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IBR
IBR
IBR
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IBR

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IBR is a novel dealing with an unusual idea for preventing human genital herpes infections. I have taken the concept of 'viral interference' -that is, the interference by one type of virus with the growth and replication of another similar type- and borrowed an animal virus from my veterinary colleagues. This virus (infectious bovine rhinotracheitis virus -or IBR for short) has remarkably similar characteristics and requirements to that of the herpes strain, but is not usually considered to be a human pathogen. The story is an extrapolation from what we know of the biological and clinical properties of both organisms, and is entirely plausible from a theoretical perspective.

In the story sporadic cases of the animal virus infection start occurring in a large Pacific northwestern city, but it isn't until a young patient of his almost dies that a family doctor begins to suspect there is a pattern to the outbreak. While searching for information in the university library, he discovers that his patient's gynecologist and a virologist involved in her hospital care have both been doing research on the unusual virus for years. The mystery deepens as we shift perspective and begin to realize others, too are interested in the disease, but for completely different reasons...

The book attempts to explore the gulf between research and its application

LanguageEnglish
PublisherGary Kinney
Release dateMar 12, 2011
ISBN9781458169631
IBR
Author

Gary Kinney

I am an obstetrician/gynaecologist recently retired from clinical practice in Vancouver, B.C., Canada. I am also a Clinical Associate Professor at the University of British Columbia. I have a special interest in gynaecologic oncology and women's issues. That is only one of many hats, however. I have a small farm and raise llamas -before that it was sheep, and goats and chickens... Well, the eggs and the racks paid for the upkeep. Oh yes, and I also paraglide whenever I find time from hiking, kayaking, sailing, and running. Did I even mention writing?

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    IBR - Gary Kinney

    Chapter 1

    The filthy blue and white bus sloshed carelessly through puddles the colour of the leaden sky, rocking gently on its antiquated springs. It was cold and damp and the streets were deserted. Gloria stared anxiously through the dirty window, wondering if her discomfort was obvious to anybody else. Sitting had been a mistake, but on an almost empty bus, standing would have been too obvious.

    She squirmed a little bit at a time, trying not to draw attention to herself, but the only other passenger seemed unconcerned, asleep amongst her parcels as the bus inched along the street. Finally, she saw the building, and dragged herself across the seat to pull the cord. Too obvious, she wondered, glancing at the woman? The woman didn’t stir, but the driver peered at her through the rear view mirror and grinned. Damn.

    She blushed as she crept quietly to the rear door, under the unwavering gaze of the driver. The woman, too, seemed to rouse as the bus pulled over to the curb, opened one eye to follow her, and smiled sympathetically. Their eyes met as Gloria went through the door; some things just didn’t require words.

    When the bus pulled away leaving her alone on the curb, Gloria suddenly felt vulnerable and all too visible, as if she were wearing a sign that everybody was reading. Just across the street, an ugly red brick building watched her indifferently like some huge squatting frog. Windows leered and winked as horrid things moved behind them; the stains on the bricks were scars; the doors, mouths that periodically snatched people at random from the sidewalk and then spat them out as shells from another orifice. Unfortunately, she too would be eaten.

    Hospitals! You couldn’t disguise a hospital, even from a distance. Each had an aura, if not an odour, of disease: flesh not quite right. Like the building had taken on what it was supposed to cure. Hospital, heal thyself.

    But no one had even made an attempt to disguise St. David's. It shouted its name in neon, sucking ambulances and cars off the street like maggots to meat. New twin steel towers flanked the dirty brick toad-parent, clutching it like gleaming pimps, smirking obscenely at the few people who managed to avoid the yawning entrance.

    A wart with cancer, she thought, and started across the street on a yellow light. Engines revved menacingly at the sight of the short, bleach-blond hair, black raincoat and shapely legs crossing defiantly in front of them. A solitary horn, like Joshua's trumpet, tried to frighten her into a run. Instead, the gray-haired driver of a '56 Ford was treated to a Parthian Fuck off! that rebounded onto other cars tempted to challenge her. Gloria could defend herself against some things...

    St. David's sneered contemptuously at her show of force. Everyone was defiant at the start, before the leveling began. Gloria understood that; it was something else that bothered her, something more than the peeling angels draped over the main entrance, or the dying spruce guarding the clinic door. Gloria could not deal with illness, much less the thin cloud of death that floated through the wards. Full of her own 25 years, she dreaded glimpses through half-opened doors: pale old men pinned to beds like faded butterflies, thin beyond belief, staring at the ceiling with sightless eyes, mouthing silent prayers for one more breath. All her life she had studied avoidance: avoidance of pain, avoidance of responsibility, avoidance of suffering... Hospitals came too close to violation. They trespassed.

