|HIV infecting a lymphocyte. © iStockphoto|
It is born with tens of thousands of identical brothers and sisters when the thin-walled, transparent, fatty bubble of their nurturing womb suddenly bursts—releasing them into the tumultuary rapids of the host’s bloodstream.
It possesses no sense of self, no manner of consciousness—even in the most rudimentary way.
It lacks any of the traditional senses possessed by other living creatures with which to perceive or discern the nature of reality.
It is no more than a tumbling, bouncing bag of unthinking protein and nucleic acids.
Yet it is capable of the most vital skill of any organism: to reproduce, to ensure the continuance of being.
It is a translucent, soccer-shaped ball with a nebulous outline demarcated by shimmering, iridescent sparks and flashes of light generated by collisions of high-energy electrons gyrating wildly along the vast, interconnected chains of atoms that comprise its outer protein coat.
It tumbles about haphazardly, swept along indifferently by powerful currents of blood through the cavernous, pale-walled arteries and dark purple veins of its host.
It knows nothing of anger or impatience.
It has no concept of time.
It knows only that it must reproduce.
Nothing else matters.
After countless, fruitless collisions, it finally encounters a potential victim.
It attaches itself to the cell’s outer covering through a series of wondrous molecular events. Its surface proteins trick the target cell into absorbing the minute invader, welcoming the monster innocently as if it were a dear and intimate friend. Yet as tiny as it is compared to the prodigious cell, it will become the Master.
There will not be—could not be—any resistance or disobedience. The infected T-lymphocyte will become a brainless lackey to this Lilliputian invader’s insidious plan.
It neither knows nor cares about accomplishment.
It is unaware that this fantastically elegant and intricate dance is almost as old as life itself.
Usurping control of its innocent, cellular victim, it initiates the de novo assembly of viral particles: new brothers and sisters. The newly infected T-lymphocyte distends and swells, pregnant with freshly created and highly-infectious HIV virions.
A few wandering, neighboring T-lymphocytes approach and caress the gravid white blood cell with specialized surface proteins designed to detect subtle abnormalities in their sibling’s outer surface.
Through the biological wisdom of their design, honed by millions of years of interactions with past foreign invaders who had entered their host’s body uninvited, these cells detect that something is dreadfully amiss.
These uninfected cells now know, in their own special and almost infallible way, that their sibling lymphocyte must be destroyed.
Excited and fully activated, these extraordinary guardians of the body sound the alarm by secreting powerful chemicals—lymphokines—into the bloodstream, in the hope of quickly recruiting cytotoxic T-cells, the body’s killer white blood cell storm troopers.
But they are too late.
The enemy has won again.
The grotesquely swollen white blood cell bursts, discharging its deadly payload. The virions scatter rapidly into the swirling maelstrom of the bloodstream, seeking new cells to infiltrate and infect, another chapter in the ancient viral battle for survival.
It knows nothing of what is happening all around it on a macroscopic scale.
Its reproduction is the only reason for existence.
Nothing else matters.
No conscious thought or reason is involved in the invader’s enterprise, yet this operation proceeds elegantly, automatically, in a ballet as old as life itself.
One living creature consumes another to ensure the continuation of its own kind—there is no right or wrong, no morality here.
It is above the mundane concerns of mice and men.
It has no concept of, no concern for presidents or popes, politics or religion, promiscuity or chastity.
It is indifferent to the nature of the large creature it inhabits temporarily, trillions of times its size.
It is the distilled essence of the living force, pushing forward and overcoming all obstacles and adversaries in its path—devoid of a soul—yet immortal in its own way.
Such are the ways of living things—such is the way of the virus.
S.E.S. MEDINA, MD, is a retired Internal Medicine specialist with a sub-specialty in Infectious Diseases who treated HIV positive individuals for over 30 years. His initial medical training took place at the New York University School of Medicine in the late 1970s when the AIDS epidemic was just beginning, working extensively on severely ill HIV infected individuals. Clinical research under Dr. Linda Laubenstein during his fourth year at the NYU Medical School resulted in a contributing paper which was included in the first medical textbook on AIDS. In addition, Dr. Medina had several family members who died from HIV infection making this disease particularly special to him.
Dr. Medina would like to acknowledge the creative and editorial contributions of his nephew and godson, David I. Banchs, in the writing of this story.