Loop (6 page)

And then in early summer, two months before they were scheduled to leave-after they'd already bought the plane tickets and the whole family had their hearts set on the trip-Hideyuki suddenly complained of stomach pain.

Why don't you see a doctor,
Machiko said, but he wouldn't listen. Hideyuki decided it was a simple case of gastritis, and made no lifestyle changes.

But as the summer wore on, the pain became worse, until finally, three weeks before their departure date, he vomited. Even then, Hideyuki insisted it was nothing. He kept refusing to be examined, reluctant to cancel the plans they were so excited about.

Finally, though, the symptoms became unendurable, and he agreed to go to the university hospital and see a doctor who happened to be a friend of his. The examination found a polyp in his pylorus, and he was admitted to the hospital.

Naturally, the trip was cancelled. Neither Kaoru nor Machiko was in any mood to travel. The doctor in charge informed them that the polyp was malignant.

Thus did Kaoru's thirteenth summer turn from heaven into hell: not only did the trip fall through, but he and his mother ended up spending most of the sweltering summer going back and forth to the hospital.

Don't worry, I'll get better next year, and then we'll go to the desert like I promised, just you wait and see,
bluffed his father. Their one comfort was Hideyuki's positive attitude.

Machiko believed her husband, but, at the same time, whenever she let herself imagine what might happen, she became despondent. She grew weaker emotionally, and physically.

And that was why it fell to Kaoru to take a central role in the family. It was Kaoru who stood in the kitchen and made sure his mother ate enough when she couldn't bring herself to think about food; it was Kaoru who swiftly absorbed enough medical knowledge to plant thoughts of an optimistic future in his mother's head.

There was an operation in which two thirds of Hideyuki's stomach was removed, and it went well; if the cancer hadn't metastasized, there was every chance he'd get well. By the beginning of autumn Hideyuki was able to return home, and to his laboratory.

It was around that time that a change began to appear in Hideyuki's attitude toward Kaoru. On the one hand, as a man he had a new respect for the dependability his son showed while he was in the hospital, but on the other hand he began to be stricter with his son out of a new determination to make him into a stronger man.

He stopped calling him "kiddo", and encouraged him to spend less time on his computer and more time exercising his body. Kaoru didn't resist, but went along with his father's new expectations: he could detect certain desperation in his father, as if he wanted to transfer something from his own body to his son's before it disappeared.

He knew his father loved him, and he felt special, as if he'd inherited his father's will; pride coursed through him.

Two years passed uneventfully, and Kaoru's fifteenth birthday came around. But changes had been taking place inside his father's body. Those changes were revealed by a bloody stool.

This was a red light signalling the spread of the cancer. With no hesitation this time, Hideyuki saw the doctor, who gave him a barium enema and x-rayed him. The x-ray showed a shadow on the sigmoid colon about half the size of a fist. The only conceivable course of action was surgery to cut it out.

There were, however, two possibilities for the surgery. One option would leave the anus; the other would remove more tissue and require the insertion of an artificial anus. With the former, there was the fear that they would miss some of the invading cancer cells, leaving the possibility of a recurrence, while the latter option of removing the entire sigmoid colon allowed for more surety. The doctor's opinion was that from a medical standpoint the artificial anus would be preferable, but because of the inconvenience and lifestyle changes that would bring, he had to leave the final decision up to the patient.

But Hideyuki didn't flinch as he coolly chose the artificial anus.
If you open me up and can't say with certainty that the cancer hasn’t spread that far, then I want you to cut it all out without hesitation,
he'd volunteered. He intended to bet on the option with the best odds of survival.

Once again the summer found him back in the hospital for surgery. When they cut him open, the doctors found that the cancer hadn't invaded as far as they had feared; normally, in this situation, leaving the anus in would give at least even odds of success. But the surgeon in charge decided, in view of the patient's expressed wishes, to remove the sigmoid colon entirely.

