Fever

by Robin Cook

  Since the Brighton scandal hit the media, security had been tightened at the Weinburger, and Charles had to knock on the massive glass door before it slid open. He was greeted by Roy, the guard, who demanded to see his identification.

  “It’s me, Roy,” said Charles, waving his hand in front of Roy’s face. “Dr. Martel.”

  “Orders,” explained Roy, with his hand still outstretched.

  “Administrative nonsense,” mumbled Charles as he searched for his ID. “What next?”

  Roy shrugged, waited to see the card, which Charles stuck two inches away from his face, then ceremoniously stepped aside. Even the usually coy Miss Andrews turned away without honoring him with her usual come-over-and-talk-to-me smile.

  Charles ditched his coat, called information for New Jersey, and dialed Breur Chemicals. As he waited he looked around the lab wondering if Ellen was still offended. He didn’t see her and decided she must be in the animal room. At that moment Breur Chemicals answered the phone.

  Later Charles admitted to himself he should not have called. He’d already had enough bad experiences that morning to have guessed what it would have been like to try to call a giant corporation with what they would consider a bothersome complaint. Charles was switched over to a low-level man in the Public Relations department.

  Rather than try to placate Charles, the man accused him of being one of those unpatriotic nuts whose stupid and unfounded environmental concerns were responsible for putting American industry in a poor competitive position with companies overseas. The conversation degenerated into a shouting match about dumping benzene with Charles saying they were and the man saying they were not.

  He slammed the phone down and spun around in a fury, looking for a way to vent his anger.

  The door to the corridor opened and Ellen entered.

  “Have you noticed?” asked Ellen with irritating nonchalance.

  “Noticed what?” snapped Charles.

  “All the lab books,” said Ellen. “They’re gone.”

  Charles leaped to his feet, scanning his desk, then the countertops.

  “There’s no sense looking for them,” said Ellen. “They’re upstairs.”

  “What the hell for?”

  “After you left this morning, Dr. Morrison stopped in to check on our progress with Canceran. Instead he caught me working with the mice we’d given the mammary cancer antigen. Needless to say, he was shocked that we were doing our own work. I’m supposed to tell you to go to Dr. Ibanez’s office as soon as you appeared.”

  “But why did they take the books?” asked Charles. Fear blunted the edge of his anger. As much as he hated administrative authority, he also feared it. It had been that way ever since college where he’d learned that an arbitrary decision from the Dean’s office could affect his whole life. And now the administration had invaded his world and arbitrarily taken his lab books which for Charles was like taking a hostage. The contents of the lab books were associated in his mind with helping Michelle, despite how far-fetched that was in reality.

  “I think you’d better ask Dr. Morrison and Dr. Ibanez that question,” said Ellen. “Frankly, I knew it was going to come to something like this.”

  Ellen sighed and tossed her head in an I-told-you-so fashion. Charles watched her, surprised at her attitude. It added to his feeling of isolation.

  Leaving his lab, he wearily climbed up the fire stairs to the second floor and walked past the familiar row of secretaries and presented himself to Miss Veronica Evans for the second time in two days. Although she was obviously unoccupied, she took her sweet time looking up over her glasses at Charles.

  “Yes?” she said as if Charles were a servant. Then she told him to wait on a small leather couch. Charles was certain that the delay was made to impress upon him that he was a pawn. Time dragged while Charles could not decide which was the stronger emotion: anger, fear, or panic. But the need to get back his lab books kept him in his place. He had no idea if they were technically his property or the institute’s.

  The longer he sat, the less certain he became that the books detailing his recent work would be a strong bargaining point. He began to wonder if Ibanez might actually fire him. He tried to think what he could do if he had trouble getting another research position. He felt so out of touch with clinical medicine that he didn’t think he could do that. And if he got fired, he wondered with renewed panic if he’d still be covered by health insurance. That was a real concern because Michelle’s hospital bills were going to be astronomical.

  There was a discreet buzz on the intercom panel, and Miss Evans turned to Charles imperiously and said: “The director will see you now.”

  Dr. Carlos Ibanez stood up behind his antique desk as Charles entered. His figure was backlit from the windows, making his hair and goatee shine like polished silver.

  Directly in front of the desk were Joshua Weinburger, Sr. and Joshua Weinburger, Jr., whom Charles had met at infrequent mandatory social functions. Although close to eighty, the senior seemed more animated than the junior, with lively blue eyes. He regarded Charles with great interest.

