Now the long quest was ending. The surgeons bent over the grail: a 14-month- old girl named Marissa Ayala.
She lay anesthetized upon an operating table in the City of Hope National Medical Center in Duarte, Calif. A surgeon inserted a 1-in.-long needle into the baby's hip and slowly began to withdraw bone marrow. In 20 minutes they removed about a cup of the viscous red liquid -- the stuff of resurrection.
The medical team then rushed the marrow to a hospital room where Marissa's 19-year-old sister Anissa lay waiting. Through a Hickman catheter inserted in the chest, the doctor began feeding the baby's marrow into Anissa's veins. The marrow needed only to be dripped into the girl's bloodstream. There, like salmon heading home to spawn, the healthy marrow cells began to find their way to the bones.
Done. If all goes well, if rejection does not occur or a major infection set in, the marrow will do the grail's work. It will give life to the older sister, who otherwise would have died of chronic myelogenous leukemia. Doctors rate the chance of success at 70%.
The Ayala family had launched itself upon a sequence of nervy, life-or-death adventures to arrive at that denouement last week. Anissa's leukemia was diagnosed three years ago. In such cases, the patient usually dies within five years unless she receives a marrow transplant. Abe and Mary Ayala, who own a speedometer-repair business, began a nationwide search for a donor whose marrow would be a close match for Anissa's. The search, surrounded by much poignant publicity, failed.
The Ayalas did not passively accept their daughter's fate. They knew from their doctors that the best hope for Anissa lay in a marrow transplant from a sibling, but the marrow of her only brother, Airon, was incompatible. Her life, it seemed, could depend on a sibling who did not yet exist.
A brave, surreal gamble. First, Abe had to have his vasectomy surgically reversed, a procedure with a success rate of just 40%. That done, Mary Ayala ventured to become pregnant at the age of 43. The odds were 1 in 4 that the baby's bone marrow would match her sister's. The Ayalas won that gamble too. In April 1990 Mary bore a daughter, Marissa. Fetal stem cells were extracted from the umbilical cord and frozen for use along with the marrow in last week's transplant. Then everyone waited for the optimum moment -- the baby had to grow old enough and strong enough to donate safely even while her older sister's time was waning.
Twelve days before the operation, Anissa began receiving intensive doses of radiation and chemotherapy to kill her diseased bone marrow. As a result, she is losing her hair. Her blood count is plummeting. Her immune system has gone out of business. But in two to four weeks, the new cells should take over and start their work of giving Anissa a new life.
The drama of the Ayalas -- making the baby, against such long odds, to save the older daughter -- seemed to many to be a miracle. To others it was profoundly, if sometimes obscurely, troubling. It called up brutal images -- baby farming, cannibalizing for spare parts. Many saw in the story the near edge of a dangerous slippery slope at the bottom of which they glimpsed an abyss, and maybe the shadow of Dr. Mengele at work.