Chapter 2: Apoptosis
I woke in time for dinner, still a little groggy from the changes in hours. I was used to operating on little sleep, your residency teaches you that with its 36-hour shifts. I pulled on a pair of shorts and a T-shirt and sandals before heading out the door. I couldn’t cook worth a damn, so I always headed over to the Pack House for meals.
Tonight, it would be a somber dinner.
I walked in the door, my nose told me it was a full house before I even reached it. The dining room was large, with an elevated section at the front for leadership and rows of tables and chairs throughout. The kitchen was restaurant style and functioned that way. The full-time staff of six was augmented by the children between 14 and 21, who helped out several meals a week with serving, dishes and cleanup. You weren’t required to eat there, but the Pack covered the cost of meals this way. I only ate elsewhere when in other towns.
I was still a few minutes early and stopped to talk and hug a few people as I made my way to the front. I saw Jessica sitting with Connor’s children, their family close by. He looked lost and was barely functioning. It was expected, and he would either pull out of it in a few days or he wouldn’t. The Alpha had already assigned watchers for him, if he went feral, it would be their job to put him down. A werewolf who retreated into his beast, who rejected his humanity due to the pain of loss, was a dangerous beast; we couldn’t allow humans or Pack to be injured as a result of it. I got to the front of table, taking the step up and standing behind my seat. I was three people left of the Alpha and Luna’s chairs, next to Gamma Bill Caldwell and his mate Virginia. On the other side, Beta Charles Thorssen was standing next to his mate Denise. He motioned me towards him as we waited for the Alpha pair.
“I’m assigning Matt Miller as your bodyguard for the next few days,” he said quietly to me.
“Something like this, you don’t know how Connor’s mind could take it. If he places blame on you, he could lash out. I can’t take that chance, so he’s going to be by you.” I looked back, he was already standing by the last chair in the row.
I knew it would do no good to argue, and he was right. Widowers could be unpredictable, and I was a fixer, not a fighter. “Thank you.” He nodded as we saw the Alphas enter and the room go quiet, and I quickly returned to my seat.
Alpha Mitch walked to his seat, Luna Connie’s hand in his. They were a handsome couple, choice mates; she had been the daughter of the Duluth Pack Alphas. When neither had found their fated mate by age 25, they had taken each other to solidify the alliance between the Packs. They were deeply in love, and she was pregnant with their second child now. Their firstborn, Melinda, was three years old, and they were hoping their next was a male to inherit the Alpha position. At five weeks pregnant, it would be another five weeks before we could tell the sex of their child by smell or ultrasound.
The Pack was standing quietly as they turned to face them. “The Boundary Waters Pack has lost a beloved member today, along with a daughter. Laura and her daughter Nokomis, which is Ojibwe for ‘Daughter of the Moon’, died early this morning despite the best efforts of our Pack and Doctor. Tonight at the moon rise, we will send their spirits to Luna. May She bless this meal and bring comfort to us tonight.”
He sat, and there was a short time of noise as everyone followed. The staff started bringing out food in bowls and platters, it was served family style. Since it was summer, the meal included breaded fish, grilled garden vegetables and potato salad. The meal was quiet, there was little conversation verbally, and I left as soon as it was over. Matt was right behind me. “I’ll stay out of your way, but not out of your sight,” he said.
I didn’t know what they were saying about me on the Pack link, but I saw their looks and it was enough. Werewolves didn’t just die like this, and I was new and being paid a lot to be their Doctor. They expected me to save her, and I didn’t.
With more time, more help, more blood… I kept running it through my mind, but every time it came out the same. She lost too much blood, too fast, and I had no chance to save them. I would have to move on, but I vowed to find out why.
At sundown we started moving into the woods towards the Ceremonial Grounds. I stayed near the back with Matt, since I wasn’t Pack, as we entered the clearing where the pyre would be. Werewolf custom was to burn the bodies, ensuring no remains or DNA would be left that could identify our existence to humans. The pyre was built inside a ring of large stones, and the bodies were wrapped in white cloth and covered with wildflowers. I could see their baby was on her chest, her arms folded over her, as if they were sleeping.
Conner was standing with the Alphas, his children holding his hands, as the moon started to rise over the horizon on this clear July night. The Pack Elders led the ceremony, ending by handing Conner a torch, the Alphas each taking one while holding one of his children. Walking clockwise around the pyre, they ensured it was evenly lit before tossing the torches into the center. The dry wood caught quickly, and the heat pushed us away as the smell of burning flesh filled the air. Clothes were pulled off and tossed in piles, as the Pack members shifted. I did the same, letting the change come over me so my wolf could pay her respects to the dead.
The moon was over the trees and shining onto the fire as Conner pointed his nose up and let loose an anguished howl of loss, his children joining him. The second time, the Alphas added their voices, and on the third howl the whole Pack joined in. I watched as they finished, Conner’s wolf was shaking. He bolted for the trees, leaping over the rows of wolves. I saw Beta Charles take off after him along with two other warriors.
He would either come back or lose himself to his grief. The Alphas took their children, they would make sure they were cared for until we knew.
