[Mid] an expl'n of what happened with Jafar

There was quite a number of people who asked for some of the science behind
what happened to Scott, and a couple requests to post it on the 'bridge. I'm
coming at this from an almost-finished Ph.D. in medicinal chemistry, so if
you've better knowledge of this information than I, you're probably right and
I'm probably quoting an obsolete memory. I may also come off more blunt and
crude than some of you would prefer, but it's the only way I can relate this
right now.

Right after Thanksgiving, Scott came down with a strep infection. Strep B to
be exact, a relatively new strain (10 or so years) and one which is decidedly
immune to most antibiotics. It's also enormously virulent, capable of taking
you from healthy to deceased in less than 100 hours, but otherwise just kinda
feels like strep when it starts; it's what killed Jim Henson a number of years
ago. The mutation which turned "normal" strep into this beasty involved a
single change in a single base on a single piece of RNA. Amazing and
interesting piece of biological adaptation from a scientific standpoint. Damn
annoying from a personal one.

They knocked him out (because an intubator is not a comfortable thing) and threw
some fairly significant antibiotics at him real early on. Which gave us a month
to get ready instead of a few days. With the help of the drugs, he cleared the
infection. Unfortunately, the extremes his body went through to win the battle
left him with a case of toxic shock -- basically the extremes his body had to go
through to beat the bacteria also beat the crap out his own organs. One of the
problems with TS is Adult Respiratory Distress Syndrome (ARDS). ARDS is a
side-effect of the healing processes of the lung. Anywhere else in the body,
you get injured, scar tissue forms on the injury, the scar tissue falls off, and
you're back to normal. Getting scar tissue on your lungs means that part of the
lung can't do it's job.

Scott was clearing that second hurdle when he was hit with a secondary
infection, a Gramm-negative rod bacteria, a cousin to E.Coli. "Gramm-negative"
is a term used to desribe a quick and simple test to classify the kind of
bacteria you have (invented by Mr. Gramm). E.Coli isn't always that bad, you
all have some in your intestines right now, and in there it's harmless. But ths
one got into Scott's bloodstream and we started the cycle over again. This
time, the bacteria caused his lungs to fill with fluid (basically pnemunoia).
More really powerful antibiotics later, he beat bacteria number two. But he
went into toxic shock again. And went into ARDS again. All this was too much
for his lungs, he couldn't keep oxygen in his blood, and he died.

The doctors aren't sure where the first bacteria came from (it's likely
airborn) or how it got into Scott. They do think that it's prone to enter
through cracks in the skin, and Scott had a skin condition which left parts of
him (like his arms) looking rather scaley (which is part of the reason he wanted
a lizard on his device). So, who knows. The secondary infection came because
he had been in the ICU for about three weeks. Hospitals are where sick people
go, so the bacteria follow. The ICU is a playground for the worst of the worst,
a fact of life that ICU physicians try to get used to, but never really do. The
second infection was acutally a meaner bug than the first, but he probably
wouldn't have blinked at that one if he'd been a little healthier. More if's
and what if's.

So what do we do to "not get it"? Well, I can tell you that none of the
hospital staff came down with any of this, and nobody who spent time with
Scott right before the illness has gotten more than a sniffle. Ditto for
those of us who spent all that time in ICU Waiting Room 1. And my feet get
cracked if I don't keep lotion on them, so maybe I coulda gotten it much like
he did. But I didn't.

What else... don't take antibiotics unless you've got a bacterial infection.
Then take the whole prescription. Saving the last 8 pills for later when you
get the sniffles means you're leaving the resistant bacteria within you alive to
spread to the next fella. And popping those pills later just does the same
thing to a whole new batch of bugs. Keep track of your health, and when you
feel ILL, see a doctor. Expecting to clear it by yourself may be the last
decision you make. Wear socks ("Socks are your friend" was one of Scott's
Pennsic Mottos).

That's basically it. If you want more scientific-y gobbelty gook, email me and
I'll throw lots of biochemistry and molecular biology your way privately.
Believe me, I restrained myself a whole lot to stick to the point (I tend to add
oodles of anecdotes and forget the story I'm relating). I don't really remember
the names of the drugs they had him on, though. This is probably not a good
thing for somebody who's looking to make drug development his trade.

adam comyn
From: Adam Zabell <zabell@stanley.bio.purdue.edu>
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Received on Tue Jan 6 17:50:09 1998