Darren meandered through the temporary corridors of the expansive conference center, thoroughly enjoying his university-sanctioned vacation to Baltimore. A glance at Darren Lejeune would betray his identity as a scientist. He wore a light blue shirt with his khaki pants, both lightly rumpled. His tie proudly displayed some cartoonish dolphins, and his glasses were appropriately thick. While he currently donned scuffed brown dress shoes, it was not an uncommon occurrence for Janet to scold him for wearing his old running shoes to work. Though he had always been a skinny fellow, having reached his late 40’s, age was now beginning to bestow some roundness to his middle. He still tried to call them “accents,” but the gray patches that had started in his sideburns had almost conquered his head. His hair long was usually long enough to be unruly, and one could tell that there were only rudimentary attempts to control it each day. His green eyes were lively and cordial and sat underneath furry brows that seemed to be perpetually arched in surprise.

He was in town for the National Symposium For Academic Microbiology, and he was pleasantly anxious to be one of the featured speakers this year. He currently found himself in the poster room, where bacteriological researchers proudly exhibited their projects. He spent most of his first day at the symposium glimpsing his way through the posters, jovially quizzing the graduate students standing next to them. While two projects stood out from the rest as the most interesting of the bunch—one describing a protein hormone produced by Pseudomonas species in acidic environments and another proposing a novel method of energy production in anaerobic bacteria—Darren could not find much that seemed overwhelmingly useful or revolutionary.

Since he had already been planning on travelling to the area for the conference, the short trip up north to the community hospital in Pennsylvania where Beth worked was an easy proposition to acquiesce. In addition, he was actually curious about what she had told him.

She had tried to enlist Darren’s services before, to his embarrassment. She consistently made the mistake of believing him to be a clinical microbiologist, which he was not. He had very little expertise regarding the symptoms and diseases that accompany bacterial infections in the human body; Darren’s knowledge centered on the characteristics and classifications of bacteria in the environment. Thus, he was surprised to find that there was a chance she actually had real use for his skills. Their arrangements called for her to pick him up after the conference and brief him on the specifics as they travelled up to her hospital in Pennsylvania. He was curious about the case, but he pushed it out of his mind in favor of more pressing matters.

The task more deserving of his attention at the present moment was the keynote presentation which he would soon be giving to his colleagues and their Ph.D.-seeking protégés. He had just begun to notice the anxiety that had been steadily building inside him. Even though he was very familiar with the material—but for a few tweaks and updated citations, it was the same one he had given dozens of times before—he always worked himself into a mild panic. This forced him to rehearse and prepare, which in turn ensured that he would address each of his points with the exact emphasis they deserved.

People who knew him described Darren as carefree, but that is not to say that Darren did not care. The conversational manner of Darren’s discussions of complex coral concepts was the kind that can only be a product of an intense and thorough understanding. As he went about organizing his thoughts into a comprehensible network, Darren ambled slowly around the convention center.

As he walked, his right hand worked furiously. At first glance, one might think he was typing on an invisible keyboard in front of his face. Upon closer inspection, however, it would become clear that Darren was not just typing—he was moving, editing, and arranging the numerous chunks of knowledge floating in his mind. Squinting as he walked, Darren was clearly not looking at his immediate physical surroundings. He technically saw them, of course, because he never actually collided with other humans or walls, but his focus was on something else. He concentrated, deeply, on a mental grid a few inches from his face. This was his staging area, the place where he could encounter the things he knew, pick them up, look them over, and see what they were really like. Swift, subtle strokes of his fingers dragged and rotated his ideas into their proper places. Darren always just said that, after years of Tetris, his mind had finally been assimilated by the game. But most people that knew him assumed his mind would still work that way even if he had never played Tetris.

This trance-like state of squinting and furious finger-work was a long-running habit for Darren, and those familiar with him merely shook their heads and smiled when they saw him enter into his patented trance. People who were new to the spectacle thought it was quite weird, but they wrote it off as one of those idiosyncrasies that often arose in the quirky scientific community. Thus, the other attendees at the convention allowed Darren to prepare for his upcoming address in peace.

