in three days—then removed the graft in about two weeks, when he was ready to accept a permanent transplant.” Scully had explained the procedure to Mulder after reading about it in Stanton’s chart, but it was good for both of them to hear it again from the expert. After all, it had been a long time since Scully’s surgical rotation, and she had spent only a few months studying transplant techniques.
“So the donor skin is only temporarily attached?” Mulder asked.
61
THE X-FILES
“That’s right. The temporary graft isn’t matched to the patient—because it’s intended to be rejected after a period of a couple of weeks. Then we graft a piece of the patient’s own skin over the wound. In the meantime, the donor skin decreases the risk of infection, and it helps indicate when the burned area is ready to accept a permanent transplant.”
“If the temporary graft isn’t matched to the patient,” Scully interrupted, “what precautions are taken to make sure the graft isn’t carrying something that could infect the patient with a communicable disease?” Bernstein glanced at her. She could tell from his eyes that he had already given this some thought. Stanton had been his patient—and as unfair and illogical as it seemed, he was partially blaming himself for what had happened. “Truthfully, very few—on my end. The skin is transported to us from the New York Fire Department Skin Bank; the bank is responsible for growing bacteriological cultures, and for checking the skin for viral threats. But they themselves are guided by the medical histories provided by the donor hospital.
There are a million things to look for, and it’s impossible to cover every possibility. If a donor dies from something infectious, they don’t accept his skin. But if he dies from an unrelated cause—and happens to be carrying something, there is a chance that it will be passed on through a transplant.”
“A slim chance?” Mulder asked. “Or a serious risk?
And could any of these transferred diseases affect a 62
Skin
patient’s brain? Enough to send him into a violent rage?”
“I would call it extremely rare,” Bernstein replied, leaning back against the sinks. “But possible. For instance, undetected melanomas have been known to spread through transplant procedures. They grow downward through the dermis and into the blood vessels, then ride the bloodstream up into the brain. And certain viruses could jump through the lower layers of the epidermis into the capillaries; herpes zoster, AIDS, meningitis, encephalitis—the list is endless. But most of these diseases would have shown up in the donor patient. Such microbe-laden skin would never have been harvested in the first place.”
Not on purpose, Scully thought to herself. But people made mistakes. And microbes were often tricky to spot, even by trained professionals. A million viruses could live on the head of a pin—and viruses were extremely hard to trace, or predict. “After the procedure, did Stanton exhibit any symptoms at all? Anything that might hint at a viral or bacteriological exposure?”
Bernstein started to shake his head, then paused.
“Well, now that I think about it, there was one thing. But I can’t imagine how it could be connected to such an outbreak of violence.”
He rubbed the back of his neck with his hand. “A small circular rash. Right here, on the nape of his neck. It looked like thousands of tiny red dots. I assumed it was some sort of local allergic reaction—like an insect bite, 63
THE X-FILES
only a bit larger. I’m not a specialist, but I can’t think of any serious disease that presents like that.” Scully wasn’t sure if the strange rash was connected—
but she filed it in her memory. She was trying to think if there was anything else they needed from the plastic surgeon when Bernstein glanced at his watch, then let out a ponderous sigh. “I’m sorry, but I’ve got an emergency surgery scheduled to start in
“So the donor skin is only temporarily attached?” Mulder asked.
61
THE X-FILES
“That’s right. The temporary graft isn’t matched to the patient—because it’s intended to be rejected after a period of a couple of weeks. Then we graft a piece of the patient’s own skin over the wound. In the meantime, the donor skin decreases the risk of infection, and it helps indicate when the burned area is ready to accept a permanent transplant.”
“If the temporary graft isn’t matched to the patient,” Scully interrupted, “what precautions are taken to make sure the graft isn’t carrying something that could infect the patient with a communicable disease?” Bernstein glanced at her. She could tell from his eyes that he had already given this some thought. Stanton had been his patient—and as unfair and illogical as it seemed, he was partially blaming himself for what had happened. “Truthfully, very few—on my end. The skin is transported to us from the New York Fire Department Skin Bank; the bank is responsible for growing bacteriological cultures, and for checking the skin for viral threats. But they themselves are guided by the medical histories provided by the donor hospital.
There are a million things to look for, and it’s impossible to cover every possibility. If a donor dies from something infectious, they don’t accept his skin. But if he dies from an unrelated cause—and happens to be carrying something, there is a chance that it will be passed on through a transplant.”
“A slim chance?” Mulder asked. “Or a serious risk?
And could any of these transferred diseases affect a 62
Skin
patient’s brain? Enough to send him into a violent rage?”
“I would call it extremely rare,” Bernstein replied, leaning back against the sinks. “But possible. For instance, undetected melanomas have been known to spread through transplant procedures. They grow downward through the dermis and into the blood vessels, then ride the bloodstream up into the brain. And certain viruses could jump through the lower layers of the epidermis into the capillaries; herpes zoster, AIDS, meningitis, encephalitis—the list is endless. But most of these diseases would have shown up in the donor patient. Such microbe-laden skin would never have been harvested in the first place.”
Not on purpose, Scully thought to herself. But people made mistakes. And microbes were often tricky to spot, even by trained professionals. A million viruses could live on the head of a pin—and viruses were extremely hard to trace, or predict. “After the procedure, did Stanton exhibit any symptoms at all? Anything that might hint at a viral or bacteriological exposure?”
Bernstein started to shake his head, then paused.
“Well, now that I think about it, there was one thing. But I can’t imagine how it could be connected to such an outbreak of violence.”
He rubbed the back of his neck with his hand. “A small circular rash. Right here, on the nape of his neck. It looked like thousands of tiny red dots. I assumed it was some sort of local allergic reaction—like an insect bite, 63
THE X-FILES
only a bit larger. I’m not a specialist, but I can’t think of any serious disease that presents like that.” Scully wasn’t sure if the strange rash was connected—
but she filed it in her memory. She was trying to think if there was anything else they needed from the plastic surgeon when Bernstein glanced at his watch, then let out a ponderous sigh. “I’m sorry, but I’ve got an emergency surgery scheduled to start in
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