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Eleven hours on an airplane were more than enough but Wesley Williams still had nearly three hours before he landed at Addis Ababa International in Ethiopia. He had tried to sleep but he could only achieve an hour or two at a time. In between his naps, he studied the case book prepared for him.

Wesley was a researcher at the National Center for Emerging Infectious Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta, USA. He had been sent to Juba, South Sudan at the request of a doctor with the Doctors International Outreach (DIO) organization to investigate what seemed to be a new viral outbreak.

Wesley hadn't any idea where the state of South Sudan was until he was well on his way to Africa. The layover in Addis Ababa would allow Wesley to do some advance scouting. But for now, he went back to sleep.

Wesley awoke as the plane touched down. He was soon in the main concourse of Addis Ababa International. Except for the occasional sign a traveler might never know where he was in the world. The airport was as modern as any Wesley had ever seen. He queried his Annie as to the location of his hotel in Juba, where the Ministry of Health was located and where the DIO clinic was located. The clinic was his main objective while staying in the capital city. The Annie was slow to respond. Obviously, the cloud connection was limited. By the time it was finishing with his request Wesley was dozing off again.

He awoke in time to hear the call for his flight. The plane was an older prop model, and he had to walk across the tarmac and climb the boarding steps. By the time the plane was in the air, he had dozed off again to the sound of the propeller engines.

The bumpy landing which woke him was an immediate indication that things would be different in Juba. Departing the plane Wesley noticed that he was surrounded by United Nations, World Food Program, and Russian cargo jets parked in a close jumble because of the limited size of the apron. It was obvious that foreign aid and foreign influence was still important to South Sudan even after years of independence.

Image - © Kjpargeter – Dreamstime(dot)com

2

As a young engineering student, Jack had been part of a research group that was developing an integrated circuit with the goal of running complex neural networks on a mobile platform. The platform would host a software-based Artificial Narrow Intelligence (ANI), commonly called an Annie.

Jack’s specialty on the team was packing the necessary functions into a three-dimensional substrate while maintaining performance requirements. He developed what he called the Matryoshka (Russian nesting dolls) approach to help meet the requirements. Jack became famous on the team for writing the software that met packing and performance compliance.

He was still an undergraduate working with the Annie group when his son died. His wife succumbed a short time later. Jack thought Miri had lost her will to live after their son died. Both Miri and Jack Jr. had been early victims in a viral pandemic that took the lives of millions.

Jack vowed to not let it happen again.

He immediately changed majors to pursue biological research in infectious diseases. His single-minded focus enabled him to pack seven years into five, and he soon found himself the youngest researcher at a very prestigious university. He would find a cure for those like his son and wife who caught the virus early before the need for a vaccine was even apparent. Jack loved his research but even so, it was becoming a strain because of the pressure for results put upon him by his adviser.

It was late at night, and Jack was working alone in the lab as usual. He was working at the synthetic biology station. Jack had chosen to use synthetic biology because of its engineering approach which could be applied to biological systems. Synthetic biology held the promise of fast and easy design of biological systems instead of the usual trial and error method most biologists were familiar with. Well defined biological building blocks were used to assemble biological systems much as one could use electronic components to design a useful electronic circuit.

Jack was using synthetic biology to develop a synthetic gene circuit that could function outside a cell and could quickly identify viral agents. It would be embedded in paper for testing. He hoped by creating this paper-based detector it would serve as a proof of concept for his approach.

Suddenly, as he bent over the station he felt a hot flash of pain in his skull, like an explosion. The pain increased and lasted more than a minute before it subsided. By that time Jack found himself sitting on the floor.

When he recovered enough to stand he secured his experiment and closed up the lab. As he walked to the curb, he took his Annie out of his pocket and unfolded it.

“Yes Jack,” said the Annie.

Jack explained his symptoms and asked the Annie what might have happened to him. The Annie took his vitals from his wrist band and ran its medical expert. It called for an Ark-car to take him to the hospital.

The self-navigating car arrived and as it drove him to the hospital he listened to the Annie conjecture about his health. At the hospital, he ended up being admitted for observation.