A few short hours later, Darren stood to the left of the podium with hands clasped. He surveyed the room as Dr. Jiao Yang wrapped up her introduction of him. He had met Yang when they were post-docs at Vanderbilt; she had since moved on to a full-time faculty post at Case Western Reserve University. She was black-haired and skinny, perky and intellectual.

“There exists a certain stigma regarding the world of science that believes most great achievements are no more than serendipity. This popular myth follows that the great ‘Eureka!’ moments are nothing more than accidents, that the discoveries, which continually push against the boundaries of our human understanding come about when a bumbling but well-intentioned researcher, usually one with crazy gray hair and a mustache, falls backwards into this while solely focused on that.

“Strangely, I have found that this myth is propagated not only by the external public, but also by the scientific community itself. The reasons why we scientists actually support an idea that minimizes the respect we are due for our work are debatable. Perhaps we enjoy this light-hearted, romantic view of science, or perhaps we are actually cutthroat enough as to want to reduce the grand achievements of our colleagues to moments of dumb luck. Regardless of the origin of the myth, people like Darren Lejeune are thinking proof of its falsity.

“People like Darren Lejeune identify the patterns present in seemingly incomparable situations. Rather than being given this while looking for that, they possess the peculiar kind of brilliance required to notice the pieces of a revelation. Their minds bring into focus the blurry details lurking on the perimeter of a scene.

“Dr. Lejeune, though he never admits to it, sees the connections between concepts. His mind places a familiar thing directly beside a foreign thing and automatically seeks out the ways that they hang together. Dr. Lejeune’s mind, either subconsciously or not, knows that events and processes are usually universal.

“I remember hearing Darren tell me how he first developed his Dome Theory regarding the structure of Acropora corals. No one knew at the time how individual corals collectively formed the beneficial reef shapes, despite no tangible connection to one another. It had always been one of those unsolvable mysteries. How were these primitive, miniscule critters coordinating their architectural efforts—even across species—to form the dome shape that serves every member of the colony? Enter Darren. While visiting a reenactment of some old American war with his family, he looks up into the sky and sees a flock of geese. They are headed in one direction, and then, suddenly, they change. Darren was so excited, ‘They all got the memo, just bam. North to South. Instantaneous.’ So, of course, it gets him thinking. And he realizes, from that, that corals aren’t thinking as a group. Each just does what’s best for itself. There is no group mentality. When every one is preprogrammed to act on its own to a given stimulus, we get what appears to be a coordinated response. Simple economics. Pretty soon, Darren has formulated the Dome Theory.

“And that’s science, to Darren Lejeune. The details fall out as soon as the general concepts are given a good shake, but the concepts themselves are big and sensible. Ideas fuel discoveries.

“I have known Dr. Lejeune for twenty years now, and I have yet to regret a single one. In that time, I have come to realize that he sets a precedent we would all be wise to follow. And so, it is my honor to present a great scientist and a good person, Dr. Darren Lejeune.”

Darren smiled awkwardly as he stepped to the podium. He was nervous, but his hours of preparation masked any sign of it from his audience. After thanking Yang for the insightful and overly complimentary introduction, he clicked a button and the first slide of his presentation flashed onto a screen behind him.

“My fellow scientists,” he began, “I have been exploring the tiny lives of coral bacteria for over 20 years. During those first few collegiate years, I was absolutely zealous in my research. Then, however, I made the disappointing discovery that reefer has in fact very little to do with reefs. My fervent curiosity may have dipped a little at that point, and of course it’s not easy spending all your time with single-celled creatures that are always trying to infect you, as I am sure you can all appreciate. But if you keep at it for a few decades, you get to know the little guys pretty well. You maybe begin to understand where they’re coming from, these bacteria. And if you spend enough time alone in the laboratory without sleeping, you start to think that maybe them and you aren’t so very different. Maybe they get lonely too? Hell, if he had had a microscope to witness the microbic need for colonies and hosts, John Donne could just as easily have said ‘No bacterium is an island.’

