He clicked on the attachment, his fingers barely coordinated enough to hold the mouse. He found what he had expected to find.
In the past month, Drs. Lee, Ames, and Hawkins had read, in total, 27 articles on the topic of myoclonic jerks. They had read no articles on the topic prior to Monday, when they had arrived at work to discover that two of the patients in their clinical trial had fallen victim to seizures that were tentatively identified as myoclonic jerks. On Monday, Dr. Lee had read 2 articles on myoclonic jerks. That was where he had stopped. On Monday, Dr. Ames had read 5 articles on myoclonic jerks, all of them broad overviews of the topic that summarized the uncertain state of the field. That was where she had stopped. On Monday, Tuesday, and Wednesday, Dr. Hawkins had read 20 articles on myoclonic jerks, none of them overviews, all of them research articles, in which everything that could be understood was expressed in charts, graphs, and tables. In LLA, when the scientific terminology was ranked by download date, the top set of correlated terms for Dr. Hawkins was "myoclonic jerks" with "CJD".
As Reid knew, Creutzfeldt-Jakob Disease, Fatal Familial Insomnia, and Transmissible Spongiform Encephalopathy were all essentially the same disease. They were all caused by the same agent. In the scientific literature, the agent was not represented by an acronym or an abbreviation. It was represented by a portmanteau, defined as "a word formed by blending sounds from two or more distinct words and combining their meanings". For the agent, the two or more distinct words, whose sounds were blended and whose meanings were combined, were "protein infection".
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