DDX

"DDX" is the twelfth chapter of Converge.

Dr. Darin walked through the halls of Clover Hospital. He entered the clinic and picked up a file. Samantha Martin, 28, fatigue and shortness of breath, exam room 2. Robert entered the room.

"Hello, I'm Dr. Darin." he said, "How long have you  experienced your symptoms?"
"It started a few months ago and has gotten much worse recently." Samantha said.

Robert started the physical exam and didn't find anything. But when he got to her hands, he noticed something.

"Your fingernails are streaky." He said.

"What does that mean?" Samantha asked.

"It's indicative of anemia." Robert said, "Your body is not getting enough oxygen. I want to admit you."

"That's not an option." Samantha said, "I don't have health insurance."

"Okay." Robert said, "Just give me access to your medical records and I'll do everything I can."

Robert brought her the forms to sign, "Also, if you would leave your number, I'll call you with any information I can get."

That night Robert looked over her records. He learned that Samantha was a soldier who was positioned in Iraq. Robert considered a foreign disease, but ruled out infection due to the lack of fever. Robert saw that her mother died of bone cancer. That would explain anemia and fatigue, but Samantha is athletic, and she did not have any swelling or bone pain. Robert continued to examine the record, and learned that she had a week old son, Jordan Abara, who died of a stroke only a couple months ago. Robert then noticed, his last name sounded foreign. He thought for a minute, then called Samantha.

"Hi, this is Dr. Darin from Colver Hospital."

"Oh, hello Doctor, did you figure out what I have."

"Maybe. I need to know  where your husband is from."

"David and I are separated."

"That doesn't matter, I just need to know what country he is from."

"He was born in the U.S., but his parents are from Guinea."

Robert smiled, "Thank you. I figured out what you have."

"Really?" Samantha asked, "What is it?"

"Sickle-cell trait." Robert said.

"What is that?" Samantha asked.

"You have a gene that produces defective hemoglobin, but also have a gene that producers normal hemoglobin. People with this condition usually don't have any symptoms, but anemia sometimes develops in athletes and pregnant women. You were both."

"What did David's heritage have to do with this?" Samantha asked.

"Well, sickle-cell trait makes a person more resistant to malaria, so 1 in 5 people in west Africa have it, since malaria is an epidemic there. I believe your son had sickle-cell disease. That's what caused his stroke. I'm very sorry to hear about that by the way."

"Thank you." Samantha said quietly.

"Anyway, to get sickle-cell disease, you need a defective gene from both your parents. David's ancestry made it quite possible that he has the gene, and you having it as well explains everything."

"So Jordan died because of me? Because of my genetics."

"You can't blame yourself." Robert said, "There's no way you could've known. And even if both parents have sickle-cell trait, there is only a 1 in 4 chance of a child getting it. This was just bad luck."

Samantha didn't say anything.
"Your condition is treatable, and it could also just resolve itself. You'll be fine." Robert said.

"Well, thanks for everything." Samantha said.

"Samantha, I realize that you've been through a lot. If you every need someone to talk to, feel free to call."

Samantha paused.

"Thank you." She said, before hanging up.