“And it’s true. After all this time hanging out with biologists, one thing has been continually pounded into my mind—organisms work together. Living things depend on teamwork to survive and thrive. And bacteria are no exception, far from it. They, probably more than any other group, utilize cooperation with other types of organisms to succeed.

“And we all know that humans are no exception, with our millions upon billions of gut flora. But isn’t that idea a bit counterintuitive at first? It is to me, at least. Bacteria are supposed to be greedy, evil little creatures. That Streptococcus did not offer me anything in return for the pieces of my throat that it consumed. And Streptococcus definitely does have plenty to learn about sharing. But on the other hand, we have Bifidobacterium, which already has an excellent grasp of the golden rule. It lives in the glorious shelter of our colons, waiting patiently for the masticated tacos and bagels that we so eagerly provide it. Then it goes to work, making short work up the digestive process, as we sit unaware. Anyone who has unwittingly killed their normal intestinal flora with an over-zealous antibiotic can appreciate the daily work done by their unsung Escherichia’s.

“But I, of course, work with coral. Always have, always will. Who could blame me—they are way more colorful than lab rats, and they scream less than humans when tested with strange chemicals. And corals have adapted to life with bacteria over the years to the point that they have essentially perfected the relationship. Now, coral cannot exist without their microscopic brethren, and most of the microbes could no longer survive without the corals.

“They have become one; they have specialized to the point that the question of what one would be like without the other is now irrelevant. That would almost be like asking what the rest of your body would be like without your skin. You would be dead. We are seeing the coral equivalent increasingly often in nature: corals bleach and die in weeks if they lose their little helpers.

“Let’s not get crazy, though, it is obviously a different situation, right? Humans beings are a single advanced organism while the coral ecosystem consists of corals and all the other kinds of species, be they bacteria or algae or amoebas or whatever. The distinction would seemingly be obvious—numerous lesser species or a single advanced one? While it might be the number of hours I spend in the vicinity of formaldehyde, that distinction is getting a bit sticky in my own mind.

“Your body contains all sorts of different systems. You have an immune system composed of lymphocytes that fight disease, a musculoskeletal system containing muscle fibers that move you around, and a nervous system with nerve cells that process data. Which one are you? You are the sum, the combination itself. You have specialized cells running around doing this and that to contribute to the whole. You are an ecosystem. And as such, there is a great deal to learn from the most famous of the organism-ecosystems, the corals. Allow me to explain…”

As Darren laid his words before the audience, he could not help but notice one individual who seemed to always be at rapt attention. Upon each scan of the crowd, this particular man in the front row demanded notice, and not merely for his garish attire, though he did stand out from the other dull and ruffled scientists in his yellow silken shirt. His stare was what truly set him apart.

The man’s dark eyes, under a pair of thin, curled eyebrows, focused unwaveringly upon Darren. They refused to blink, as if it were simply beneath them. Even as he spoke, Darren could ascertain the message sent by the eyes, which remained slightly squinted yet very wild. They expressed interest without curiosity, approval without surprise. Darren got the feeling that the man was not learning new information, but happy to hear someone explain what he already understood.

Upon ending the presentation, Darren left the stage quickly and exited the room through the back door. He was in a hurry to meet Beth, who had seemed very eager to get him to the hospital as fast as possible.

He stood loosely, hands in his pockets, as he perused the lobby for her presence. She was now 15 minutes late. This did not surprise Darren, even after her fervent desire for promptness. He sighed.

It was then that he noticed the man wearing the yellow shirt—something in the vicinity of a bright goldenrod—walking directly at him. His speed was such that his long, black hair was disturbed by the wind resistance. The dark eyes were once again fixed upon him. Before either had said a word, the man’s hand was extended towards Darren. He took Darren’s hand, gave it not a shake but a quick pull inwards so that he simultaneously grasp Darren’s shoulder with the other hand.

“It is”—the man paused here before continuing—“so very exciting to meet someone with such a proper understanding of the world. Thank you, professor.”

