Decay: Genesis

Letter to Dr Ludwig van Hermann:

“Washington, White House, Friday, 14th February 1992.

Dear Dr Ludwig van Hermann,

I am writing to inform you, sir, that your request to establish a care centre in the city of Ashfort-Kingsport has been approved. I ensure you, everything is set in place in pursuit of finding the cure for necrosis. I made sure of that myself, that the centre is equipped with all the resources you have asked for – I hope you will find everything to your satisfaction.

I've pondered this, sir, but don't fully understand why you'd take up such a task? Well I mean as your long time friend from Harvard, I will put it simply - you're fighting a war every doctor has declared, and eventually all failed. Why fight death? A spirt. A god. The Absolute end - its the path we all took when we stepped foot on this earth. However, I cannot stop to admire your determination to defy this reckless fate. What irreversible fate will necrosis bring to anyone unfortunate enough to come into its grasp? But I shall not pester you more about it. I have no mind of a doctor or researcher.

With this letter, you can find the key to the care centre. I hope it will meet your hospitality needs. The care centre is located in the centre of Ashfort-Kingsport city. In the massive Central Park. I have ordered it to be re-built spacious and large just like you have described it. Additionally, the park is large enough to drown out all the hustle and bustle of the city around it.

Yours truly,

President of the USA.

P.S. I hate how formal the letter sounds...Ludwig, I miss you man. You are a mystery to me, Ludwig - I know you for long, and I know you’re a man of altruism and kindness.”

5 years earlier, April 1987, Sydney, Australia:

On Saturday, 11th April 1987, St Mary’s and John’s Hospital, Sydney, Australia. A patient was rushed into the ER. Hermann looked at the patient’s appearance, and felt his heart drop. The patient’s left hand had two punctures in the palm. “What...what...what happened?” he was only able to mumble out the question. The assisting paramedic looked at him and answered, “Patient is male early 20s, bitten by a Red-bellied Black Snake. Left palm.”

The paramedics moved the patient into a free bed area and moved him onto the bed. With two strides he was at the patients side, clutching the wounded hand. The skin around the mark was already turning black. Ludwig's eyes stared at the marks, his mind reeling. Hermann gestured at a nurse, “150cc's of antivenom. STAT!” then he turned to the patient and said, still holding the mans hand in his, “Don’t worry sir, you will be fine." The patient was covered in a thin sheen of sweat.

“Report back to me when the patient improves. Keep him overnight for observations if the necrotic process does indeed spread. I want to be notified immediately,” he said as the nurse returned with a syringe, injecting it into the patient’s IV bag. “150cc's of Antivenom!” she said, then looked at the doctor and nodded, “I will notify you if there are any changes, sir.” She smiled at him. Hermann nodded, turned and walked away.

He moved with purpose. His mind raced hundreds of miles an hour as he retired to his study to find ways he can help his patient. “How am I meant to save him?” this question kept washing against his lips. He sat down in his chair, behind his desk. He put his head in his hands and closed his eyes. “What should I do?” he muttered “How should I help him?” but nothing came to him.

As night came and went the patient’s state was getting better. Ludwig was standing over his patient and filling out paper work, occasionally looking up and gazing at the lingering bite - the wounds were cleaned and wrapped up but who knew what it could develop into.

The soft beeping from the monitor was the only other thing that accompanied the scratching of Ludwig's pen and the breathing of the patient. The patients eyes fluttered open. Dr Ludwig stood up and walked over. "Good evening, Mr Thompson. How are you feeling?" he asked, voice concerned and soothing. "Better, but in pain." Ludwig nodded and wrote down something. "Now then, sir, do you remember anything?" Ludwig asked, the patient closed his eyes and groaned softly, but said in a shaking voice. "Yes. I was umm, I was in my garden, tending to my roses, when a snake lunged at me and bit me. The rest is a haze. I can't tell you any more Doc, sorry." Dr Herrmann was nodding calmly, his pen moving non-stop on the paper. "Well, you are safe. You have received antivenom and are on strict bed rest until we can help further. However, I have some bad news."

The patient, who was pale and still feverish, went even more pale - if its possible - and his eyes fell onto his hand. The skin on the palm was black. Dead. His eyes widened in shock and fear, "Wh...wh...what happened?!" he screamed and looked at Ludwig with fear in his eyes. "The upper and inner parts of your skin tissue around the bite on your palm is dead." The patient whimpered in fear and tears began to roll down his cheeks. "Will I lose my hand?" he begged in a teary voice, Ludwig shook his head. "Labs came back and there is a healthy section of skin from your right thigh. We think we can make a skin graft and replace it."

