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07 –23 – 1999 | SOUTH SIAM | WEEK 5
The inside of your respirator fogs as you process another case. Natcha moves her fingers from left to right, tracing an “H” for your patient to follow. Her left eye tracks, but her swollen right eye stays still. The pupil is lethargic, barely twitching in response to your penlight.
You gently feel around her face. Her swollen skin burns at your touch.
“Infection?” asks Natcha. “But the test is negative.”
“Yes,” you reply. “The rapid test is for bacteria. Unfortunately, I don’t think this is a bacterial infection.”
You collect a sample and stain it with periodic acid. A meshwork of necrotic cells encased by pink-red ribbons resolves under magnification, branched like some spiny coral.
“Right angle branching. Rare septations. Mucormycosis. We need an amphotericin formulation.”
The diagnosis bothers you as you measure the antifungal formulation. Over the past few months, you’ve observed a gradual but steady rise in fungal infection in your district. The infectious agents were varied – ranging from common dimorphic yeasts to aggressive black molds. Affected individuals were universally refugees – not the poorer migrants that you may have expected, but those with enough wealth or status to retain a small measure of both after entering customs.
Natcha pushes a formulation of liposomal Amphotericin-G into an IV line. The patient would be transferred to a regional hospital within an hour; your clinic simply can't manage a case of this acuity. For now, you watch her dip into a fever, shaking as the medication mixes into her bloodstream.
>Roll 1d20+4, best of 3. [DC:10, 15] [+3 BONUS from +1 STAFF, +3 MEDS]
AND
>CHART. Review the patient’s medical records for unusual information.
>BLOOD. Run a full panel of blood tests on the woman and see if you can identify anything unusual.
>GENE. Run her sample through a high throughput sequencer and search for genetic defects.
>WRITE IN.
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07 –27 – 1999 | SOUTH SIAM | WEEK 6
[PATIENTS SCHEDULED: 272/270] [+60 Bonus from +1 STAFF]
>PREPARE. Your HOSAKA suite is dated, but it can still make essentials that are otherwise lacking here. Small molecules, large molecules, and simple bispecific. Vectors and phages if you invest a measure of time. [MEDS +2] [You have 3]
>HIRE. Your office is small, but perhaps you can find one more person to help with your patients. Natcha has proven surprisingly competent. Perhaps there are other candidates who are equally skilled. [STAFF +1] [You have 1]
>REPORT. The trend is still emerging, but it may interest the ministry of environmental purity. [FAVOR +1]
>CONTACT. There is no such thing as a former employee. GRAIL Pharmaceuticals is patient, and the corporation provides generous rewards for information that could help them foster new markets and create new customers. [FAVOR +1, MEDS+1]