The next morning a doctor came into Jack’s hospital room.

“Mr. Jackson?”

“Yes.”

“I have to tell you Mr. Jackson that was a reckless thing to do, driving by yourself to the hospital instead of calling for an ambulance. What if you had another attack with no medical personnel around?”

“Well sir, I guess I wasn’t exactly thinking straight after such an episode, have you ever had such an attack?”

“I have not,” said the doctor, softening somewhat. “I guess I would be a bit confused myself under similar circumstances. By the way, I’m Doctor Greyson, I’ll be your attending physician.”

“So what do you think happened to me? I feel fine now.”

“I believe you had a transient ischemic attack. Sometimes called TIA or a mini stroke.”

“My Annie suggested that was a possibility, but I thought that a stroke was something that usually happened to older people?”

“That is generally the case. But it can also happen to anybody at any time in their life. It could be caused by an inherited risk, it could be lifestyle choices, or it could be an imbalance of an amino acid, specifically homocysteine levels in your blood; or it could be all of the above. That is what we are going to find out. I’ve ordered the necessary tests and questionnaires for you to fill out.”

Dr. Greyson turned to leave but looked back to say, “Please be honest when filling out the forms, the diagnosis depends on it.”

Jack had answered the questionnaires as accurately as he could through the data diagnostics Annie. The results would be run through another ANI program and combined with his medical history to make a preliminary diagnosis for the doctor. Jack had also had an MRI and a complete blood workup. And now he was told that another test had been ordered, and an intelligent gurney would be here any moment to take him to the exam room. The I-gurney finally showed up an hour later. He queried the robot about what test was scheduled next.

“Don’t you know?” asked the I-gurney.

“No. No one has told me anything except that I had another test scheduled.”

“Oh dear, I thought you knew. You are scheduled for an angiogram of the carotid artery in your neck. Let me see here,” said the I-gurney accessing the hospital’s database.

“Mr. Jackson, it says here that your carotid could have caused your attack. Therefore, the test. This may take some time; you should try to visit the restroom now.”

Three hours later Jack was back in his room and starving. It was late in the day and because of the tests, he hadn’t been allowed to eat any breakfast. He begged the floor nurse to bring him some food. The nurse agreed. The robotic food butler showed up with a small bowl of apple sauce and a slice of bread. Jack was just about to beg the food butler for more when Doctor Greyson came in.

“Well Mr. Jackson, I’ve reviewed the tests and questionnaires and data history from your wrist band, and I believe you did have a transient ischemic attack as I said this morning. The levels of homocysteine in your blood are high. You also have other lifestyle risks that we need to address.”

“What do you mean, lifestyle risks?”

“You seem to have an all work and no play profession Mr. Jackson. It’s widely believed that contributing factors to TIA are a sedentary lifestyle and high stress. All work and no play, you know. Also I suspect your diet is not as varied as it should be in fruits and vegetables. Would I be correct in that assumption?”

“I guess so. It’s true that I have put my work above everything else in my life for the last five years. But I have my reasons.”

“I’m sure you do Mr. Jackson but this attack should be taken as a warning. You are at high risk for a stroke in the next six months; a stroke that would probably end whatever you are trying to accomplish at work. So, we need to start now to reduce that risk.”

“What do you mean?”

“We will use gene therapy to repair any cell damage you may have suffered but I would still suggest that you plan a sabbatical from your work to reduce your stress level.”

Jack was quiet.

Finally he said, “That’s quite a choice you are offering me doctor. My work means everything to me. But as you say I won’t finish it if I have a stroke.”

He sighed, “I’ll need some time to think. Would a month be a good rest interval?”

“I would suggest six months Mr. Jackson. At the end of that time if you’ve followed all my recommendations and the homocysteine level is in an acceptable range, then a reasonable work schedule could be resumed. A balanced work-life would be possible.”

“I see. Thank you doctor.”

“Okay Mr. Jackson, I’m going to recommend your release. I have ordered some prescriptions for you; the nurse will explain your treatment regimen. You should be ready to go home in about an hour.”

After the doctor closed the door Jack sighed.

Oh Miri, what now?