The patient sighed in relief and tears of joy replaced the ones that fell from fear. "Thank you doctor. Thank you so much." he said. Ludwig nodded, noted some things down and walked away, letting his patient sleep. As night went on, a nurse entered Mr Thompsons room and replaced the IV bag, adjusted the blinds and left - muttering something about late night shifts are her favourite activity to do.

The morning came. Ludwig was making his way to visit his patient and prep him for the surgery. The second he entered the room, the loud and uninterrupted beeping of the monitor caught his attention. His eyes fell to the screen and the worst nightmare came true. Ludwig laid his eyes on a flat line.

Dr Ludwig van Hermann, lost his 15th patient in his whole 28 year long career as a health practitioner. A nurse walked in, the same one from yesterday – when she saw the monitor and the doctor's grim look, she gasped. “I’m so sorry sir...I just stepped out for a moment, he was-” but Hermann stopped her. “How long ago did you see him?” his voice was steady, pained and sad. “3 minutes ago, sir, there was nothing wrong to note with the patient. Nothing that would show he was dying. He was stable...I don’t understand.” she said. Ludwig nodded. “Which means he died just now. Was he sleeping?” he ignored the nurse and stepped deeper into the room. “Yes, he was sleeping...but how does this have to do-” but he stopped her again. “He passed away in his sleep...my guess is that he was allergic to the ingredients in the antivenom we gave him yesterday, or there was something else that led to complications. He passed away in his sleep, feeling no pain...”

Ludwig looked down at his watch “Time of death, Saturday 12th April 1987, 07:45 am... St Mary’s and St John’s Hospital, Sydney, Australia.” he said in a grim tone. He was one of those doctors who couldn’t stand to bear the death of their patients, and calling this death was one too many now. The nurse looked at Ludwig and said "Sir?" Ludwig didn't answer. "In the 3 years of working with you, I've never seen you lose a patient." Ludwig walked over to the patient’s bed and pulled the covers over his head. “Rest now, sir, may your soul be free.” he said, then walked out, making his way back to his study.

Later the very same day, Ludwig walked down to the hospital morgue. His feet heavy and his eyes heavy with grief. He dragged his feet to the patients cold and lifeless body - unable to look at it again, but something was pulling him to it. With a single flick of his wrist he removed the cloth which covered the cadaver. His eyes panned to the palm first and then gently lifting it he looked down at the blackened skin of the palm. "Why does this always end in grief?" he asked himself.

His hand moved into his pocket, but he hesitated. "Why?" The question echoed in his mind. Then taking out a Canon EOS 650 camera.

CLICK.

The picture was taken, it only needed to be rendered. "Why?"

Diary entry, Dr Ludwig van Hermann:

“Sunday 12th April 1987 10:15,

Dear Diary,

Today I failed my 15th patient. Yesterday a man of early 20s was admitted into my care. He was bitten by a Red-bellied Black snake – the effect of the bite was small, only 2 cm in diameter from the area of the bite. The patient was administered antivenom at 14:18 and appeared to be stable. After closer examination, there was one way to treat and stop the spread of the necrotic tissue.

After 3 hours, at 17:20, a lab report came back to me with the result for the optimum skin and living tissue transplant to replace the dead tissue – the most optimum spot was from the right thigh. I planned to operate in the morning, when I was making my way to inform my patient of the great news, I found him dead.

The sight of my patient dead broke me...reminding me of my first failure. The first time I failed to save a dying child. Back when I was working for the Red Cross in Niger. I lost my first patient to cancer. That day still haunts me. But it was so long ago. I was young and stupid and inexperienced – I should’ve waited for my mentor...for someone who was better skilled at the surgery. I failed the patient, I failed myself, and I failed the family I promised to keep their son alive.

I think it is time to return back home. Back to the US. And then...I think it is time to finally start focusing on the question that has stayed rooted in my mind from the time I became a doctor... ‘How can I stop death? How can I slow its icy grasp on anyone?’ I’m done stalling, I learned all I can, and now I am ready to undertake my goal to find a cure and stop tissue death...or even pull people away from death's grip. I hope I will succeed...

Signed,

Dr Ludwig van Hermann.”