12.21 Read Free Page A

waking state and panic-inducing alertness, nearly all FFI patients died after a few weeks of total sleeplessness, and there was nothing Stanton or any other doctor could do to help them.
    “Don’t get ahead of yourself,” he told Thane. “Worldwide incidence of FFI is one in thirty-three million.”
    “What else could cause complete insomnia?” Thane asked.
    “A misdiagnosed methamphetamine addiction.”
    “This is East L.A. I get the pleasure of smelling meth-breath every day. This guy’s tox screen was negative.”
    “FFI affects fewer than forty families in the world,” Stanton said, moving down the line of cages. “And if there was a family history, you would’ve told me already.”
    “Actually, we haven’t been able to talk to him, because we can’t understand him. He looks Latino or possibly indigenous. Central or South American maybe. We’re working on it with the translator service. ’Course, most days here, that’s one guy with a GED and a stack of remaindered dictionaries.”
    Stanton peered through the glass of the next cage. This snake was still, and there was a tiny gray tail hanging out of its mouth. In the next twenty-four hours, when the other snakes got hungry, it would happen in every cage in the room. Even after years in the lab, Stanton didn’t enjoy dwelling on his role in the death of these mice.
    “Who brought the patient in?” he asked.
    “Ambulance, according to the admission report, but I can’t find a record of what service it was.”
    This was consistent with everything Stanton knew about Presbyterian Hospital, one of the most overcrowded and debt-ridden facilities in East L.A. “How old is the patient?” Stanton asked.
    “Early thirties probably. I know that’s unusual, but I read your paper on age aberrations in prion diseases, and I thought maybe this could be one.”
    Thane was doing her job right, but her diligence didn’t change the facts. “I’m sure when genetics comes back, it will clear all this up quickly,” he told her. “Feel free to call Dr. Davies later with any further questions.”
    “
Wait, Doctor
. Hold on. Don’t hang up.”
    Stanton had to admire her insistence; he was a pain in the ass when he was a resident too. “Yes?”
    “There was a study last year on amylase levels, how they’re markers for sleep debt.”
    “I’m aware of the study. And?”
    “With my patient it was three hundred units per milliliter, which suggests he hasn’t slept in more than a week.”
    Stanton stood up from the cage. A week without sleep?
    “Have there been seizures?”
    “There’s some evidence on his brain scan,” Thane said.
    “And what do the patient’s pupils look like?”
    “Pinpricks.”
    “What happens in reaction to light?”
    “Unresponsive.”
    A week of insomnia. Sweating. Seizures
.
    Pinprick pupils
.
    Of the few conditions that could cause that combination of symptoms, the others were even rarer than FFI. Stanton peeled off his gloves, his mice forgotten. “Don’t let anyone in the room until I get there.”

TWO

    A S USUAL, CHEL MANU ARRIVED AT OUR LADY OF THE ANGELS —mother church for Los Angeles’s four million Catholics—just as services were ending. The journey from her office at the Getty Museum to the cathedral downtown took almost an hour during rush hour, but she relished making it every week. Most of the time she was cooped up at her research lab at the Getty or in lecture halls at UCLA, and this was her chance to leave the west side, get on the freeway, and drive. Even the traffic, bane of L.A., didn’t bother her. The trip to the church was a kind of meditative break, the one time she could turn off all the noise: her research, her budget, her colleagues, her faculty committees, her mother. She’d have a smoke (or two), turn up the alt-rock of KCRW, and zone out a little. She always pulled off the exit ramp wishing she could just keep driving.
    Outside the enormous cathedral, she dashed out the end of her second