“Most would be considered young for Alzheimer’s,” Bob said. “Only two are over sixty-five. As for tests on Barker and Hughes, all we have available at the moment is that they are negative for Alzheimer’s.”
“So, we are back to considering whether to send Stanley Kramer’s samples down to New York City,” Jack said, his voice reflecting some impatience.
“What do you think, Melanie?” Bob asked. “Can we find someone to drive down to the city this afternoon?”
“I should think so,” Melanie said. “It is the middle of the summer. People aren’t all that busy. I’d be happy to take the job myself if you could do without me for an afternoon.”
“Hell, no!” Bob said with a shade of humor. “I’m not facing an afternoon of patients without you. But otherwise, I agree. It shouldn’t be that difficult to find someone. Carol might even be willing to do it if she can combine it with a stopover at Macy’s.
“All right, here’s the plan,” Bob continued. “We’ll finish here and clean up, and then we’ll head down to Ted’s Diner for a deserved lunch. Over burgers, we’ll decide the next step.”
Chapter 16
Thursday, July 24, 12:25p.m.
Essex Falls, New York
Jack and Laurie were thrilled to return to Ted’s Diner, and walking in with Dr. Bob, as he was generally known around town, was like walking in with a movie star. Just about everyone in the restaurant came up to say hello, including Ted himself. It turned out the elderly man with the not-so-clean apron manning the grill and the fryer was none other than Ted. Also, one of the older women servers in the matching black dresses turned out to be his wife, Charlotte.
“I’m impressed with the service you get here,” Laurie said after Charlotte had seated them at the only freestanding four-top table in the restaurant and taken their drink orders. The table was situated in an alcove at the very front of the restaurant looking out at Main Street. Apparently it was a table reserved by Ted for the town’s celebrities, like Dr. Bob.
“Ted and Charlotte’s fifth child had some medical issues,” Bobexplained. “They ended up having to spend more time with me than they would have preferred.”
“Bob is being much too modest as usual,” Melanie said. “He managed their child through a very difficult and serious episode of leukemia, eventually achieving a total remission.”
“That’s truly wonderful, Bob,” Laurie said with sincere respect.
“Well, you do what you can,” Bob said offhandedly while blushing. Then: “What’s everybody going to have? My treat!”
They all ordered hamburgers with several portions of French fries for the table.
“Laurie, I want to thank you for walking us through the autopsy this morning,” Bob said the moment the waitress left. He had to talk loudly to compete with the overall noise level in the old diner with its tile floor and embossed metal ceiling. “I certainly could have benefitted from such a tutorial before I did my first autopsy. Unfortunately, I didn’t know what I didn’t know.”
“Autopsies generally are not difficult,” Laurie said. “The important thing is to be thorough and consistent.”
“I get it,” Bob said.
“Let’s talk about neurodegenerative disease,” Jack suggested. “Or is it too noisy in here? Or is it too depressing over lunch? What does everybody think?”
“I don’t mind,” Bob said. “Do you mean Alzheimer’s disease in particular?”
“No, I’d like to discuss neurodegenerative disease in general, of which Alzheimer’s is a prime example. I would have signed Stanley Kramer out as probable Alzheimer’s disease pending further testing, but you have said that today’s case looked like and clinically resembled your two previous cases, Barker and Hughes, and bothof them tested negative. In my book that means Stanley is probably going to test negative, too, wouldn’t you all agree?”
Everyone nodded.
“So where does that leave us?” Jack questioned. “I’d have to say ‘up-the-river-without-a-paddle.’ Then, looking directly at Bob he added: “Tell me again! In theNew York Timesarticle you cited involving the mysterious outbreak up in New Brunswick, Canada, what brain disease were they worried about?”
“Creutzfeldt-Jakob disease, at least initially,” Bob said.
“Whoa,” Jack said. “Meaning mad cow disease, which certainly caused one hell of a stir when it popped up in England some forty years ago. What was the ultimate outcome in New Brunswick?”
“Strangely enough, the New Brunswick cases ended up testing negative for mad cow disease, similar to our cases testing negative for Alzheimer’s. Ultimately and luckily, the New Brunswick outbreak then just petered out and stopped over several months. Unfortunately, not before quite a number of people sickened and died.”
“It’s encouraging that it at least stopped,” Jack said. “So, there was no ultimate diagnosis made in that episode.”
“Certainly not when the article was written,” Bob said. “And I never heard any follow-up, which I’ve looked for, so I guess, no, a final diagnosis wasn’t ever made.”
“Too bad, because it seems we’re facing a remarkably similar situation,” Jack said. “The difference is that here it doesn’t appear like whatever is going on is stopping, at least not yet.”
