Wednesday, April 29, 2009

FEVER II.

FEVER
(Part II.)


Something about how children die -- a memory stays clearly in the family message about some relative (or only acquaintance) who survived WWII alone with two little children -- a boy and girl. Both were sick, deadly sick. They needed to be given medicine orally. Girl was weak already, mother could give her the medicine. Boy was stronger, he resisted and died. If you know this, don't you give medicine to your child, no matter what?


Man and Woman didn't get medicine to Child. They resigned themselves. Lying on either side of hot, little body. On guard, they sleep on pins and needles. They wake up also on pins and needles, and sleep fitfully throughout the night, as does Child. They wait. Early in the morning, the fever goes down. They succeed in infusing aspirin tea to Child, at least ...


Science can be found in the most unbelievable places. But this institute we know already, and the pigeon too. In the morning pigeon waits for Man in front of the institute, his feathers ruffled, he is stooped and silent.


Something about how pigeons die -- one clever man renowned scientist and essayist, his name Dr. Lewis Thomas, wrote in a noteworthy essay "Death in Nature." He analyzed there the strange characteristic in animals to die unobtrusively and alone, and he documents how many animal species at the right time seek seclusion and leave their society. He also speaks about how little dead animals, mostly birds, we see with regard to how many must die daily of natural causes -- but he's wrong. In this case, surely, our pigeon perseveres in staying in front of the doors of the science institute. Man sometimes sees it there when he, nervously, looks up from his work. What chance has this pigeon when sickness attacks it, when the viral platoon, ready for anything, penetrates the defensive position of its mucous membranes, distributing its worst to the most sensitive tissues. They drill through the head the cell walls and smuggle in false information of their nuclei acids. Genetically coded tapes, which the affected cells believe, record the information into its own circuitry and then, work on multiplying viruses and consequently on total destruction. When things go so far, what could a pigeon do as an individual, a being, a whole entity. ..? Somewhere deep inside, a life-and-death struggle goes on for the highest values. Now, in this moment, the control center of the pigeon's "me" is no longer involved in the struggle and the pigeon is consigned to the role of spectator. It can only cross its fingers and (fictively) send word down to every cell even not knowing its place in the line of battle. The message needs to be strong. Do fight somehow ...for everybody!


What else can this little amazed pigeon do, moving through every possibility in its sclerotic head? What else can it do, only ruffle its feathers, cower and wait? And yet the command must burn in the brain -- in this mindless head -- and to this feeble body to go and meet Man ...in fact, no, just now the pigeon has disappeared. Man thinks that the pigeon has already flown out as he didn't see it from his office. But it is just for a moment. Man again catches a glimpse of the pigeon on his way to the laboratory in the basement. It already moves nearer to the ventilator, not far from the entrance to the institute.


Pigeon had moved to a warm place, this was paramount, it was intuitive thinking to help light the internal fires for the fight ...


Instructive, too, is: "Immunity system has to discern 'alien' (sickness germs) and 'rebellious' (one´s own cells) and inactivate them. If the system is not successful, the whole situation can end fatally.
The first line of defence (macrophages, monocytes and neutrophiles) and natural killers in other sequences do valuable specific immunic reactions, secured by B-cells and T-cells. B-lymphocyte, under the influence of antigens (the material triggering immunological reaction) and with the presence of growth factors, make immunoglobulins, divide and mature in a few days into plasmatic cells. They mostly fight against bacterial infections. T-lymphocytes kill strange or virus-infected and changed cells in the organism and have an immuno-regulation function."
An important difference between T and B lymphocytes is the way in which antigens are distinguished. B-cells know directly antigens. Meanwhile, T-cells know fragments of antigens in a bond with albumins with a main histocompatible complex (MHC). This phenomenon we call MHC restriction ...


Something about how children die -- children die almost like pigeons and, what is worse, some kids die because of medicines that pigeons never try. Man knew about it when he complained to lab technician about worries concerning the fever. They fight with it as they would of at the medieval times. The heavy artillery of the antibiotics the doctor still didn't offer.


"It's worrying," sympathetically agrees the lab technician. "They say that the flu at the end of WWI killed more people than the war itself -- minimum 20 million."

"It's too much, I am not sure ..."

"No, really, they wrote about it in a magazine you get here monthly ...this popular scientific one ...I'm sure you read it, too. It's terrible when you imagine that even today people die of flu and pandemics. Then, tell me how it's possible that no one has found some really effective and non-toxic, viro-static medicine by now ..."

"Do you think that ..."