    She also avoided doctors when she could. Stuffed with words, advice pinned to their chests like medals, they seemed only gesture-deep. Cure lay beyond them. To fix one thing, they tipped the scale the other way. Her first abortion had taught her that. Nothing had been in balance since. But things were seldom in balance for her anyway; now, at least, she had an excuse for a change.

    There was only one doctor Gloria trusted, and it was not for what he had done, so much as what he had admitted he couldn't. She liked people who couldn't do things. Dr. Trower was a gynaecologist who couldn't do a lot of things: he couldn't stop smoking; he couldn't keep up with new fashions, and had therefore stopped trying. And most important of all, he couldn't hide the fact that he cared. There was something distinctly old fashioned about him, and his dark, rumpled suit, grey hair and twinkling eyes only confirmed the impression. Everybody said so -everybody in her class at any rate. Most of the girls she knew at the university went to him or his clinic at St. David's. He was discrete.

    Gloria took a deep breath and headed for a side door with a discoloured sign over it that had once proclaimed 'Clinic' in large gothic letters. The 'C' was still readable, but the rest was blurred, making it appear more like a quote from the Bible -a moral direction- than a destination. But she was too preoccupied with her fire to notice the sign. Walking was difficult and composure more so.

    Shouldn't be so bad, she said aloud to herself as a distraction. Maybe if I describe the symptoms well enough, Dr. Trower won't need to do an internal exam. She saw someone coming through the door and lowered her voice to a whisper. Actually, all I need is a cream, or something. But she knew it was hopeless. The clinic was run by interns and residents. Dr. Trower was merely the staff man to whom they went for advice. Still, he was in charge, so he'd likely be around somewhere.

    As she leaned on the heavy door, she smelled the usual nauseating odor of sweat seeping through the cracks. Three young men loitered near the door, their legs sprawled impudently across the aisle. One man in patched jeans, brown leather boots and a tee shirt with 'Captain Crook' on the breast, eyed her with obvious interest while she picked her way around the legs. As she stepped over his boot, it rose almost to her crotch. Flustered, she smiled. He was about 20, with short, curly brown hair combed forward. His face was clean and soft, despite a studied lewdness. He had a part to play and was acting for his friends. But his eyes gave him away. When the two others laughed and tugged suggestively at their flies, his eyes did not join in. How else can I meet you? he seemed to say.

    Gloria usually welcomed encounters like this, but today she was not in the mood. She reached down quickly and dug her nails through his pant leg to leave no room for doubt. Mock screams and laughter announced her entrance and increased the distance to the reception area. By now, everyone was looking at her, including the nurse behind the desk.

    May I help you, miss? she said, disapproval straining the professional politeness.

    Quietly, and too quickly, Gloria mumbled through her reddened face, I think I've got an infection, and I want to see Dr. Trower. She thought maybe adding his name would have some effect.

    Do you have an appointment with him?

    No. I didn't know I could make one. I thought you were just supposed to come here and wait.

    Well, said the nurse, beginning to relent, Dr. Trower occasionally sees his private patients here, but only on referral from their family doctor. However, there is a new resident doctor from the GYN service here today, so I imagine Dr. Trower will show up. Your name, please.

    Gloria Donnick.

    Address?

    Gloria gave her all the information and was told she would have to wait 10 or 15 minutes. She smiled and walked over to an empty chair near the end of the room. It was not a place one voluntarily hung around. Time did funny things there. An attempt had probably been made to decorate the waiting room at some stage, but either the money had run out, or someone's tastes had. The floor was okay: orangish things on a blue and white background. The walls, however, were off-yellow or just dirty. Chipped wooden seats were arranged in rows in the center, and like a church, an aisle ran through the middle and around the periphery -functional, but ho hum. Doors ringed the outer corridors like beads on a necklace, each one a different colour at one time, perhaps. Now, just numbers relieved their monotony. The only touch of life Gloria could find was a wilting fig tree desperately hanging on to a space beside the desk. All of the accessible branches had been picked clean by years of bored kids, the more enterprising of whom had even had a go at the upper foliage. No matter, the plant, like the people waiting, was doing its best in hard times.

    The rows of chairs all faced the main desk, so on busy days the receptionist must have felt more like a teacher than a nurse. No doubt she was pleased at the small showing so far. Gloria didn't mind either, but she did feel somewhat conspicuous after her entrance. Only the nurse watched her with any interest, however.

