Lorenzo's Oil Page #5

you'd have a therapy.

No, you wouldn't quite have a therapy.

You would have a way of

lowering the fatty acids to normal.

If you wish to inhibit biosynthesis...

...have you considered

fatty-acid manipulation?

There is some literature,

a rat study, Russian or Polish.

Polish. Straszak.

I have copies right here.

Polish Journal of Biological Sciences

1979, Volume II.

They loaded the diet with one fat

and decreased biosynthesis of another.

Yes, I remember this article.

And also in Canada, they have seen

the same thing in miniature swine.

As a matter of fact,

I've seen it in human cells.

In human ALD cells.

From patients with ALD,

I took fibroblasts - skin cells, OK?

Each one carries the same genetic defect.

I incubated them with oleic acid and

reduced the saturated C24 and C26...

- ...by more than 50 per cent.

- Excuse me, Doctor.

You said oleic acid?

Yes, monounsaturated C18,

the main component of olive oil.

- Surely this is the basis for a therapy.

- Slow down.

These are studies in cultured cells. We

don't know it'll work in a human being.

Well, then, take the olive oil

and try it in a patient and see...

Augusto, olive oil is forbidden

in the diet:
C24, C26.

Yes, but then use whatever

Dr Rizzo fed his fibroblast.

Pure oleic acid would be very toxic to

an intact organism, an animal or human.

It would need to be the triglyceride form,

which is edible, but that's not available.

All right, can't you take ordinary

olive oil and extract the C24 and C26?

You could, but it's a very complicated

procedure and would be very expensive...

...especially to produce the quantities

for a clinical trial.

Have you contacted chemical companies?

No one will tool up for that.

Not for an experiment,

not for something with no market.

- Then you haven't tried?

- No.

If we were able to get triglyceride,

then we can change all that, right?

Yes. It has to be triglyceride

to be edible.

Edible form. Triglyceride.

No one here can help you.

Then do you know anyone else who does?

I'll send you back to the switchboard.

- Which extension, please?

- Research and development.

R&D.

- I need a triglyceride form of oleic acid.

- Your name, Doctor?

- No, I'm not a doctor.

- Are you with a company?

No, I am not with any company.

I'm the mother of a sick child.

- A mother?

- That's right.

- And you want...?

- Oleic acid.

- The lines are busy.

- I'll wait.

Papa makes you

spaghetti al pomodoro...

...seasoned with basilico,

the royal herb for our prince.

Badabib, badabab, badaboom.

Come on, Lorenzo, take a little bit.

That's a boy.

The best lead

came from the symposium:

...oleic acid in the triglyceride form.

Now it's our only hope for Lorenzo.

Don't fret, Mrs Odone.

You will hear from him within the hour.

- You can be sure of it.

- Thank you. That's 301...

Don't worry, I have the number.

- Thank you very much.

- You're welcome. Bye-bye.

So, as the swallowing reflexes weaken,

he's less able to handle his own saliva.

We'll all have to be pretty vigilant. We

really have to stay on top of this thing.

If we allow any saliva to get down into

his respiratory tract, we block his airway.

We don't wanna do that.

Here we go. Put your

thumb over the valve.

When you don't want suction,

release your thumb.

Hi. It's ProtoChem again.

I'll connect you to our Mr Pellerman.

- I believe you want some oleic acid.

- Yes, in triglyceride form.

You're lucky. We're testing a glycerol

trioleate here as an industrial lubricant.

Industrial? Then... is it fit

for human consumption?

I don't see why not.

It's a purified olive oil.

Without saturates? Pure monounsaturated

C18 in triglyceride form?

- Yes, ma'am.

- You're sure?

It happens we have one bottle here,

sitting idle on the shelf.

Marvellous! How can we

get our hands on it?

- Sorry. Go ahead.

- How can we get our hands on it?

This is... beautiful.

- And it's entirely harmless?

- Gus, you're talking to an Italian.

- It's only olive oil.

- Yes, that's harmless. It's like... sugar.

And yet, to a diabetic,

sugar can be lethal.

You see, the trouble is we don't know to

what extent Lorenzo can metabolise fats.

Yes, well, Gus, it's been seven months

since Lorenzo was diagnosed.

Now he is silent. He's immobile.

Augusto, I am a scientist...

...and I'm of absolutely

no use to you whatever...

...unless I can maintain my objectivity.

And I am not a scientist. I am a father.

And nobody can tell me what dressing

I put on my kid's salad, OK?

Augusto...

This science of medicine.

You know, it's not like physics.

There's no mathematical certainty.

And because we deal with human beings

who suffer, it can appear heartless.

I know.

You realise that any collaboration

of mine would have to be unofficial?

S, s, of course. Now, the dose.

We think 40 grams a day.

- That's too much. Say 30.

- 30?

Yes. Any more than that

might damage your son's liver.

Darling, they're about to start.

We're going to send this blood away

to establish a baseline, my brave boy.

Because today we all start

the fight against the boo-boo.

There. All done.

Lorenzino, this year we celebrate

Thanksgiving a little early...

...with a fine barracuda

like we used to eat in the Comoros, huh?

And Papa has cooked it

with the aromatic dill.

And now...

...we add the special olive oil

which Mama found.

Hm? All right?

There we go.

Deirdre.

All right, Lorenzo. Here we go.

- There we go.

- You did good, buddy boy. Real good.

Your Aunt Deirdre means "well", darling.

In this house, we cherish our adverbs.

I expect you to do the same

when you get your voice back.

- Hello?

- Mrs Odone, this is Dr Nikolais's office.

I have Lorenzo's results. There's been a

small drop in the saturated C24 and 26.

- About 15 per cent.

- 15 per cent?

Dr Nikolais said not to get carried away.

It could be a spontaneous variation.

- Am I allowed a tiny squeak of joy?

- We'll know more next month.

Thank you.

Michaela!

Augusto! Get something

to hold down his tongue!

Oh, my baby!

So, this is a kind of seizure,

like epilepsy?

No, not a seizure. It's a paroxysm.

It's triggered by saliva in the windpipe.

- But we suction him.

- Regularly.

I know, but even so, some saliva

gets caught in the trachea.

In any other child,

a cough would get rid of it.

In Lorenzo, it becomes

a scrambled chain of reflexes...

...that amplifies into

what you have just seen.

If this happens again,

what can we do about it?

Just help him try to ride it out.

We're all flying blind here, folks.

The best I can offer is sedation.

But if it's not epilepsy, then he's aware

of what's happening while it's going on?

Well, it's possible.

And if he has another episode,

we could talk him through it.

It's possible, Michaela.

It's possible.

- S, s. A 50 per cent drop, right?

- That's correct.

Thank you very much. Thank you!

Fantastico! Fantastico!

I very well understand that we are not

scientists, but we have observed this...

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