Chronic Fatigue Synd

Chapter One

In The Beginning

Poems are made by fools like me,
but only God can make a tree.

— Joyce Kilmer

There is every reason to suppose, Joyce Kilmer
aside, that no man, given his free choice,
would try to make a tree anyway.

— Isaac Asimov

The Earth was practically new, a mere three hundred million yearsold, give or take a few tens of millions of years. Much of the planet was still steaming from the heat of accretion and from the decay of short-lived radioactive elements injected into the solar system almost at the moment of Earth's formation.

From continent-spanning nets of wrinkles and ruptures emerged outflows of basaltic lava wide enough to accommodate the Red Sea. There was steam and dust and radioactivity in the air, and torrential rains. No splashes of green challenged the forces of erosion. Almost as quickly as it formed, the bare bedrock was hewn down into gravel and powder. Where the seas — actually little more than oversized lakes — met land, the beaches were glittering black bands of volcanic sand.

This was the protocell era, from which simple organic molecules emerged as the phenomena we call life. In seas that were only then accumulating from the exhalations and regurgitations of a very young Earth, little bags of protein had already self-assembled into clumps of microspheres and long hollow tubes with tantalizing septaelike divisions. They looked like colonies of living cells, butthey were nothing more than the equilibrium of forms naturally assumed by random collections of amino acids. Their seemingly multicellular arrangement was no different from the behavior of fresh-blown soap bubbles, which form spontaneously into such familiar, stable shapes as hollow globes and hemispherical doublets. Organic microstructures obey the same physical laws and also seek stability. Multicellularity was there at the beginning, on Day One, and was dictated by nothing more exotic than basic physics.

As for what formed the microstructures in the first place, that was no cause for astonishment, either. You can cook up the very same structures in your own kitchen in about twenty hours. Simply take any combination of substances containing carbon, hydrogen, oxygen, and nitrogen, and apply any form of energy — electricity, heat, shock waves — then shake the resulting mixture of protein building blocks vigorously, and you will come up with little bags and tubes of protein: protocells. They are not life (though some of them will scavenge more protein, grow, and divide), and they were not life 4.3 billion years ago, but they were getting close to it.

The truly astonishing thing was that stray bits of crystalline RNA and DNA, riding on the winds and currents, occasionally found their way into protocells. Some would eventually take control of the protocells, and a day would come when protocell descendants — creatures that were then only latent on Earth — would ripple with energy-releasing and -capturing molecules that conducted symphonies written on DNA and performed by protein. Other knots of nucleic acid would form viruses and try to rewrite the score, threatening to throw the entire symphony into chaos.

This is the story of one aberrant bit of nucleic acid, the EpsteinBarr virus, and its impact on one protocell descendant: Homo sapiens, a.k.a. Man — specifically one Charles Pellegrino.

Excerpt From The Diaries Of Charles R. Pellegrino
JuLy 20, 1985
Viral Capsid Antigen Titer 2560

"Epstein-Barr virus," my physician friend with the sheets of blood test results said as we stepped into my office, which is also my laboratory, which is also my bedroom. just three words: "Epstein-Barr virus."

"What exactly does that mean?" I asked.

"Well, are you interested in fascinating diseases?"

"Yeah. Sort of "

"Well, Charlie, you've got one!"

One of my titers is 2560. Of all the diagnostic tests available to my friend Jesse, the titer has been the most telling. It works something like this. In testing for an antibody to a specific virus, an anti-antibody is used. If the anti-antibody reacts with a sampleof my blood, then the antibody to the virus is present and I have, at the very least, been exposed to the virus. To find out how serious the exposure has become, the blood serum is diluted (primarily with saline solution, or "sea water," which is what blood is mostly made of. The specific antibody tested by the viral anti-antibody is intended (by my body) to attack the outer, spherical shell of an invader (the virus) possessing only seventy genes and so small that two thousand of them could be strung side by side across the width of an eyelash. The serum to be tested is diluted to one part serum in ten parts of saline, then one in twenty, one in forty, and so on. At some point the serum becomes so dilute that viral antibodies are no longer detectable. A person who has had mononucleosis, one of the more common manifestations of the Epstein-Barr virus, might produce a viral capsid antigen titer of 20, or even 40. When the titer goes well beyond one part blood serum to 80 parts saline and viral antibodies are still detectable, the physician begins to suspect that he is dealing with a major league infection. When tests for antibodies to other portions of the virus's anatomy are similarly "off the scales," and when serum iron levels are half what they ought to be, copper levels are 25 percent above normal values, and additional blood results indicate a state of inflammation throughout the entire body, the physician knows that the activity and the sheer population density of virus particles in the patient have reached the panic range — especially when people at the blood testing laboratory call from across the continent to tell him he's sent them one of the highest titers on record. "Just out of curiosity," they want to know, "what condition is the patient in?"

For starter — just for starters — I have developed an unusual form of arthritis. The vertebrae of my spine have fused from the base of my neck all the way down. Now my neck is fusing and I cannot get into my car without banging my head. My immune system seems to be confused by the virus. It's attacking my bones and collagen (connective tissue). The very antibody-producing cells that are supposed to defend me against the invaders are not merely losing the war — they've joined the other side!