Polite Dissent

Manhunter #18 “Who’s Your Daddy, part 3: Domestic Violence”
Marc Andreyko, writer
Javier Pina and Fernando Blanco, artists

Kate Spencer’s biological father, Walter Pratt, has myeloma. Enlisting the aid of the villainous Dr. Moon, he has kidnapped his own grandchild in the hope that he can be used as a donor for a bone marrow transplant.

Myeloma is a cancer of the blood forming cells of the bone marrow. Because of this, it can present as both a blood disease (anemia) and a bone disease (bone pain and unexpected fractures). Kidney failure and frequent infections are also common. Myeloma has a high mortality, with the average survival after diagnosis being on the order of three to five years. Myeloma can be treated, but rarely — if ever — cured.

Chemotherapy and radiation therapy are the main therapies for myeloma. Bone marrow transplant is another option. This can either be an autologous transplant (using the patient’s own bone marrow), or an allogeneic transplant (using the bone marrow of a matching donor, usually a relative). Autologous transplants put less of a strain on the patient, but do not prolong the survival to the same extent that allogeneic transplants do; however, allogeneic transplants are much harder on the patient and are usually reserved for younger patients.

What about Walter Pratt?

How he was diagnosed, and how low ago, is never mentioned. There is a forearm x-ray visible in Dr. Moon’s office, so it’s fair to assume that Pratt has been having some bone symptoms (a bad sign). It is no surprise that Pratt is pushing for an allogeneic transplant as it gives him the best chance at survival, though the moral costs are high (which is clearly not a problem for him). Pratt would generally be considered too old for an allogeneic transplant, but his super-powers will likely aid his recovery, making it a viable choice after all.

Still, Dr. Moon’s proposed treatment has me concerned.

First, as Pratt himself notes, the lab and operating room are far from sterile. Due to the radiation and chemotherapy, as well as the myeloma itself, Pratt is going to be much more susceptible to infection. Sterility is very important.

Second, Dr. Moon gives Walter a radioactive “cocktail” to drink that will destroy his bone marrow. When radiation is used to treat myeloma, it is given externally, not internally. A radioactive cocktail will destroy more gastrointestinal tract than bone marrow. There are some oral chemotherapy drugs for myeloma, but they are not radioactive. Both radiation and chemotherapy take several days to have a full effect on the bone marrow. Walter would not be ready for a transplant that same day.

Third, since when is Dr. Moon an oncologist? He generally focuses on the mental aspect of patients, not their physical side.

Andreyko seems to have his myeloma facts down, so I doubt these are slip-ups on his part. I suspect these “errors” are intentional and his way of showing how sadistic and manipulative Dr. Moon is, and that he is not above experimenting on conveniently available victims patients. Pratt undoubtedly knows this, but also realizes that this may be his only chance for treatment.