The lab technician interrupts again, "Yes, I think they wrote that there, too ..."

He interrupted her this time, "But our little baby only has some fever. It usually respond to aspirin, and it is harmless ..."

"Harmless like harmless," she said, "You didn't hear about harmfulness of salicylans and, therefore, aspirin, too? Some children died, they say. Some of the side-effects are more intense bleeding, among other things ... I thought that you knew about it ..."


There are moments when Man catches himself red-handed in one monotone idea -- in one short sentence. Question -- what else do I have to know? I have to know that child can be sick. I have to save him from the fever, but if I can't I have to know who, where and how to call for help. I have to know how to proceed for advice. And I also have to know that this help can fail fatally?!!
When Man was Child's age, step by step, slowly, one after the other, he came to understand the rules of how the world works (fairy tales providing the first examples). He was stunned how everything is clear, in fact, logical in its cause and effect. He told himself, if all these conditions hold true it's impossible that he don't achieve his goals and some promised bonuses along the way. But he never again felt this colossal faith that things go the way they are supposed to. So, aspirin, too, already ...


Man then read, specifically: "Aspirin" (Pharmacopiae on ingredients and description of effects) side-effects ... in usual doses, probably 6 percent of people experience some moderate breakdowns GIT (nausea, dyspepsia and vomiting), occult bleeding. In long-term use, hypocromic anemia, which in 20 percent can be accompanied by GIT bleeding (melene, hematomese, in ulcerations can come tissue loss and perforation). Increased bleeding with symptoms of epistaxis, skin sufusis, breakdown of blood production (trombocytophenia, aplastic anemia, agranulocytosis led to even pancytophenia). The risk of renal failure, papilar necrotis, and liver failure. Tinnitus affects up to 1 percent, and deafness 3 percent. In allergics, induction of asthma attacks, occurrence of skin eruptions, sometimes some breakdowns similar to Stevens, Johnson and Lyell syndrome, the possibility of Reye syndrome in children (suddenly hyperpyprexis, metabolic acidity, neuropsychic breakdowns, hyperpnoesis, vomiting, spasms and liver breakdown) ...


Man was sure until today (God knows why?) that aspirin was the one cure in the world without side-effects -- a big breakthrough of this century. He never heard about the possibility of breakdown of blood production and Reye syndrome.

And Child? Mystery. Problem. How many times, willingly, it push into its mouth things which don't seem reasonable. And now this time when Child doesn't want aspirin, are Man and Woman being unreasonable?Man calls home nervously. But Woman answers peacefully, Child is okay. It's fortunate that they didn't panic and use antibiotics. It could have hit Child's little heart or liver. ..(Man made a subconscious note to himself in one of the key memory lobes of the brain, a lobe that also holds the ability to solve problems and make decisions as well as ability to plan -- read Pharmacopiae on antibiotics ...). But it's not a priority. Indeed, Child is playing already. It draws. Man hears Child's little voice in the background and he puts down the receiver. The world, notwithstanding salicylans, Reye syndrome and Man's ignorance about the side-effects of antibiotics, continues to turn ...


Something about how pigeons die -- when Man leaves the institute (as usual, the last, he still refuses to deviate from the battle plans of the day) he doesn't see the pigeon. It is not near the container, nor near the ventilator. Man, light on his feet, goes home and -- treads on the dead pigeon. He gets scared for a moment. He looks directly into the pigeon's popped-out eye, which still holds the immediacy of infantile surprise that death is only a cruel, unjust joke. Really, how does pigeon's brain know that the fight in the hull of the body was definitely lost? Does a messenger run up through the nerve-racked body to warn of the danger? If so, where could he run to in the corners of the cold, little confines of the pigeon's head? When does he know that end is near and until this moment, when he realizes but is not able to perceive it? Or is the power of the fever so merciful that you simply can't realize this? How does it happen that the clockspring seized up, ending the whole humdrum existence of the pigeon?


Man, hesitatingly steps over the little cold pigeon. Then he comes back from the shed and takes a shovel and a bag and carefully buries the pigeon -- flipping the pigeon into the container. It seemed so easy. Dragging the heavy lid off the container, the story of the pigeon which had been looking for help was over. "You know," Man says tacitly to the dead pigeon, "I can't help you. We have no institution for you. Otherwise, I would call there." And Man, resolute and almost satisfied, goes home.


The day finished in an impossible way. It finished badly. With the coming night, the fever returns. It again grips the Child, moving like wildfire ...


The End


Translation by Robert M. Davis

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