Proof of Heaven: A Neurosurgeon's Journey into the Afterlife

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 found in the stomach of a patient who died in a North Carolina hospital. The strain immediately got the attention of doctors all over the world when it was discovered that KPC could potentially render a bacteria that absorbed it resistant not just to some current antibiotics, but to all of them.

If a toxic, antibiotic-proof strain of bacteria (one whose nontoxic cousin is ubiquitous in our bodies) got loose in the general population, it would have a field day with the human race. There are no new antibiotics in the ten-year pharmaceutical development pipeline that could come to the rescue.

Just a few months earlier, Dr. Brennan knew, a patient had checked into a hospital with a powerful bacterial infection and was given a range of powerful antibiotics in an effort to control his Klebsiella pneumoniae infection. But the man’s condition continued to worsen. Tests revealed that he was still suffering from Klebsiella pneumoniae and that the antibiotics hadn’t done their work. Further tests revealed that the bacteria living in the man’s large intestine had acquired the KPC gene by direct plasmid transfer from his resistant Klebsiella pneumoniae infection. In other words, his body had provided the laboratory for the creation of a species of bacteria that, if it got into the general population, might rival the Black Death, a plague that killed off half of Europe in the fourteenth century.

The hospital where all this occurred was the Sourasky Medical Center in Tel Aviv, Israel, and it had occurred just a few months previously. As a matter of fact it happened at about the time that I’d been there, as part of my work coordinating a global research initiative in focused ultrasound brain surgery. I’d arrived in Jerusalem at 3:15 A.M. and after finding my hotel had decided on a whim to walk to the old city. I ended up taking a lone predawn tour of the Via Dolorosa and visiting the alleged site of the Last Supper. The trip had been strangely moving, and once back in the States I’d often brought it up with Holley. But at the time I’d known nothing of the patient at the Sourasky Medical Center, or the bacteria he contracted that picked up the KPC gene. Bacteria that, it developed, was itself a strain of E. coli.

Could I have somehow picked up an antibiotic-proof KPC-harboring bacteria while I was over in Israel? It was unlikely. But it was a possible explanation for the apparent resistance of my infection, and my doctors went to work to determine if that was indeed the bacteria that was attacking my brain. My case was about to become, for the first of many reasons, a part of medical history.