The man stood very still after saying this, still holding Darren’s hand and shoulder. His eyes were slightly wider than before and, to Darren’s discomfort, very much looking at him.

“Thanks, I appreciate that… and, I guess, you’re welcome?” said Darren as he released his hand and leaned back, away from the eccentricity of the yellow man. “But I have to apologize; I can’t say that I recognize you.”

“Ah, yes, professor—we have yet to have the pleasure.” His pencil-thin mustache jumped up and down as he spoke, exaggerating his words. It was distracting. “My name is Amos Culliford, and I believe in progress. I thus accept you as a friend, professor, as you are a believer in nature, and there is, of course, nothing quite so progressive as nature—the dear essence of life, striving forward with her resolute mechanisms of constant change.”

Darren paused for a moment, somewhat unnerved by the persistent stare of the dark eyes.

“Yeah, I have to agree with you there, Amos. Seems like standing still is falling behind, right? Humans or corals, we’re all fighting the same fight.”

“Precisely!”

Amos Culliford continued to stare intensely at Darren, seemingly oblivious to the awkward pause. He was unusually tan for a laboratory researcher.

“So, Amos, which university are you with? Are you a post-doc, or—”

“I now have the great honor of freedom, professor. I claim independence! After so many years of senseless turning as a cog in the academic machine, I am thrilled to currently find myself at the helm of my soul. The good Lord, the Force behind the worlds, has indeed seen fit to bless me with significant fiscal glories. In order to be a good steward of the resources entrusted to me, I knew that I must escape the traditional boundaries inherent in government-funded ventures. Thus, I am now involved solely in private projects. You can imagine the exhilaration in that, professor!”

“Yeah, that’s the dream. You get to think about the science without slaving over grants all day.”

“It is wonderful. But I should add in further response to your previous query that I cannot consider myself to be a pure scientist at present, though I do contribute to many who do. My irons are certainly in many fires, but I find that the post which is most prominent in my life is my role as head of a private research institute known as the Quedah.”

“It sounds like you have a great thing going. What brings you here?”

“New ideas, professor. I like to be well-versed on all frontiers of intellectual advancement. Your presence, especially, attracted me to this site. And after hearing your words, I am convinced. We must continue to discuss your ideas, but I would prefer to do so in a freer venue. I am just beginning to become acquainted with my new yacht. You must come sailing with me, professor. Bring your family, of course! I know you are a man of the ocean.”

At that moment, Darren breathed a deep sigh of relief at the sight of Beth Farmoore hurrying across the lobby. He turned to Culliford with newfound resolve to end the encounter.

“Yes, but I would rather be in it than on it. Besides, the kids get motion sickness pretty easy just in the car, so—Beth! Great to see you,” he said as he gave her a hug. Then he quickly added, referring as much to the present as the general past, “It really has been too long.”

“Yeah, sorry, traffic and things. Sorry. I missed your talk; I’ll need the colloquial edition in the car. Which is where we need to head now, actually, seeing how it is very double-parked at the moment.”

“Amos Culliford,” said Culliford, extending his hand to Beth.

“Beth Farmoore,” she replied. “Sorry to greet and run.”

“Thanks for the offer, Amos,” Darren said to Amos as Beth was pulling him across the lobby. “Good luck with your—er—work.”

“And you with yours! I look forward to the time we meet again,” said Culliford.

Within minutes, they were en route to Oswald H. Adams Community, Beth’s home hospital, located in central Pennsylvania. Although the trip from Baltimore to Adams Community would usually require a good two and a half hours, Darren felt confident it would be somewhat shorter with Beth at the wheel. As always, her appearance conveyed efficiency and professionalism. While so often the hectic schedule of a physician persuaded her colleagues to undergo only the bare essentials of personal upkeep, Beth had escaped the trap. Her chestnut hair always hung in neatly formed curls ex to the tops of her shoulders. She did not fight the years that showed on her face but rather embraced the wisdom they suggested. Her skin naturally carried a touch of healthy color whether or not it had recently been exposed to ultraviolet rays. The vulnerability of large brown eyes contradicted the no-nonsense air of thin, tight lips.