    It was a strange feeling, being observed, and Gloria wasn't sure how to deal with it. The worst thing was that she couldn't actually catch anyone at it. The young man had left, so it wasn't him, and no one else appeared interested in her. Once or twice, she thought she saw the nurse studying her, but when she returned the stare, the nurse seemed to be looking elsewhere. In fact she smiled when their eyes finally did meet, reached for a folder, and called her name.

    As Gloria worked her way along the row of seats, she noticed the nurse talking to a young, well scrubbed doctor dressed in OR greens and a white lab coat.

    Dr. Vandenz will see you, said the nurse, disappearing through one of the numbered doors, and as Gloria followed her, he grinned. Maybe it wasn't going to be so bad after all, she thought.

    The room was strictly functional: an examining table on one side, a desk and chair on the other -no carpet, no frills. In and out -that was what the designers had asked for, and that was all they got.

    Undress from the waist down, and cover yourself up with that, said the nurse, pointing at a folded sheet of paper. Dr. Vandenz will be here in a moment.

    Although she only had to remove a skirt and panties, Gloria decided to undress quickly before the doctor arrived. She wasn't sure just why that was important, but it was.

    The folded paper felt rough against her skin as she climbed up on the examining table, but at least it was quiet. The paper that covered the table was hard and crackled as she wiggled her bare bottom along it to get comfortable. She stopped for a moment, hoping no one in the waiting room could hear her, and when nobody laughed she moved a little further from the stirrups. Her eyes wandered around the little room. It was about 10 feet square, and lit by a single 100 watt bulb that hung like a white grape from the center of the ceiling. The only things her initial appraisal had missed, were a stool and goose-neck lamp cowering like beaten animals at the foot of the table. And that was it: a storage room that had moved up the ladder. No distractions -except for a crack in the wall above the table where some frenzied patient had probably smashed it with her fist.

    Just as she was beginning to get anxious again, Dr. Vandenz walked in. He was a very intense man -everything about him told her so. His friendly, no-nonsense manner covered him like fur. But he was undeniably handsome. Gloria figured him for about 30, Protestant, and a virgin -why she didn't know. Protestant, because he looked Nordic -or maybe Aryan. He had blue eyes, high cheekbones, and hair blond enough to qualify for the Hitler youth movement. Gloria loved him.

    It was his eyes that set him apart, though. They seemed to burrow into anything with only the slightest glance. She wondered if he saw her in layers, like an anatomy book, and began to blush. But all he did was introduce himself and sit down at the desk. Although he had obviously just come from surgery he was immaculately groomed. Not a hair on his head was out of place, and his part was ruler straight. His lab coat was clean and even his shoes were shined. The only thing he had in common with other doctors she had seen was his pockets. He seemed to have a need to carry everything he owned in his pockets -or rather in the vicinity, since things were hanging over the edges and threatening to hook onto anything with a point. And when he walked, he tinkled like a milkman on his route, although Gloria, despite her best attempts, never discovered why.

    What can I do for you? he began in the usual way. Gloria was a little disappointed -she had expected more from him.

    I think I have an infection. I've had the same thing before, she added quickly, but I don't have any more cream for it.

    How long have you had the infection in your vagina? he said, obviously unimpressed with her diagnosis.

    She was flustered for a moment -she hadn't expected him to name the organ in question -at least not without warning. Ahh, two or three days.

    Ever had gonorrhea, syphilis, herpes, or any other sort of sexual infection? He made them sound like articles of clothing.

    Gloria could tell this wasn't going to be an in-and-out session now he was getting personal. She knew the questions were routine and probably important but she was embarrassed. He paid no attention to her blushes and began to take a more thorough history. He seemed particularly pleased that she had never had any sexually transmitted diseases, despite her rather numerous partners.

    You've been lucky, you know, he said, looking up from his notes. We've been seeing a real increase in STD over the past couple of years -especially from herpes and human papilloma viruses... almost an epidemic. He sighed and started to write. By the way, when was your last Pap smear? We should probably do one today... an ounce of prevention, you know.

    You mean while you're in the neighbourhood? she joked, thinking she was original. He grinned anyway.

    Well, I think it's time we did something about that problem of yours, he said, getting up from the desk. Just lie back on the table and put your feet in the stirrups. ... Good. Now wiggle your bottom down to the edge.

    The moment she had been dreading was upon her. Not knowing what else to do, she obeyed.

    You'll feel me touching you down below, Gloria. Just try to relax the muscles while I insert a speculum.

