"Rejection?" Patrick asks.
"Yes. In essence, you're trying to convince your body that the donor cells are actually yours, because you have the same six proteins on them. If you can't do that, your immune system will reject the bone marrow transplant, which leads to Graft Versus Host disease."
"Like a heart transplant."
"Exactly. Except this isn't an organ. Bone marrow is harvested from the pelvis, because it's the big bones in your body that make blood. Basically, we put the donor to sleep and then stick needles into his hips about 150 times on each side, suctioning out the early cells."
He winces, and the doctor smiles a little. "It is painful. Being a bone marrow donor is a very selfless thing."
Yeah, this guy was a fucking altruist, Patrick thinks.
"Meanwhile, the patient with leukemia has been taking immunosup-pressants. The week before the transplant, he's given enough chemotherapy to kill all the blood cells in his body. It's timed this way, so that his bone marrow is empty."
"You can live like that?"
"You're at huge risk for infection. The patient still has his own living blood cells . . . he's just not making any new ones. Then he gets the donor marrow, through a simple IV. It takes about two hours, and we don't know how, but the cells manage to find their way to the bone marrow in his own body and start growing. After about a month, his bone marrow has been entirely replaced by his donor's."
"And his blood cells would have the donor's six proteins, that HLA stuff?" Patrick asks.
"That's right."
"How about the donor's DNA?"
Dr. Bessette nods. "Yes. In all respects, his blood is really someone else's. He's just fooling his body into believing it's truly his."
Patrick leans forward. "But if it takes-if the cancer goes into remission-does the patient's body start making his own blood again?"
"No. If it did, we'd consider it a rejection of the graft, and the leukemia would return. We want the patient to keep producing his donor's blood forever." She taps the file on her desk. "In Glen Szyszynski's case, five years after the transplant, he was given a clean bill of health. His new bone marrow was working quite well, and the chance of a recurrence of leukemia was less than ten percent."
Dr. Bessette nods. "I think the prosecution can safely say that however the priest died, it wasn't of leukemia."
Patrick smiles at her. "Guess it felt good to have a success story."
"It always does. Father Szyszynski was lucky to have found a perfect match."
"A perfect match?"
"That's what we call it when a donor's HLA corresponds to all six of the patient's HLA."
Patrick takes a quick breath. "Especially when they're not related."
"Oh," Dr. Bessette says. "But that wasn't the case here. Father Szyszynski and his donor were half-brothers."
Francesca Martine came to the Maine State Lab by way of New Hampshire, where she'd been working as a DNA scientist until something better came along. That something turned out not to be the ballistics expert who broke her heart. She moved north, nursing her wounds, and discovered what she'd always known-safety came in gels and Petri dishes, and numbers never hurt you.
That said, numbers also couldn't explain the visceral reaction she has the minute she first meets Quentin Brown. On the phone, she imagined him like all the other state drones-harried and underpaid, with skin a sickly shade of gray. But from the moment he walks into her lab, she cannot take her eyes off him. He is striking, certainly, with his excessive height and his mahogany complexion, but Frankie knows that isn't the attraction. She feels a pull between them, magnetism honed by the common experience of being different. She is not black, but she's often been the only woman in the room with an IQ of 220.
Unfortunately, if she wants Quentin Brown to study her closely, she'll have to assume the shape of a forensic lab report. "What was it that made you look at this twice?" Frankie asks.
He narrows his eyes. "How come you're asking?"
"Curiosity. It's pretty esoteric stuff for the prosecution."
Quentin hesitates, as if wondering whether to confide in her. Oh, come on, Frankie thinks. Loosen up.
"The defense asked to take a look at it, specifically. Immediately. And it didn't seem to merit that kind of request. I don't see how the DNA results here make a difference for us or for them."
Frankie crosses her arms. "The reason they were interested isn't because of the lab report I issued. It's because of what's in the medical files."