“So the guy presents with severe fever and fatigue, his heart is pounding out of his chest, his respirations are elevated, and his white blood cell count is nice and high—all the great clinical signs of bacteria in the blood,” Beth said as she negotiated her way through the hectic freeways of Philadelphia on her way towards Adams Community. Her attention seemed to be focused on the road as she darted between lanes, but she proceeded in her explanation unfazed. “We try to culture his blood, but nothing grows. We’re confused, but we go ahead start with the standard broad-spec antibiotic regimen.”

“Which ones?”

“Vancomycin and a fourth generation cephalosporin, which are pretty typical for us in cases of sepsis without a known bug, and then we threw in gentamicin.”

“Sounds great,” said Darren as he shrugged agreeably. “I’m with you so far. You’re the doc.”

“Right. So we give it a few days, and things aren’t changing. The guy has no traumatic injuries; he’s not immune compromised. Something should be happening: either he should get better or get way worse. I’m looking for options, and on a whim¸ I decide to throw his blood on a flow cytometer. Sure enough, we see something bacteria-sized—and from the look of it, there was a lot of the something in his blood. We go back to check the cultures, and there’s still nothing. Pretty weird. We start trying all sorts of different culturing conditions, and eventually we get something. Turns out that temperature and nutrient-base don’t matter, but we needed to increase the—“

“Salinity,” said Darren. He was smiling. “I am guessing that you have a halophile on your hands? I suddenly feel a tinge of usefulness.”

Beth was looking at him with a hint of feigned annoyance.

“Yeah, that’s it—the bug needed salt. Once we gave it some, it showed up on the plates. With nothing else to do, we ran the PCR, and the closest match is a Vibrio. Suffice it to say, none of us are all that familiar with Vibrio infections.”

“So, vanc, gent, and cefepime—that sounds great. A dude gets a raging infection, broad spec antibiotics are initiated. The bug gets slowly wiped out, whether it’s Vibrio or not, but the dude takes a little while to recover after the infection clear. I’d guess he’d be back to normal before too long, right? Cool case, but it doesn’t seem too weird.”

“You wouldn’t think so, but his blood is still full of bacteria. The levels have actually shown a small but steady increase ever since—the bug is still growing.”

“That is bad news. But—I mean—I feel sorry for the guy, but what exactly is my role here? I don’t really know how useful I can be, outside of providing false hope by masquerading as a clinical expert.”

“He’s not dead yet, even though he should be. I am taking that seriously; we can still beat it, as long as we kill the bug. But that is becoming a huge problem. Darren, I try to stay current on any conventional human pathogens. But this one is, well, foreign. It’s related to Vibrio by PCR, but it doesn’t act like any Vibrio I’ve heard of. It’s got me pretty confused. That’s why I wanted to get you involved. I know the bacteria that usually matter to people, but you focus on the rest of the microbial world. You know, the irrelevant bugs.”

“Well, not to be vain,” answered Darren. “But I have always considered myself the foremost expert in the field of irrelevance.”

They arrived at Oswald H. Adams Community Hospital late in the afternoon. It serviced a town small enough to require only one hospital, but the inhabitants were numerous enough—and unhealthy enough—to ensure a healthy volume of customers. Since it was Saturday, the parking lot was relatively empty. However, the hospital did require a number of unlucky healthcare personnel to show up on weekends for the patients who had the gall to become sick outside normal business hours. One of these was Bill Crabtree, a fellow physician in Beth’s internal medicine practice. The members of the practice shared in-house call responsibilities on the weekends. Each took one weekend every six weeks; this was his.

Beth and Darren found him in the physician’s lounge on the second floor. While it is often a stretch to refer to common rest areas in professional buildings as “lounges,” the term was quite apt in this case. Bill sat on a leather recliner, feet raised, watching reality television on a large flat screen TV. His stethoscope lay on a table beside him, next to a half-eaten blueberry muffin.