    As he said it, she felt a cold, hard, smooth object force itself deep within her before she could even take a breath, let alone relax. He opened it slowly, but she still felt intense pressure and burning.

    Sorry, he said, but didn't do anything.

    Just then, a soft knock rattled the door and an older man poked his head in. Sorry to disturb you, Dr. Vandenz. The nurse said your patient wanted me to have a look, too.

    It’s okay, Gloria. This is Dr. Trower -he's the doctor in charge of the clinic.

    Dr. Trower wasn't taken aback in the least by her position, and merely entered with a wink and closed the door. Obviously, he'd been in situations like this before and counted on charm to pull him through.

    I'm sorry to barge in, Gloria, he said as he walked to the edge of the examining table and put his hand on her shoulder.

    His eyes were as soft as his hand, and she believed him. But all this time, she could feel Dr. Vandenz working inside her -cleaning stuff off, she figured. Well, it helped to have Dr. Trower there: he took her mind off the violation below.

    The nurse tells me Gloria has an infection.

    It was an opening gambit.

    That's right, Vandenz said, responding on cue, and proceeded to summarize her history in large words.

    Dr. Trower seemed interested and joined him at the foot of the table. The younger doctor sat down on the stool again and evidently pointed at something in her vagina, because it led to a muffled discussion between her legs. Then he went at her with a stick once more.

    Okay, said Trower. Go ahead. And after another squeeze of her shoulder, he left the room.

    Be finished in a sec. Dr. Vandenz was addressing her, but because it required no answer, she put her thoughts elsewhere. In fact he did finish in short order, and let her sit up.

    I'll just look at this under the microscope, he said, holding a glass slide up to the light. You can get dressed now. And off he went, too.

    Wasn't so bad, she decided out loud as she was leaving the hospital. Same infection as before though... I coulda saved 'em a lotta trouble if they'd listened.

    *

    As aware of her body as she was, Gloria was unable to describe what was wrong at first. But something was. The cream from the clinic was working -in fact almost gone- but that wasn't the problem. It seemed somewhere else. Everywhere else. What dulled her sensitive bio-awareness was the depression. Depressions to Gloria were one or two hour shadows in an otherwise sunny life. They never lasted past supper. But this depression was a different species -different phylum even. It started gradually with a feeling of weight on her chest, and lack of energy. This alternated with waves of emptiness -rolling in like nausea. When the emptiness came, she would become disoriented and wander through the house unable to rest, unwilling to respond to anything but simple questions.

    This worried Gloria's mother. Her daughter was never moody, and rarely sick, so the sudden change was disturbing. Drugs, were her first thought. A girl from a small town who had to weave her way into the closely-knit social fabric of a large university might be tempted. She was almost happy when Gloria developed a cough and chest pain over the next few hours. Drugs didn't do that -the flu did. When she felt her hot forehead, she was convinced.

    Well, that's it, then, she said to her husband, and trundled off to find a thermometer.

    But an hour later, the 'flu' had become markedly worse. Gloria's temperature rose to 40.5'C. And she began to cough up bloody tissue. Then the cramps started, doubling her over for minutes at a time. At first she could make it to the toilet; then she couldn't -a blinding headache took away what little capacity for movement she had left.

    Gloria was delirious by the time the doctor arrived. He took one look at the blood-stained sheets and gasped. The smell was overpowering, but the change in the young girl he had known for years was unbelievable. Her hair was matted with blood and mucous, her once calm eyes screamed in torment. Her skin was blotched and bruised as if she'd been in a fight. And as she thrashed about on the bed, he noticed that she had been incontinent of bloody feces.

    When they finally got her to the General Hospital she was comatose. Dr. Abrams was puzzled. In his forty-odd years of general practice he never seen anything progress so rapidly. And he had a bad feeling about it despite the technology of the intensive care unit. The internist in charge of the unit was worried too. Despite antibiotics, her fever continued to rise. A spinal tap confirmed his suspicions: Gloria had an acute meningitis. Something unknown had inflamed her brain, and continued to do so despite their efforts. Twenty-three hours after admission, Gloria died.

    In a large university, few incidents -even tragedies- are considered memorable outside of the small circle of those directly affected. Gloria's death and manner of dying spread rapidly through the arts faculty, though. It wasn't so much the death that bubbled uneasily amongst the students, it was more the speed and unexpectedness. No one her age should die of an infection. Information was scanty: the cause of death was likely viral in origin and therefore probably contagious. Definite proof and identification were lacking, however. So were source, and means of spread. Where little is known, much is feared, and so for weeks after her death, the university clinics were overwhelmed by students with shades of Gloria's symptoms. Any diarrhea or headache was a source of panic.