I went back to the clinic, unable to sleep I busied myself with cleanup and restocking. I checked the cultures, there was no evidence of harmful bacteria yet, but it was still early. The tissue samples were more telling. The cross-sections of the placenta showed that the endometrial lining had prematurely thinned, something that shouldn’t happen until the ninth month. In addition, apoptosis of trophoblast cells and endometrial epithelial cells had occured, facilitating premature placental release.
In layman’s terms, her placenta detached as if she had already given birth, when the baby was still developing. The detachment caused massive bleeding and fetal distress.
I sat back in my lab chair, my head spinning. The process of placental release was a complicated chemical process, but once apoptosis (programmed cell death) began, it can’t be reversed. Whatever started this reaction killed her.
If we were human, I’d be consulting with the top specialists in the country right now. If it was caused by a bacteria or virus, we’d be calling Atlanta and getting the Center for Disease Control on the line. I’d have access to the top labs, to scanning electron microscopes, pathology experts, everything. Of course, I had NONE of that available to me because the LAST thing we could allow was for our DNA, our tissue samples, to get analyzed closely.
Werewolves have always been present in the States, but never in the mainstream. We couldn’t be in the military, we couldn’t live among humans for extended periods. When I went to medical school and internships, I had to be Alpha ordered for my wolf not to shift; even if it cost me my life, I was not allowed to shift outside of visits to my home Pack in Zumbrota.
There were only about four hundred Packs in North America, and almost all were in remote locations where their homes were away from humans. The risks increased with exposure, so there weren’t careers among the humans, you were lucky if you even got college through them. My fellow doctors and nurses had to be exceptions; we needed training not available through Packs, and we had to keep up our medical licenses and an official practice, so we could have access to drugs and equipment.
I worked as a relief doctor at two clinics, one in Silver Bay and one in Grand Marais. I had done a surgical residency, but never got board-certified. I knew I would never be able to maintain THAT license living in a remote Pack. Instead, I dropped back to General Practice, doing rotations in obstetrics and pediatrics that would be more helpful to my Pack career. I had a lot of help, my Alphas were supportive and so were my parents; my father was the Pack doctor, and my mother his nurse. This rotation was a good way to get me experience and pay off the loans I had taken from my Pack to get my education.
So, there were few people I could reach out to, but the first one was my Dad. I emailed him with photos of my samples and a summary of my findings, and asked him to call me when he’d had a chance to review them. I then called Larry Jennings, he was the Pack Doctor in Duluth, and the most experienced one around. I wanted to drive down and meet with him, bringing my samples so he could examine them himself. I left a message on his phone, knowing it was late and he was probably asleep. Turning off all the lights, I walked out of the lab towards the stairs. Matt was in wolf form, guarding the door to the clinic. I told him goodnight and went upstairs to my apartment.
Two AM, and I was asleep again.
I slept until nine, when my phone rang. It was Larry, he had gotten permission from his Alpha for me to visit and was available after dinner. I got dressed and grabbed a late breakfast before heading back to my office to do research. Early in the afternoon my father called; he didn’t have much to add, but he did promise to look into it for me. Neither of us had found anything helpful in our research yet.
I swung by the kitchen to get a sandwich and cookies to go before hopping in my Ford Ranger extended cab 4x4 to head down to Duluth. I loved my little truck, it never let me down. I would do house calls at allied Packs, so I had medical supplies and a full trauma kit in the back seat. I waved to the sentry as I left, and put a CD in the stereo as I drove.
The Duluth Pack was located northwest of the city, at the very edge of the changeover to the deep Northern woods. The Pack was the second largest in the state, about five hundred wolves, and owned every home in their isolated development. Their homes were built in a way unlike the cookie-cutter suburbs that were springing up in the sixties and seventies. Build around a community center and small downtown, the homes were in concentric circles around the center, with open spaces and parks maintained around them. It looked like a nice place to live, and the wolf in me understood how it made their Pack defenses easier.
I rolled up to the entry, a good half mile off the paved road, and was stopped by one of their sentries. “Hi Alex,” I said as he opened the door and jumped in. “How are Mary and little Robert doing?”
“Go right to the clinic, Vivian. Doc’s in an emergency and can use your help.” I pulled forward, I could smell his distress. “One of our pregnant females started bleeding at dinnertime, the whole Pack is worried.”
Going as fast as I was comfortable, I went to the clinic building. It wasn’t enough. I could tell by Alex’s face she didn’t make it. “I’m sorry,” he said.
He didn’t say anything, he ran off, probably to be with his mate. I got out, leaving my samples on the seat. If I was right I wouldn’t need them.
The family was filled with grief, Pack members were trying to comfort his mate as he broke down. I walked past them to the procedure room, just as Larry walked out. His scrubs were bloody, and he was taking off his gloves and tossing them in a bin. “I’m sorry, Larry.”
“It was just like you said,” he said as his shoulders slumped. “It came on so fast, I couldn’t get the bleeding stopped in time. Even after I delivered the baby, the placenta was falling apart. It’s like her tissue was dissolving in front of me, sections would discolor and then rupture.”
I looked past him, his nurse was helping to clean up. “Go talk to the family, I’ll help get her cleaned up and then we can talk.” He nodded and walked off.
I pushed the door open, the smell of blood and death was strong in the room. A young woman, not even twenty, was cut open on the table, her baby by her side. Perfectly formed, maybe 18 weeks, and he never had a shot at life.
Whatever this was, we had to figure it out quickly.