“Dr. Crabtree,” said Beth as they approached him, emphasizing the word doctor. She said it patronizingly and left it to him to decide whether or not she was joking. He made a grand motion out of turning his head to look at them, as if to compensate for the fact that he had no intention of leaving the chair. His hairline had receded substantially, but numerous solitary hairs remained on the top of his shiny head, as if the balding process had left these wispy stragglers behind. His wide eyes, perpetually watery, peered at Darren through thick-framed glasses. It was not that he was a bad doctor; it was just hard to believe he was a good one.

“Hullo, Beth,” he said warmly. “Nice of you to visit me during my call weekend. Can’t drag yourself away from the hospital, eh?”

“Nope. Not all of us are as adept as you at forgetting about this place when we aren’t here.”

“Well,” he said, mistaking her words for a compliment, “I just make sure there’s always some time left to focus on myself. It’s about priorities, you know. It’s all a balance.”

“It is. This is Dr. Lejeune, by the way, he’s with ID. We just came in to check on my patient.”

“Oh, yeah, Mrs. Nevins is still having that profuse diarrhea. Good idea to bring in the infection doc—I mean, my God, the color alone is pretty concerning, and when you throw in the odor… I mean, it’s not even necessarily bad, it’s just—“

“No, Bill, it’s about Mr. Roth. Albert Roth. The old guy with the crazy bloodstream infection. The guy we’ve been talking about all week.”

“Oh, that guy. He died.”

“What? Seriously? When?”

“This morning. Nursing called me around nine and said he was going down the crapper. By the time I got up there, his blood pressure was on the floor and he was circling the drain.”

“Shit! He’d been stable for so long.”

“Well, I think he might have been septic. Sepsis can do that, you know. I’ve seen it. It’s an unpredictable disease, you know.”

“I’m aware, Bill.”

“Oh, and it turns out the infection wasn’t very mysterious after all.”

“What do you mean?”

“They got another set of blood cultures once he started to crash, and it grew E. coli. Four out of four bottles positive. Must have been pretty heavy in the blood, too, since it’s already growing from this morning.”

“Shit. Shit! I’m sorry, Darren. I guess I brought you out here for no reason.”

“Well, hey,” said Bill, “we can have him take a look at Mrs. Nevins while he’s here at least. We really need to get her stool situation figured out.”

Darren’s Florida-darkened skin became suddenly pallorous, and his eyes widened in horror. He turned to face Beth only. “Uh, actually,” he began, “I might want to take a look at the cultures for the, um… the deceased fellow. Is the micro lab in this building?”

Beth nodded slowly while also smirking at the prospect of Darren approaching a malodorous patient. She signaled their departure to Bill with a wave of her hand, and they exited the lounge.

They traveled to the basement in search of the pathology laboratory. Beth had been there on a few previous occasions to speak with the pathologists regarding their reports, but probably not more than a half-dozen times in all during her long tenure at the hospital. Darren could not help but notice that the lab was situated beside the hospital autopsy facilities, which included the morgue. Thus, he mused, while they examined the cultures of living bacteria, the man from which they had been taken would be lying dead just a few yards away. The path lab itself consisted of a winding corridor lined with lab equipment, at the end of which was the micro department where the bacterial cultures would be located.

On account of it being late afternoon on a Saturday, the laboratory was largely empty. There were occasional small bays of lab space extending off of the main corridor, and a few lonely technicians sat in these little bays placidly running tiny vials of blood through grey, plastic boxes that sat on the desktop. One or two of them looked up while Darren and Beth walked by, but Darren got the sense that they didn’t really notice them in any meaningful way. The grey boxes, each about the size of a microwave, performed very important and very distinct functions. In reality, by analyzing the blood taken from patients on the wards, these boring boxes provided as much value as any person or thing in the hospital. Some measured electrolytes, some measured blood cell counts, and some measured dissolved oxygen and carbon dioxide; but one could not easily see any difference between the anonymous gray devices with a casual glance. Despite numerous fluorescent lights, the lab seemed to have a strange dimness about it.