    But eventually, as with all things, the memory of her death blurred, and the students resumed their usual complaints of missed periods and vaginal discharge. The horror never quite went away, though. Nor did the trickle of patients keeping Gloria's memory alive.

    Chapter 2

    'University' is a magic word -ask anyone in high school. And for some, to be sure, it stays just that: a word. But for Patti, it had become an elaborate fantasy world, populated by men in tweed with books under their arms who strolled around a tree-lined campus in little groups discussing life, and other important things. Nearby, skirts spread casually on the grass, women who weren't attending classes or writing term papers in the library would gather to dispute current economic policy, and perhaps comment on the tweed. It would be a world of limestone words and sacred halls lined with obscure ideas. Truth would be tacked to bulletin boards, and kindly, grandfatherly old men with twinkling eyes and Shakespearean voices would explain what it meant.

    Well, at least that's how Patti saw it. Patti liked to think of things in metaphors. She fancied herself a tree, absorbing ideas through her leaves; the roots, she figured, gathered words to express them. At other times she was an unbaked cake, ingredients ready, waiting for some special reason to combine. 'Imaginative' was the word her teachers used to describe her but 'impractical' or 'dreamer' might have been equally descriptive.

    Patti had floated through high school with little need for studying, and therefore plenty of time for indulging her vivid imagination. In fact, the teachers had encouraged her fantasies, rightly connecting them with an above-average intelligence trying to make sense of what it saw. They channeled her into the creative arts: drama clubs, poetry clubs, debating societies -any club or forum where she could be allowed to roam freely with her mind. A child needed to be accepted. It helped, of course, that she was attractive; students and teachers alike seemed drawn to her. Short, curly brown hair framing what she liked to think was a freshly-scrubbed face, a dimple when she smiled (which she did often), straight ivory-white teeth when she laughed, and all of these on a Cinderella height of 5 feet, showed off her usually pale blue clothes like a model. Patti dealt with most things in blue; it leant consistency to her actions, she thought.

    The area of her life that had the least consistency, she freely admitted, was the sexual one: a romantic idealism often precluded the experience, and the family rule of home by eleven did little to foster the experiments. This didn't usually bother her, but sometimes -when she was alone- she longed for big breasts, and someone with soft hands. Most of the time, however, she just watched her friends disappear one by one into someone's arms. Intellect, she decided, had made her a coach, not an athlete.

    The truth was, Patti just hadn't met the right man. She knew what he should be: a mature college man -say 25 or so- who smoked a pipe (aromatic blend). And when he was about to express an opinion, he should preface it with, It seems to me.... Perhaps he'd be a writer, maybe a philosopher. An archeologist would even do. At 17, Patti had a lot to do, and she knew a man like that would help. Oh yes, and he should also be athletic or at least outdoorsy, and have his own apartment close to the campus -the two seemed related somehow.

    So it was with this in mind, and the sounds of The Student Prince echoing in her ears, that she chose the only large, but not too distant (her parents again) university that appealed to her. She enrolled in the Faculty of Arts, of course.

    All universities are impressive: it's how they justify their expense. Some do it with money alone -as if display itself were power; others profess a prestige borrowed from the past. Patti liked neither of these options, so she chose on the basis of yet another criterion: setting. Mountains and ocean eclipsed almost everything else. Even so, her school had no less commanding architecture, it was just... eclectic. Considered as a whole, it was captivating, but despite the individual merits of each building, there seemed to be no common theme binding them together. A nucleus of limestone and ivy fed by cloistered paths, would suddenly give way to an alien cement invader whose walls stained like some incontinent old man when it rained. And on the coast, moisture was a way of life. Some buildings had been painted in embarrassment, while others were tolerated like clumsy children. Patti's favorites were the ones covered with cedar planks and set deep in the trees. She imagined they contained big wooden beams, and rooms with stone hearths where professors huddled in the cheery warmth to write their papers.

    The campus was huge; it seemed planted in wilderness on the edge of town, and if she lowered her eyes from the distant cityscape, it was possible to believe she was in a separate world. And with over a hundred buildings, and twelve thousand full-time students, the possibilities were almost infinite: a walk on the cliffs cocooned in mist, swimming in the Olympic pool, bowling at the Student Building, or even life on the freeway in one of the pubs. University was an endless experiment.

    But by the end of the first week and its attendant orientations, initiation ceremonies, and cash layouts, she was thoroughly bewildered. Things

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