Zein finally resolved to probe further into the molecular irregularities of the skin's biological clock, immersing himself in the reference volumes he had meticulously gathered.
He revisited every detail of Sulastri's medical records, cross-checking them against her laboratory results, which, astonishingly, were entirely unremarkable, as though she had never once suffered the slightest ailment.
Hours slipped by as he scrutinised every observation, analysing each with relentless precision, until at last he uncovered a subtle anomaly overlooked by the physicians who had previously treated her.
His attention settled on Sulastri's former profession, a retired nurse, which now seemed crucial in unravelling the enigma of her current condition.
"There must be some hidden thread in Mrs Sulastri's past work that explains how she could develop such a peculiar disorder!" Zein murmured, lost in thought.
"I must see her first thing tomorrow!" He added, his resolve hardening.
He carefully closed the reference books and returned them to their rightful places on the shelf.
A glance at the clock revealed it was already 2:55 a.m.
Exhausted yet with his mind still brimming with questions, Zein finally allowed himself to rest, intending to resume his inquiry at first light.
** * **
The following morning, at precisely 7:20 a.m., Zein set off for Derisa Hospital in his car, still preoccupied with the perplexing case of Sulastri.
He drove swiftly, reaching the hospital fifteen minutes later.
With brisk steps, he made his way to Isolation Ward 3B, where the patient was admitted.
Inside, several doctors were already present, Dr Iman, an internist, Dr Bagus, a surgeon, Dr Hendra, a neurologist, and Director Widodo, engaged in conversation with Sulastri herself.
Zein paused at the door, observing the discussion.
They were reviewing Sulastri's condition, which remained an enigma.
Dr Iman spoke first, his tone calm yet considerate, "Mrs Sulastri, the skin biopsy indicates only mild, non specific inflammation!"
"This means there are no definitive signs of a skin disease, yet the spots you've been experiencing remain unexplained!" He added.
Dr Bagus continued, "We've performed fungal and parasitic cultures, all negative! No infection has been detected that could account for the colour changes!"
"We also conducted autoimmune tests! The antibodies were borderline normal, so we can rule out systemic lupus erythematosus or vasculitis linked to immune dysfunction!" He explained further.
Dr Hendra chimed in, "We even checked melatonin and cortisol levels to see if any hormonal irregularity could be influencing your circadian rhythms!"
"Unfortunately, the hormone readings show no significant fluctuations that might explain the daily changes in your skin pigmentation!" He concluded.
Sulastri exhaled, her frustration evident, "So, Doctors, what exactly is happening to my skin? Why do the spots turn from red to black every day? I feel like my body isn't functioning properly!"
Zein's gaze swept over the room, resting briefly on each doctor before he spoke again, his tone measured yet insistent.
"I've reviewed every single test, every biopsy, every hormonal assay. Everything appears normal. Too normal, in fact! Yet the symptoms persist, and they do so in perfect synchrony with the day-night cycle!" He explained, his voice low but firm.
Dr Hendra shifted uneasily, "Are you suggesting… that the cause lies outside her body?!"
"Precisely!" Zein replied. "The pattern, the timing… it's as if her skin is responding to an external trigger, something we've not yet identified. Something entirely overlooked by conventional examination!"
Dr Iman's eyes narrowed, "External?! Do you mean environmental?! Or… psychological?!"
Zein shook his head slowly, "Not merely environmental, not psychological either. There's a molecular rhythm at play here, one that interacts with her peripheral skin clock!"
"I suspect a factor that's either chemical, photic, or possibly both, an influence that the human body has adapted to, yet remains undetectable under normal clinical scrutiny!"
A hush fell over the room. Even Director Widodo, usually quick to speak, remained silent, absorbing Zein's words.
"I'll need to observe Mrs Sulastri directly!" Zein continued, his gaze settling on the patient herself. "And I'll require full access to her environment, her daily routine, and any external exposures she may have had! Only then can we begin to understand what's truly happening!"
Sulastri, listening with wide, apprehensive eyes, whispered, "You mean… there's a reason outside of me?! Something causing this?!"
Zein allowed a small, measured smile to appear, "What I'm suggesting is that Mrs Sulastri has likely been subject to this phenomenon for many years, even while she was actively working as a nurse!"
"Indirectly, it was precisely her profession that seems to have instigated the emergence of this condition!" He continued, his voice calm yet authoritative.
"What?!" Dr Iman, Dr Bagus, and Dr Hendra exclaimed in unison, taken aback by his assertion.
"You're not jesting, Doctor?!" Dr Iman interjected sharply, his tone carrying a mixture of incredulity and challenge.
"How could such a thing possibly occur?!" He pressed, struggling to reconcile Zein's explanation with his understanding.
"It is entirely plausible!" Zein replied evenly, his gaze piercing yet steady.
"It can occur in a nurse repeatedly exposed to specific chemicals over a prolonged period! Strong antiseptics, disinfectant solutions, even topical medications routinely used in isolation wards or ICUs, can leave microscopic residues upon the skin, particularly if protective measures were inadequate!"
Zein stepped closer to Mrs Sulastri, continuing, "Chronic exposure to such substances may induce modifications in genes regulating the circadian rhythms within skin cells! Genes such as PER1, CRY2, or BMAL1 maintain the cellular biological clock!"
"In Mrs Sulastri's instance..." He added.
"...A minor mutation or epigenetic alteration may have arisen from cumulative chemical exposure!"
"It does not manifest as a major disorder like cancer or acute dermatitis, yet it is sufficient to perturb pigment signalling, giving rise to the speckles that change colour according to her daily cycle!"
He paused, letting the weight of his words settle, then added softly, "Moreover, prolonged work beneath artificial lighting with minimal exposure to natural sunlight can exacerbate this circadian disruption!"
"Her body misinterprets the passage of time, and the consequences are rendered visible directly upon her skin!"