Once again autumn found Hideyuki checking out of the hospital. For the next two years he'd lived in fear of signs of a relapse, as he strove to get used to life with a colostomy.

Exactly two years later there was another sign, this one a yellow light, as it were. Hideyuki became feverish and his body took on a yellowish cast, symptoms that got worse day by day. One look at his jaundiced condition told the doctors that the cancer was attacking his liver.

The doctors hung their heads. They thought they'd made sure, over the course of two previous surgeries, that the cancer hadn't spread to the liver or lymph nodes.

It was at this time that Kaoru began to suspect that what they were seeing was the emergence of some unknown illness, something that was indeed a kind of cancer, but one different from those previously known. His interest in basic medicine intensified. In the summer of his seventeenth year, having graduated from high school a year early, he entered the pre-med program in the same university that his father had attended.

The third time he lay down on the operating table, Hideyuki lost half his liver. He subsequently checked out of the hospital, but neither Kaoru nor Machiko could make themselves believe now that the battle with cancer was over. The family watched for enemy movements with bated breath, wondering where the cancer would invade next; the return of a peaceful, happy home life was something hardly to be hoped for.

That cancer won't rest until every organ in his body has been plucked out,
Machiko insisted, and she wouldn't listen to any of Kaoru's medical knowledge. If she heard about a new vaccine, she'd scramble to get her hands on it even before it was fully tested. Hearing vitamin therapy was effective she tried that; she pressured the doctors into trying lymphocyte treatment; she even sought salvation in charismatic religion. She was willing to try anything-she couldn't swear she wouldn't sell her soul to the devil if it would save her husband's life. It depressed Kaoru to see his mother running around like a woman possessed. It was beginning to look like his father's death would also mean the collapse of his mother's psyche.

After that, Hideyuki spent most of his time in his hospital bed. He was still only forty-nine, but he looked like an old man of seventy. His hair had fallen out as a side-effect of the anti-cancer drugs, he was emaciated, his skin had lost its luster, and he was constantly running his fingers over his whole body and complaining of itchiness. But even so, he never lost his attachment to life. As his wife and son sat by his bedside he'd hold their hands and say, ''You listen to me, next year we're going to that desert in North America." And he'd force a smile. It wasn't exactly false cheer-he obviously fully intended to fight this illness so he could keep his promise. The sight was both reassuring and painful.

As long as his father showed such a positive attitude toward life, Kaoru never entertained thoughts of giving up. No matter how bad the cancer got, Kaoru believed his father would conquer his illness in the end.

At around this time, a type of cancer with the same progression as Hideyuki's began to be identified, first in Japan, then worldwide. At first the true cause of this new strain could not be identified, as if it lay wrapped under a veil. A few medical professionals supported a theory that it was the work of a new virus that turned cells cancerous, but they couldn't explain how this cancer virus differed from others, and besides, there had been no reports of such a virus being successfully isolated. But the vague suspicion spread.

It can take several years after a new disease has been identified to pinpoint the virus that causes it. The lag was especially understandable in the case of the cancer that had afflicted Hideyuki and millions of others, because at first it looked just like any other cancer: nobody realized they were dealing with a new disease. But gradually the world came to be gripped by fear that a terrible new virus had been unleashed.

Finally, one year ago, the new cancer virus had been successfully isolated in a laboratory at the medical school of Fukuzawa University. With that they had proof: a virus was the cause of this metastatic cancer.

The new virus was named the Metastatic Human Cancer Virus, and it was thought to have the following characteristics.

First, it was an RNA retrovirus that actually caused normal cells to become cancer cells. Thus, anyone infected with the virus ran the risk of developing cancer, regardless of whether or not they had been exposed to carcinogens. However, there was room for individual variation: there were confirmed cases, though only a few, of infected people who were mere carriers, never developing cancer themselves. It took on average three to five years from the time of infection for the cancer to grow large enough to be detected clinically, although the degree of individual variation in this was great.

