Harry despised getting up early, but if he was going to fit in a run, his jam-packed lobbying schedule required it. As he burst out of the condo elevator, he tripped over the mop bucket and his Air Jordans slid on the gleaming marble before his momentum was stopped by the glass entry door. Shaking a bruised hand, he glanced around for someone to blame.
“Fuckin puta.” The spit from his lips was aimed at a young pregnant woman, no more than a teenager, cowering on her knees with a sponge in her hand. “What’s your name, bitch?”
“Dee, Denise. I’m sorry.” The words slipped her lips in a whisper.
“Duh, dunce Duneze. You’re gonna remember me as the guy who got you fired.”
In the cool October dawn, the streets were damp from an overnight shower and slickened by colorful fallen leaves. With gentrification of the neighborhood, Harry hoped to make a killing when selling his Columbia Heights unit, but the nights remained a risk for gang shootings. Around the corner, a shell casing in the gutter and bullet holes in the beat-up Chevy confirmed noises he had heard at three o’clock.
Wiping at his brow, already beading sweat with his brisk pace, he refocused on the morning’s schedule. He had to buttonhole some key members of Congress over a bill scheduled for a floor vote later in the week. If a company labelled their product a food supplement instead of a drug, the Food and Drug Administration exempted it from oversight. Some major and minor adverse health effects prompted do-gooders to argue for tighter governmental control. But thank God there were more vocal advocates on the side of the supplements, willing to pay him big bucks to maintain their market freedom.
By the time of his return to the condo, the cunt was gone. Add her sorry ass job to the morning’s checklist.
Whether it was the stress of the firing or the long scary walks between buildings for bending and cleaning, Dee was in the hospital a few weeks before her due date. With no medication, she pushed baby Jessie out on Halloween. Last fall had started with promise—a scholarship to Howard University. But too many tasty whisky sours at a dorm party led to this. The mewling five-pounder with the satin skin and dark doe eyes made up for all the trauma. Nursing came naturally, despite all the remembered cautionary tales from long-gone aunties in Alabama.
The condo was only a shrewd financial investment and place to lay his head during the D.C. lobbying. Harry’s real home was in Big Stone Gap, southwest corner of Virginia in the heart of Appalachia, and he hurried back there in time for the fall election. Only five thousand people, coal country, and one of the most conservative towns in the state. The hundreds of thousands earned in consulting fees paid for a beautiful old farm, which he didn’t work, but the autumn gold foliage was spectacular.
Family and friends—those words had little relation to Harry. Everyone was a means to an end. Around Veterans Day, as the evenings frosted and multicolored leaves carpeted the soil, his heart softened. When spotting an annoying raccoon scratching at the back door, he let the animal in. It was sociable—maybe others had fed it before. Pansies. But after scrounging under the sink, he located the old dog bowl and some stale Purina Dog Chow, leftover from the coonhound he dumped along the rural road after it bit him.
The coon was soft and gray, maybe fifty pounds, so shouldn’t be begging. But the ringed tail and white-framed black mask reminded Harry of his ancestors’ frontier days—didn’t they brag about being descendants of Davy Crockett?
Harry kicked out his booted feet and leaned back in the hand-hewn wooden kitchen chair. He kept popular with the local citizenry by buying their craft products, even though he despised their folksy ways. Anyone who didn’t spend a thousand dollars on a suit clearly didn’t value themselves enough for Harry to respect them, either.
The ridge had record snowfall, contradicting the hysterical Dems who screeched nonstop about climate change. So Hairy, his kindred spirit, spent the cold months inside, amusing Harry by dipping dog biscuits into the water bowl to clean them with his cute versatile paws. As Hairy chomped the coonhound treats into tiny pieces, Harry downed shotglasses of the local hooch, and poured a few drops into the water dish.
“Join me, bud.” He smirked when the coon lapped it up. The only heavy effort either made was Harry shoving another log in the woodstove, keeping them both toasty.
When the warmth of spring allowed outside playtime, Dee bragged to other moms about Jessie’s advanced development. At only five and a half months, Jessie supported her own weight when playing in the pocket garden a few blocks from Columbia Heights Village. Dee lay next to her in the grass, inhaling the floating scent of hyacinths and rubbing the smooth glossiness of white magnolia blossoms dotting the area like snowdrops.