Darren and Beth reached the end of the corridor and entered a separate room containing two metal workspaces designed for handling bacterial specimens in a sterile environment. A glass screen slid down in front of one’s face, allowing one to work with the bacteria without fear of inhaling them. One wall was lined with incubators, which were very much like refrigerators with glass doors, only they kept things hot rather than cold. They maintained the bacterial colonies at 37 degrees Celsius. It was no accident that the perfect temperature for growing these particular bacteria was the same temperature as the inside of a human body. One could see limitless Petri dishes stacked on the shelves inside the incubators.

“So is the pathologist here now?” asked Darren.

“I doubt it,” said Beth. “They take call from home. I am sure there is some kind of emergency that would inspire them to come in on a weekend, but I don’t think I’ve ever witnessed it.”

“Are they going to mind a stranger looking at their cultures?”

“No, they’ll be fine. It’s probably an honor for your kind, right? Somebody taking an interest in your work, like showing off your craftsmanship to other artists at a gallery.”

Darren shrugged. “Sounds good.”

“Besides,” said Beth with a touch of indignance, “these are my cultures anyway. They came from my patient.”

They found Albert Roth’s collection of Petri dishes, and Darren set to work on the cultures taken earlier that day. The dishes contained a thick, amber-colored, gelatinous material called media that was rich in nutrients and bacterial fuel, and Roth’s blood had been scraped along the surface of the material (or “plated”). Bacteria present in the blood grew up in little white circular colonies wherever they stuck to the surface of the media. Many of these circular colonies had already become confluent with one another, which indicated that there had been a large amount of bacteria present in the samples of blood from the morning. Darren could not tell much from looking at the colonies with his naked eye, but he recognized the short, red rods in the microscope once he put them on a glass slide. A quick perusal of the results of the biochemical tests that had already been performed confirmed to him that it was in fact Escherichia coli growing on the plates. One of the most common bacterial pathogens in the hospital, E. coli infections certainly did not necessitate Darren’s presence. He moved on to the prior cultures.

She handed him the dishes that contained salt-enriched media, which allowed for growth of halophilic (“salt-loving”) organisms. These colonies too had become confluent across the surface of the media, due to the long duration that had passed since they were first plated. After preparing the slide, he peered through the microscope at what appeared to be little red commas.

“What do you think? Could this just have been the early stages of the E. Coli infection that killed him?” asked Beth.

“Not a chance. They’re Vibrios alright—this is not the same infection that he died of today. You’re sure this came from the blood?”

“Yeah. Could be a contaminant, though, I guess.”

“I doubt it. It’s tough to come by a halophilic Vibrio by accident. Invasive infection is rare for them, though. I’ve heard of Vibrio vulnificus doing it, but I don’t know if any other kind gets into the blood with any regularity.”

“Where does one come by a halophilic Vibrio?”

“In the ocean.”

“So the blood is a crazy place for it, then?”

“I don’t think it’s a common place for it to be, but it’s not really unnatural, per se. The chemistry of ocean water is pretty similar to the chemistry in blood, as far as the electrolytes are concerned. I mean, we all came from the ocean originally, right? We mammals just carry a bit of it around with us for nostalgia’s sake.”

Beth looked slightly annoyed. Darren had known her long enough to realize that the frustration was not directed at him, necessarily; she just did not like loose ends. She pursued truth relentlessly once she got started on something.

“So you said you ran the PCR—what species did it say it was closest to?” asked Darren.

“It told me that it had the most homolog with Vibrio hollisae.”

Darren put his hands up and shrugged. “That gives us pretty much nothing,” he said. “I think I have heard of it causing disease once or twice, but that’s extremely rare. Honestly, hollisae is really only notable for being generic, at least as far as Vibrios are concerned.”

“So he had two infections, one after the other,” said Beth. She sat on a stool, holding her head in her hand as her elbow rested on the lab bench. “Unfortunate fellow. I guess that makes sense, in a way—maybe the Vibrio weakened his immune system enough to let the E. coli take over and finish him off?”

Darren shrugged. “Sounds good to me. You’re the doctor.”

