Last early evening I was boredly reading some ESPN headlines. Jonathan Kuminga, check; Mark Williams traded again, check. Kristaps Porzingis traded. I read a headline about it on draft night but didn't feel drawn to read it, oh what the hell, it's 6 o'clock Saturday night, it's not like I have a hot date or something.
"Mysterious illness". Ah, yes! I remembered now. Gasping for breath on the sidelines when he came out in the playoffs. Missed a bunch of games with a respiratory infection, noi, in February. Came back and wasn't himself. Easily fatigued. Ineffective on floor. Head coach Joe Mazzulla said Porzingis "couldn't breathe". Porzingis described his symptoms in vivid, though still mysterious, terms:
-"really, really fatigued. Not normal";
-“My system is not perfect right now, not working the way it should. I could just lay down over here and just take a little nap."
"I'm not sure [what it is]. Even right now, I played 11 minutes and I'm gassed."
-"many symptoms that were super weird”.
-Ominous terms, too:
"I haven’t been this sick, probably ever, in my life.”
Sounded like COVID or "Long COVID", whatever that is, if it exists. Why didn't Beans just tell us what was wrong with him?! Why the mystery?
Brad Stevens, or Pete Buttigieg, one of them, "revealed", that's the new buzz word in headline clickbait, "revealed" the "mysterious illness": Post-Viral Syndrome (PVS). Which isn't really a diagnosis.
Medicine has this brilliant technique for dealing with things that their brilliance can't figure out, they give them official-sounding names that are really gobbledygook. They even have a three-tiered code for bullshit. Syndrome is at the bottom; it's the height of bullshit. "Use 'syndrome' for a 'constellation' of symptoms that don't add up to anything that you can diagnose", students must be told in medical school. So Post Viral Syndrome wasn't really a "reveal". What was the virus that he was post from? There were five candidates: common cold, COVID-19, flu, pneumonia, Epstein-Barr. The "Celts" in their "reveal" removed the fig leaf only to show that it was not COVID.
Epstein-Barr. Have a glancing familiarity with Epstein-Barr. USMLE with Dr. Ana. "See? When you make an actual diagnosis, a novel one, you get to put your name on it. It's not a bullshit 'syndrome' anymore. You're immortalized with a disease." I didn't associate Epstein-Barr with breathing difficulties and extreme fatigue in world-class athletes, though, I associated it with cancer. My medical education is still in the toddler stage. Looked up Epstein-Barr.
Epstein-Barr virus. See, I didn't even know that. It is the, or one of the, most prevalent viruses in human beings. 90% of adults worldwide have, or had, it! And it does lead to cancer in a small percentage of cases, I hadn't misassociated the two. When I read that it was a virus certain loose atoms in my mind connected virus generally and cancer generally. There is, or was, maybe it has been debunked, a medical theory that cancer generally has a virus at its source. "I bet", to self, "Epstein-Barr is the source of that theory."
In rare cases, EBV causes mono, "kissing disease," which results in, "extreme fatigue (Porzingis), fever, sore throat, and swollen lymph nodes." (not Porzingis, as far as is known (which isn't far)). "Post-infectious chronic fatigue syndrome has also been associated with EBV infection.[63][64]" No mention of breathlessness either, the other major Porzingis symptom.
I read on. The details hooked me deep:
EBV...is the first human oncogenic [cancer-causing] virus to have been discovered and to this day, it remains the only human pathogen that can immortalize and transform cells in vitro (Niedobitek, 1999). Epstein Barr
Nothing like firsts and "immortalize" to revive my old detective habit of mind. I read on.
"Immortal": a cell line is immortal--and this is the only immortal cell in humans--when somehow it is able to evade the normal life, and death, cycle. It just keeps on growing and multiplying. Never heard of such a thing.
There was an Irishman who spent some 20 years in British colonial Uganda in the 1940's and 1950's. He noticed Ugandan children with a weird jaw cancer. In 1958 he published his findings in a British medical journal. His name was Dennis Parsons Burkitt and he got the jaw cancer named after him, Burkitt's lymphoma. Burkitt's lymphoma, t(8;14) (Anki flashcards)! Was familiar with Burkitt's lymphoma. Burkitt's lymphoma was one of the cancers caused by Epstein-Barr!
How was the connection made between what was to be called Epstein-Barr virus and Burkitt's lymphoma? By hunch and legwork, as a lot of cases are solved by detectives:
In 1961, Epstein, a pathologist and expert electron microscopist, attended a lecture on "The commonest children's cancer in tropical Africa—a hitherto unrecognised syndrome" by D. P. Burkitt, a surgeon practicing in Uganda...(Wikipedia)
I read on. This detective story has an unhappy ending. The perp is identified but cannot be located and locked up, i.e. no vaccine for EBV is available--for a weird reason. The last text entry in Wikipedia on EBV:
Although under active research, an Epstein–Barr virus vaccine is not yet available. The development of an effective vaccine could prevent up to 200,000 cancers globally per year.[12][13] The absence of effective animal models is an obstacle to the development of prophylactic and therapeutic vaccines against EBV.[24]
"The absence of effective animal models"??? Yes, you see, proposed vaccines for EBV cannot be tested ethically on humans because it causes cancer, so researchers have used, mice, monkeys, rabbits, and hamsters, all of which are lacking a certain human element. I actually read the scientific article on this insurmountable obstacle.
A Chinese team was working on a vaccine with human subjects, but,
Due to the biosafety standards imposed in vaccinology, this initial clinical study was not pursued.
Another test on humans, by a Belgium team, using Chinese Hamster Ovary,
...seemed to attenuate the severity of the disease associated with EBV infection; on the other hand, they did not prevent the infection itself (Tangye et al., 2017).
On and on. Researchers were hoisted on the petard of the prohibition on directly injecting humans with some form of EBV because of its oncogenic properties, and no effective vaccine exists:
Last but not least, another major obstacle [to a vaccine] consists in the absence of efficient animal models, affecting not only the development of prophylactic vaccines, but also research on therapeutic vaccines (Rรผhl et al., 2020).
The Boston "Celtics" express confidence that Kristaps Porzingis will be free of his "many symptoms that were super weird" and can play this summer for his native Latvia in the European Basketball Championship. Easy to be confident when you have off-loaded a mystery. It is now Team Latvia's problem, and the Atlanta "Hawks" problem, to which Boston traded Porzingis.