Dee was distracted, cobbling together odd jobs to put food on the table while the neighbor lady took in one more-too-many infants in her unlicensed day care. Her favorite time of the day was Jessie’s bath in the kitchen sink. She was proud of Jessie’s beauty—the glistening, smooth skin that smelled like heaven, and the soft dark curls. She pressed her lips to Jessie’s, and the baby giggled.
On the pleasant April afternoon, Harry’s impatience showed with every rapid movement as he circled the Tidal Basin, Japanese cherry blossoms budding pink and purple. This was the only time of the year he enjoyed being this close to the Deep State.
When admiring a bud straight on, the vision in his left eye became cloudy, but no pain or itching. He swiped the eye and didn’t feel any discharge or tearing. As he glanced around at the larger tree, there were a few white floaters. His Dad had cataracts before drinking himself to death at seventy. Only in his forties, Harry was way too young to have that problem, at least the eye issues.
He perched on a step of the Jefferson Memorial, clear view of the Washington Monument piercing the sky above the rippling water of the Basin and tourists whooping on paddle boats. Thumbing through the names on his phone, he located one of his White House contacts.
The guy was a special agent of the U.S. Secret Service, and they served in Iraq together before Harry was discharged for insubordination. Harry refused to implicate the guy in his misdeeds—the only nice thing he did in his life. So a favor was owed. The agent referred him to an ophthalmologist who used to be at Walter Reed before his own military service was cut short—something about harassment of an Army nurse.
“But he’s top notch, I promise,” Harry’s comrade assured him.
Within two hours, Harry had cleaned up from the run and Ubered to one of the sprouting office towers in Crystal City. After dilation, the doc gazed into Harry’s eye with the ophthalmoscope.
“No inflammation in the anterior segment or the vitreous cavity. That’s good—nothing wrong with the front or middle of your eye. Let’s shift to the retina at the back.”
The doc adjusted his position. “Fuckin’ A. Never seen one of those before.”
Harry’s slight drawl deepened with fear. “Hey, don’t freak me out. What’re ya talking about?”
“Live nematode—worm—swimming slowly in the subretinal space.”
Seemingly overnight, Jessie developed a vacant stare and droopy head. At the emergency room, the doctor scratched his forehead. “I’m sorry—not sure what’s going on. If it was infectious, she should have a fever.”
Dee rocked Jessie as she sucked on the bottle. “But it’s not my imagination.”
“She’s appears to be drinking well, how’s her appetite?” the doctor asked.
“She still eats fine—no throwing up, no loose stools.” Dee held the baby more closely. “But something’s off. Jessie’s different.”
The uptight intern shoved thick glasses higher on his nose. “I did a thorough physical exam. As you can see, there are no skin changes. My stethoscope revealed no gastrointestinal or respiratory abnormalities.”
“There must be somebody else we can talk to,” Dee insisted. She let go of her hands for an instant and Jessie flopped against her chest. “She was sitting up fine until three days ago.”
“I don’t have enough evidence to call in a specialist on a Friday night,” the intern responded, stubbornness strengthened. He experienced the wrath of highly paid superiors more than once. “I need stronger evidence to disturb them before Monday. But I can take a blood sample.”
Jessie screamed bloody murder with the needle stick, oceans of tears flooding down from her inky eyes. She wasn’t a hundred percent weak, requiring both Dee and a nurse to restrain her.
In the tiny apartment on Sunday, Dee covered one ear to block the fighting neighbors and held the cell phone to the other. Jessie had a high proportion of eosinophils, one of the WBCs or white blood cells, but they didn’t know why. When Dee complained that Jessie could no longer turn over on her own, they scheduled an appointment with a neurologist for Monday morning.
Back at the hospital the following day, Dee shifted her weight on the chair, unable to sit still. The plump seventy-year old lady who introduced herself as Dr. Bautista set down her hammer. “I can confirm the reduced muscle tone you described, and decreased deep tendon reflexes.”
The younger eye doctor leaned against the wall, waiting for his senior to finish. “Good news—there’s no indication of vision problems when I look inside her eyes. However, she is unresponsive to tracking my visual stimuli, and there are some subtle involuntary eye movements, what we call nystagmus.”
