Chapter 110
‘Itcan take up to twenty-four hours for food to pass from the mouth to the anus,’ Doyle said. ‘That’s a journey of nine inhospitable metres. And, DI Flynn’s right, unless something stops the barrier-coated poison from working its way out, work its way out it will. Through peristalsis, which is basically a series of muscular contractions, the digestive system will process anything it receives. The scientists who needed pills to stay in the body longer than peristalsis would allow, had to develop tablets that could stop the digestive system doing what it is designed to do.’
Doyle filled a clear glass beaker with water. She dropped the white paracetamol tablet and the blue and white paracetamol capsule into it. She swirled the water with a pen. After a few moments the tablet started to dissolve and sank to the bottom of the beaker. A few seconds later, the capsule began to break up.
‘As you would expect, the immediate-release medication did what it was supposed to. If this beaker was a stomach, the medication could now be absorbed by the body.’
She then reached into her pocket and removed another blister pack. She popped it and held up a disc-shaped tablet.
‘I got this from the hospital pharmacy. It’s chlortenoxicam, an anti-inflammatory drug,’ she said. ‘Now, watch what happens.’
She filled a fresh beaker and popped it in. Nothing happened. It didn’t dissolve and it didn’t sink. It just bobbed on the surface like a tiny fishing float.
‘This is a stomach-specific floating drug delivery system,’ she said. ‘It’s for drugs that need to be absorbed by the stomach, or drugs that don’t do well in the intestines.’
‘It floats?’ Flynn said.
‘It does. They have a bulk density less than the gastric juices and are designed to float until the barrier that coats the drug dissolves. They’ve been around for a long time and are getting more and more sophisticated.’
‘So it’s like a ping-pong ball in a toilet. It doesn’t matter how many times you flush, the ping-pong ball isn’t going down the U-bend.’
‘Exactly. Now imagine that same ping-pong ball has something inside that will damage the toilet. Until the ball leaks or degrades, it will remain in the bowl, completely harmless. And this isn’t science fiction – MIT have just designed a capsule that unfolds into a star shape big enough to avoid the two-centimetre gap that leads into the intestinal tract. They believe it will be able to stay in the stomach for up to a month.’
‘What’s MIT?’ Poe asked.
‘The Massachusetts Institute of Technology, Poe,’ Bradshaw replied. ‘It’s a privately run research university in the United States of America. Twenty-six Turing Award winners, eight Fields Medallists and forty-one astronauts have been affiliated with MIT.’
‘Big heads,’ Poe said. ‘And I was at Kendal College at the same time as Stephen Machalepis. He was pretty famous.’
‘What did he do?’
‘Bit one of the Queen’s corgis.’
Flynn sniggered. ‘He’s sometimes hard to keep on task, Estelle,’ she said. ‘But if it’s floating in Salt’s stomach, why aren’t we just sticking a camera down his throat? If it’s there, why can’t we just grab it like we’re playing an arcade claw machine?’
‘Two reason why we can’t, DI Flynn,’ Doyle said. ‘He’s recently eaten, so it’s unlikely the surgeon would be able to see it. And even if we could, retrieving it through the oesophagus would be terribly dangerous. While it’s true endoscopic accessories now include attachments that can grasp things, I believe the risk would be too high. If I’m right, and I can’t see how else it could be done, the Botanist uses a barrier that degrades over a specified period of time. It would be comparatively thick to begin with, but by now it will have the structural integrity of an over-baked croissant.The endoscopic attachment wouldn’t be able to retrieve the tablet without piercing the barrier. And if the barrier is pierced, the tablet delivers its payload.’
‘Which is why Salt is being prepped for surgery.’
‘Doctor Mukherjee will cut vertically into the abdominal cavity, through the skin, fat, muscles, muscular aponeuroses – they’re the tendons that connect muscles to the thing the muscle moves – and the peritoneum. He’ll move a couple of things to the side then open up the stomach. Just like he would if the stomach’s lymph nodes had to be removed. Once he has access, he’ll use a surgical spoon to scoop out the contents.’