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And when rays of warm sunlight begin to peak above the boundary of eastern seawall, the sequencer sends a blurt of compressed sequencing data to your HOSAKA terminal. You blink traces of drowsiness away from your eyes, and scan over the results – your eyes flitting between different filters and graphs.
Each patient has a laborious list of deleterious variants, but the defects you are looking for are as conspicuous as they are baffling.
Based on their histories, patients one through seven had received T-cell enhancement from WangLi Biotechnica: a Chinese splicing conglomerate. From what you recall, the modification targeted the TCR alpha and beta loci on chromosomes 7 and 14.
You scroll through their sequencing data. In lymphocytes, the spliced loci were completely absent. A near vertical drop in read depth at the TCR loci. If it were not for the matched fibroblast control, you would assume that the patient had a germline deletion in that gene.
You check the next set of patients. Eight through twenty two. BioGEN; interferon receptor cluster replacement. The pattern repeats. The recombinant locus is absent – cut out from the genome without a trace. Many of the gene are survival-critical; accordingly, all the patients had decimated T-cell counts in the low-tens.
You check the last patient. Twenty-three. The young man with the cryptococcus infection. You saw him yesterday. Minimal response to amphotericin. Dead from uncal herniation during ambulance transport. And….
You rub your eyes. His chart indicated that he received T-cell enhancement from GRAIL pharmaceuticals. Despite your misgivings about the company, this instance of splicing work was excellent: a constellation of genetic changes, conducted across 23 distinct loci responsible for T-cell signaling.
The display of the HOSAKA flares amber. You count the gaps. Twenty three specific deletions, across 23 distinct receptor loci, removing any and all traces of human tampering. His T-cells responded appropriately by shutting down, their immunologic inputs severed.
You close the display, and step outside. The morning light sweeps across the landscape; the sluice pumps pause their constant, reverent drone. You cast your gaze further out. Buddha’s graven palm drapes a lengthening shadow upon the city walls, and her hollowed eyes continue to profess their endless rejection of man's hubris. The empty orbits teach you something that sequencing data cannot.
>CULTURE. Attempt to isolate any novel viruses or infectious organisms from the immunosuppressed patient. Perhaps there is something that does not appear on the usual panels?
>PROTEIN. Attempt to perform proteomic analysis of blood samples using microcapillary separation followed by MALDI-TOF mass spectrometry. Perhaps there are traces of proteins or metabolites not usually present in human blood?
>WRITE-IN.