Beth did not respond but continued to sit with her brow furrowed, as if she were not yet satisfied. Darren looked down at the pile of Petri dishes she had given him; he had scanned them all. He noticed that the salt-enriched Vibtio plates were nearly two weeks old at this point—he was surprised to see the hospital had not thrown them out by this point, especially since they had already been read as positive.

“Hey Beth, why are these all still here?” he asked, pointing to the culture dishes.

“I spoke up and asked the pathologist to save everything for Roth.”

“So you still have the original plates that didn’t grow anything? The ones with normal media, before you found out it was a halophile?”

“Sure. They’re just plain culture media in Petri dishes, but feel free to have a look.” She retrieved the plates from the incubator and returned to the lab desk. As she set them down, she was shocked to discover that life had sprung up in every dish. The creamy white specks could be found on the surface of the media in every dish. They were small and sparsely distributed, but they were there.

“Eureka,” said Darren nonchalantly as he held up a dish in front of his eyes. “We are growing something.”

“It’s got to be a contaminant,” said Beth. It was quite common for a fungal or bacterial cell from the environment to find its way onto a plate of media and create a false-positive culture, particularly when the cultures had been kept as long as these had. “These were all negative when I checked them after five days.”

“No, I think these are legitimate. Look—you can even see two kinds of colonies here.” He showed Beth, and, sure enough, she was able to identify two distinct types of colonies on the media. One had a grayish hue and a rougher, more textured appearance, while the other took on more of tan coloring with a smoother appearance.

“And they’re all like that,” continued Darren. “Four separate cultures, all growing the same two bugs. These aren’t contaminants, they’re just slow-growers. Sometimes great things just need a little time to develop, you know.” All species of bacteria multiply at different rates, some of which can be extremely slow.

“So this is the E. Coli and the Vibrio I assume? They were both here all along?”

Darren shrugged again. “I doubt it—I’ve never known E. Coli to take its time with anything. But hey, let’s take a look.” He started to prepare another Gram stain, which would enable him to see the bacteria on a slide under the microscope. For Darren, the process of performing a Gram stain could best be compared to the way another person flossed their teeth or buttoned a shirt. He was aware of all the steps as they happened, but he did not need to contemplate the next one before his hands started their work on it.

Minutes later, Darren peered through the lens of the microscope and into what could be confused with modern abstract painting. It looked as if someone had dipped a brush into purple paint and then snapped their wrist towards the canvas, flinging all manner of drips and dollops onto the target in a disorganized array. Most important to Darren was the absence of any red color.

“No Vibrio, No E. Coli,” he stated. “If I were to hazard a guess, I’d say you’ve got two types of Gram-positive rods here, but I can’t be certain. It could be that one of the species is just really difficult to Gram stain.”

Beth looked at the slide to quench her disbelief.

“Four bugs? In his blood for three weeks?” she exclaimed.

“Well, three bugs, actually,” corrected Darren. “The E. Coli isn’t here. If that had been in his blood back then, we’d be seeing it. It’d grow fast and assert itself. I’m pretty sure it got introduced late in the game.”

“Ok. These other three infect him, weaken him, and set him up for the fatal blow: the E. coli.”

“Eh, maybe. But you said yourself that he wasn’t getting any worse. It certainly sounds that these three bugs were affecting him, but I’m not sure they would have killed him. He was stable for weeks, right?”

Beth looked annoyed again. “So you’re suggesting the bacteria were satisfied with almost killing him? They didn’t want to take it any farther? They took pity on him before the big, bad E. coli came and spoiled the party?”

“No, not pity,” said Darren, a tad defensively. “A balance. Maybe they found a balance; that’s all I’m saying. He shrugged again. “Hey, when you bring in a guy that knows corals, you get advice that applies to corals. What do you expect?”

She took a deep breath. All things considered, she did not have a better answer.

“You going to run the PCR analysis on these new ones?” asked Darren.

“I can. We just send them to a place in Philly and bill it to the hospital. You want me to let you know what they find?”

“Yeah, let me know. It’ll be nice to get an update on my patient in a few weeks.”

Next Chapter: The Line