Dr. Bautista, in a grandmotherly gesture, scooped the infant up. “We’ll admit baby Jessie and run more tests.”
Harry’s temper overcame his judgment and he shoved the eye doctor away, leaping to his feet. “How can I get a worm in my eye?”
He ran well-groomed hands through thick auburn hair. “Maybe when I was in Iraq. Other guys ended up with PTSD or traumatic brain injuries, and I land a parasite.”
But his naturally suspicious mind hit the pause button, and he grabbed the collar on the doc’s white coat, pulling him close. “Say ‘ah’, doc, I want to smell your breath. One of those three martini lunches, and you’re trying to extort me for some exotic, expensive treatments.”
The ophthalmologist was equal to Harry’s bluster. “Sit your butt back down in my chair, hombre, and I’ll take photos to prove it to you. While those are developed and analyzed, I’m sending you to a parasitologist for blood and stool samples. If you can’t poop today, maybe she’ll extract a sample digitally—I bet you’d like that.”
The next day was typical D.C. spring rainy gloom. Winds roared in from the Appalachians and scoured the cherry blossoms—tourists hit the highways and airports to go home. The National Cherry Blossom Parade was cancelled, and Harry stopped back at the eye doctor’s office.
“I think you’re full of shit,” he greeted the specialist, after admiring the striking twenty-something receptionist for ten minutes. “Everything’s coming back negative on my other tests. But I do appreciate the intro to the Korean doc for the parasite consultation. I’ll give it a week so it won’t seem creepy, then ask her out.”
Confident of the results, he dropped back into the exam chair. “It’s morning, so presumably you haven’t had those cocktails with lunch. Check my eye again and I dare you to find something.”
The ophthalmologist smirked. “Sure, why not? And then I’ll show you the photos of your fundus.”
After adjusting the ophthalmoscope, he grinned. “Active little bugger you got there. Moved to a different spot.” Before Harry could explode out of the chair again, the doc opened the screen to his laptop and pulled up the photo file. “See that squiggly little worm? Not supposed to be there.”
Harry still wasn’t satisfied. “Fuck it—there’s no guarantee this photo is from my eye. I don’t know what kind of scam is going on, but it’s impossible for me to have something like that.”
“You’re welcome to a second opinion,” the doc responded. “But I can knock it out with a laser, and the sooner the better. I’m already seeing serious damage, including optic atrophy and attenuated retinal blood vessels.”
Harry acquiesced. “Let’s get it over with, I’ve no time to waste.”
The scary names for his problem refocused him on the eye doctor. Diffuse unilateral subacute neuroretinitis or ocular larva migrans—Harry tilted his head up, froze his smile, and tapped the footrest as the ophthalmologist prepped the equipment. The laser got the worm—there was no more evidence on repeat check-ups.
During the days after the initial neurologic exam, cultures done on Jessie’s blood and cerebrospinal fluid were all negative for any bacteria. Viral meningitis—that was the diagnosis of record. When Dee asked for an explanation, Dr. Bautista explained it was an inflammation of the lining of the brain and the spinal cord—a foregone conclusion with neurologic signs and no bacteria.
The next recommended step was a lumbar puncture—sticking a needle in Jessie’s spine. The cerebrospinal fluid drawn out had a high number of eosinophils, forty-five percent of the WBCs, with normal less than one. As the nurse went to retrieve Jessie’s mother, Dr. Bautista reflected that the name sounded wonderful in its Greek origin—‘eos’ for dawn and ‘philein’ meaning to love. But when Dee returned, she explained that the cell was implicated in a long list of nasty problems—asthma, allergies, parasitic infections, and disorders of the skin, gastrointestinal system, blood vessels, or connective tissue.
“Whatever’s going on, it’s reflected in the blood, too.” Dr. Bautista handed Dee the test results. “Current sample has twenty-seven percent eos, when normal tops out at six.”
