cellular wall. Then imagine that it can simultaneously copy several strands of DNA and split into two daughter cells everytwenty minutes or so. In an hour, you’ll have 8 of them. In twelve hours, 69 billion. By hour fifteen, you’ll have 35 trillion. This explosive growth only slows when its food begins to run out.
E. coli are also highly promiscuous. They can trade genes with other bacterial species through a process called bacterial conjugation, which allows an E. coli cell to rapidly pick up new traits (such as resistance to a new antibiotic) when needed. This basic recipe for success has kept E. coli on the planet since the earliest days of unicellular life. We all have E. coli bacteria residing within us—mostly in our gastrointestinal tract. Under normal conditions, this poses no threat to us. But when varieties of E. coli that have picked up DNA strands that make them especially aggressive invade the cerebrospinal fluid around the spinal cord and brain, the primitive cells immediately begin devouring the glucose in the fluid, and whatever else is available to consume, including the brain itself.
No one in the ER, at that point, thought I had E. coli meningitis. They had no reason to suspect it. The disease is astronomically rare in adults. Newborns are the most common victims, but cases of babies any older than three months having it are exceedingly uncommon. Fewer than one in 10 million adults contract it spontaneously each year.
In cases of bacterial meningitis, the bacteria attack the outer layer of the brain, or cortex, first. The word cortex derives from a Latin word meaning “rind” or “bark.” If you picture an orange, its rind is a pretty good model for the way the cortex surrounds the more primitive sections of the brain. The cortex is responsible for memory, language, emotion, visual and auditory awareness, and logic. So when an organism like E. coli attacks the brain, the initial damage is to the areas that performthe functions most crucial to maintaining our human qualities. Many victims of bacterial meningitis die in the first several days of their illness. Of those who arrive in an emergency room with a rapid downward spiral in neurologic function, as I did, only 10 percent are lucky enough to survive. However, their luck is limited, as many of them will spend the rest of their lives in a vegetative state.
Though she didn’t suspect E. coli meningitis, Dr. Potter thought I might have some kind of brain infection, which is why she decided on the lumbar puncture. Just as she was telling one of the nurses to bring her a lumbar puncture tray and prepare me for the procedure, my body surged up as if my gurney had been electrified. With a fresh blast of energy, I let out a long, agonized groan, arched my back, and flailed my arms at the air. My face was red, and the veins in my neck bulged out crazily. Laura shouted for more help, and soon two, then four, and finally six attendants were struggling to hold me down for the procedure. They forced my body into a fetal position while Laura administered more sedatives. Finally, they were able to make me still enough for the needle to penetrate the base of my spine.
When bacteria attack, the body goes immediately into defense mode, sending shock troops of white blood cells from their barracks in the spleen and bone marrow to fight off the invaders. They’re the first casualties in the massive cellular war that happens whenever a foreign biological agent invades the body, and Dr. Potter knew that any lack of clarity in my cerebrospinal fluid would be caused by my white blood cells.
Dr. Potter bent over and focused on the manometer, the transparent vertical tube into which the cerebrospinal fluid would emerge. Laura’s first surprise was that the fluid didn’t drip but gushed out—due to dangerously high pressure.
Her second surprise was the fluid’s appearance. The slightest opacity would tell her I was in deep trouble. What shot out into the