Second, the cancer was contracted through the direct introduction of virally-infected lymphocytes into the body. That is, it was not spread through the air, but through sexual contact, blood transfusions, breastfeeding, and similar contact. Thus, it was not what would be called highly contagious. But there was no definitive evidence to say that it would not at some point in the future become transmissible through the air. This virus mutated with frightening speed.

Due to the similarity in the manner of its transmission, some scholars speculated that the new virus was the result of some sort of mutation in the AIDS virus. Perhaps the AIDS virus had sensed that it was about to be eliminated by vaccines, and so had colluded with an existing cancer virus, skilfully changing its appearance. And indeed, there was a nasty resemblance between the two viruses, not only in how they spread, but in the way they nested in cells in the human body.

When the Metastatic Human Cancer Virus, carrying reverse-transcription enzymes, merged with human cellular tissue, the RNA and reverse -transcription enzymes were released to synthesize the double helix of DNA.

Then, this synthesized DNA mingled with normal cellular DNA, turning the cell cancerous. Which was bad enough. But it didn't end there. The cell could now no longer tell the difference between its own DNA and the viral DNA, and so it kept manufacturing the cancer virus and releasing it outside the cell. The released virus made its way into the bloodstream and the lymph stream, where it deviously fought off attacking immune cells while awaiting the chance to move into a new host.

The third characteristic: when the cancer started, almost without exception it metastasized and spread throughout the body with frightful strength. This, of course, was why it was called the Metastatic Human Cancer Virus.

There are benign tumours and malignant ones, and the difference between them lies in the thorny questions of invasiveness and metastasis. A person may develop a tumour and still have no reason to fear, as long as it doesn't spread through the surrounding area, move into the blood and lymphatic vessels, and metastasize.

But this metastatic cancer spread through rapid reproduction and extreme invasiveness, and was highly resistant to the immune-system attacks it experienced as it circulated through the lymph and blood streams. It was much more likely than normal cancer to survive in the circulatory system.

As a result, anyone who came down with this cancer had to assume a 100% probability that it would metastasize. The question of whether or not one survives cancer can be restated in terms of whether or not one can prevent that cancer from metastasizing. With a 100% chance of metastasis, it was essentially impossible to hope for a complete recovery from MHC.

The fourth characteristic was that the cancer cells created by this virus were immortal-they would live forever if their host didn't die.

Normal human cells have a limit to the number of times they can divide over the course of their existence-just like humans themselves, they have a certain span of life allotted to them at birth. For example, by the time a person becomes an adult, his or her nerve cells have lost their ability to reproduce themselves, so that they are no longer replenished. It might be said that nerve cells have the same lifespan as humans do.

In this way, the aging and death of cells is intimately connected with the question of human lifespan. But these cancer cells, when removed from a host and sustained in a culture fluid, went on dividing infinitely-they would never die.

There were certain religionists who pointed to this and spoke of it in a prophetic vein, saying, If
we could harness the power of these cancer cells and transfer it to normal cells, we would be able to achieve immortality
-
we’d never grow old.

But of course these were nothing but amateurish delusions. It was paradoxical that cells which had achieved immortality would then kill their human hosts, assuring that they themselves would die. But it was a paradox that, by and large, people managed to accept.

It was the rainy season, early summer of the year before Kaoru was to take his national examinations, and every day was a busy one for him. Visiting his dad and working a part-time job took up so much of his life that he barely had time to look after his mother's mental state-much less study.

If left to her own devices, his mother would try to get her hands on anything that claimed to be effective against cancer; Kaoru had to keep a constant watch so it didn't get out of control.

Hideyuki didn't approve of his son spending so much energy on his part-time job. He felt that his son should concentrate on studying, and that splitting his time between that and working was essentially a waste. The idea that Kaoru was doing it on account of his own illness irritated him even more: Hideyuki insisted that he could pay for Kaoru's school expenses, that they had enough money in savings. As far as talking big went, he was as healthy as ever; but the optimism in his words was Kaoru's salvation.