After a brain scan the next day, the doctor reviewed all the results in her darkened office. First she slipped the CSF and blood slides under her microscope. Despite the lyrical origin of the eosinophil name, no one would dispute that they were weird. The cytoplasm, primary gel-like substance of the cell, was filled with large rough particles stained a nauseating yellow-red or orange when exposed to the eosin dye. Lobes with cell nuclei were broken up and irregular, staining dark and threatening. Of course, the strange-looking cell wasn’t the culprit—just the body’s response to fight off something else.
Most dramatic of all were the magnetic resonance images Dr. Bautista pulled up on the laptop. Acute demyelinating or disseminated encephalomyelitis—ADEM. The destruction of the protective myelin sheath was indicated by multiple small lesions in the brainstem at the rear of Jessie’s skull. Dr. Bautista picked up the phone to summarize it for the mother.
“I’m sorry, Denise, but the scans aren’t good. Jessie’s body is attacking its own covering of nerve fibers. This can happen after viral or bacterial infection.”
Initial treatment included an injection of immunoglobulin antibodies through Jessie’s vein. But the next day, her eye movements worsened and she began smacking her lips. Her head was arched back, arms and legs thrust out, and toes pointed down. Dr. Bautista administered a steroid injection to reduce the inflammation, with no effect.
For someone so sick, Jessie kept eating, drinking, and breathing normally. But the nurses had to feed her. Dee tried to do it on her daily hospital visits, but when Jessie shrieked and pushed away, the staff took her back. At night alone in the bed they had shared, Jessie transformed in Dee’s dreams to a creature out of a horror movie.
One month later, when the hospital said there was nothing more they could do, an ambulance took Jessie to a specialized rehab center for children. She was blind. The muscle stiffness remained and she was diagnosed with a form of cerebral palsy. Worst of all, the previously bubbly, affectionate infant appeared to have no cognitive function at all—dead inside.
Dr. Bautista could never confirm for Dee what changed her vibrant child to a conscious but uncomprehending, barely-alive form. One diagnosis was briefly discussed, with no laboratory confirmation. Neural larva migrans or NLM—invasion of the brain or spinal cord by parasites.
Dee had no clue how Jessie could have been exposed to parasites. She didn’t even understand what they were. The amount of soil that slipped into Jessie’s tiny lips in the park never crossed her mind. Pica or geophagia, a predilection to eating dirt—none of the health brochures at the hospital warned about it. As Dee and Jessie had slept cuddled on the single mattress, the neighborhood raccoons explored the park, helping themselves to a few veggies from the community garden and relieving themselves in the dirt.
Before Harry left the heat and humidity of D.C. for the refreshing altitude of the Appalachians, the Virginia Department of Health interviewed him in detail about his life and habits. They blamed Baylisascaris procyonis, the most common intestinal roundworm of raccoons. In the raccoon intestine, the female worm can be nine inches long as the coon poops eggs into the soil, ready to penetrate a human’s intestinal wall after ingestion and migration to the nervous system and eyes. When the State Public Health Veterinarian asked to trap and test Hairy, Harry refused to cooperate.
“At least let us collect some of his stools from the environment,” the old broad begged. She could have been right—Hairy did make occasional messes inside. But Harry hadn’t been home to let Hairy inside for two months, since the eye problems started. Animal lover, the state concluded, afraid of what the big bad guvm’t might do to the creature.
The crickets chirped and bird song was muffled as low sun rays glanced through the thicket of mountain laurel and clusters of bell-shaped, purple-streaked flowers. The air was so dense, he could see water molecules dance in the light beams. At least, out of one eye. The retina had detached in the left one, and he was legally blind on that side. Taking it in stride, he thought the black eyepatch added a rakish air, intriguing to the ladies. Recumbent on the bright blue Adirondack chair, Harry shook the plastic container with the dog biscuits. Despite months apart, Hairy scampered into the meadow as programmed. Soft patches of black and gray fur floated in the sunbeams after the shotgun blew him apart.
In the short story “Bandit”, economic stratum and access to power influence the outcome from exposure to a mysterious microbe. Through the MayaVerse HOME | DrMayaMaguire, Dr. Millicent Eidson explores the threats of animal diseases based on work with the Centers for Disease Control and Prevention and state health departments. Awards include best short play from Synkroniciti and honorable mention in the 2020 Jim Martin Mystery Story Contest sponsored by the Arizona Mystery Writers.