8.

Israel

By eight the next morning, Holley was back in my room. She spelled

Phyllis, taking her place in the chair by the head of my bed and squeezing
my still unresponsive hand in hers. Around 11 A.M., Michael Sullivan
arrived, and everyone formed a circle around me, with Betsy holding my
hand so that I was included, too. Michael led a prayer. They were just
finishing when one of the doctors specializing in infectious diseases came
in with a fresh report from downstairs. Despite their adjusting my
antibiotics overnight, my white blood cell count was still rising. The
bacteria were continuing, unimpeded, with the task of eating my brain.
Fast running out of options, the doctors once more went over the
details of my activities in the past few days with Holley. Then they
stretched their questions to cover the past few weeks. Was there anything
—anything—in the details of what I’d been doing that could help them
make sense of my condition?
“Well,” said Holley, “he did take a work trip to Israel a few months
ago.”
Dr. Brennan looked up from his notepad.
E. coli bacterial cells can swap DNA not only with other E. coli, but
with other gram-negative bacterial organisms as well. This has enormous
implications in our time of global travel, antibiotic bombardment, and
fast-mutating new strains of bacterial illnesses. If some E. coli bacteria
find themselves in a harsh biological environment with some other
primitive organisms that are better suited than they are, the E. coli can
potentially pick up some DNA from those better-suited bacteria and
incorporate it.
In 1996, doctors discovered a new bacterial strain harboring DNA for a
gene coding for Klebsiella pneumoniae carbapenemase, or KPC, an
enzyme that conferred antibiotic resistance on its host bacterium. It was