  Joshua Weinburger, Jr. was the stereotypical businessman, impeccably attired, obviously extremely reserved. He glanced at Charles with a mixture of disdain and boredom, switching his attention back to Dr. Ibanez almost immediately.

  Seated to the right of the desk was Dr. Morrison, whose dress mirrored Joshua Weinburger, Jr.’s in its attention to detail. A silk handkerchief, which had been carefully folded, then casually flared, protruded from his breast pocket.

  “Come in, come in!” commanded Dr. Ibanez good-naturedly.

  Charles approached Dr. Ibanez’s huge desk, noticing the conspicuous lack of a fourth chair. He ended up standing between the Weinburgers and Morrison. Charles didn’t know what to do with his hands, so he stuck them into his pockets. He looked out of place among these businessman with his frayed oxford-cloth shirt, his wide out-of-style tie, and poorly pressed slacks.

  “I think we should get right to business,” said Dr. Ibanez. “The Weinburgers, as co-chairmen of the board of directors, have graciously come to help us manage the current crisis.”

  “Indeed,” said Weinburger, Jr., turning slightly in his chair so as to look up at Charles. He had a tremor of his head and it rotated rapidly in a short arc to and fro. “Dr. Martel, it’s not the policy of the board of directors to interfere in the creative process of research. However, there are occasionally circumstances in which we must violate this rule and the current crisis is such a time. I think you should know that Canceran is a potentially important drug for Lesley Pharmaceuticals. To be very blunt, Lesley Pharmaceuticals is in precarious financial condition. Within the last few years, their patents have run out on their line of antibiotics and tranquilizers, and they are in desperate need of a new drug to market. They have committed their scarce resources into developing a chemotherapy line, and Canceran is the product of that research. They hold the exclusive patent on Canceran but must get the drug on the market. The sooner the better.”

  Charles studied the faces of the men. Obviously they weren’t going to dismiss him summarily. The idea was to soften him up, make him understand the financial realities, then convince him to recommence work on Canceran. He had a glimmer of hope. The Weinburgers couldn’t have risen to their positions of power without intelligence, and Charles began to formulate in his mind the way he would convince them that Canceran was a bad investment, that it was a toxic drug and would probably never be marketed.

  “We already know what you discovered about the toxicity of Canceran,” said Dr. Ibanez, taking a short puff on his cigar and unknowingly undermining Charles. “We realize that Dr. Brighton’s estimates are not entirely accurate.”

  “That’s a generous way of putting it,” said Charles, realizing with dismay that his trump card had been snatched from him. “Apparently all the data in the Canceran studies done by Dr. Brighton has been falsified.” He watched the reaction of the Weinburgers out of th
e corners of his eyes, hoping for a response but seeing none.

  “Most unfortunate,” agreed Dr. Ibanez. “The solution is salvaging what we can and going forward.”

  “But my estimates suggest the drug is extremely toxic,” said Charles desperately, “so toxic, in fact, that it might have to be given in homeopathic doses.”

  “That’s not our concern,” said Joshua Weinburger, Jr. “That’s a marketing problem, and that’s the one department at Lesley Pharmaceuticals that is outstanding. They could sell ice to Eskimos.”

  Charles was dumbfounded. There wasn’t even the pretense of ethicality. Whether the product would help people made no difference. It was business—big business.

  “Charles!” said Dr. Morrison, speaking for the first time. “We want to ask if you could run the efficacy and toxicity studies concurrently.”

  Charles switched his gaze to Dr. Morrison and stared at him with contempt. “That kind of approach would be reducing inductive research to pure empiricism.”

  “We don’t care what you call it,” said Dr. Ibanez with a smile. “We just want to know if it could be done.”

  Joshua Weinburger, Sr. laughed. He liked aggressive people and aggressive ideas.

  “And we don’t care how many test animals you use,” said Morrison generously.

  “That’s right,” agreed Dr. Ibanez. “Although we’d recommend you use mice since they’re considerably cheaper, you can use as many as you’d like. What we’re suggesting is doing efficacy studies at a very wide range of dosages. At the conclusion of the experiment, new toxicity values could be extrapolated and then substituted for the falsified data in the original toxicity study done by Dr. Brighton. Simple as that, and we’d save lots of time! What do you say, Charles?”

  “Before you answer,” said Morrison, “I think I should warn you that if you refuse, it will be in the best interests of the institute to let you go and seek someone who will give Canceran the attention it deserves.”

  Charles looked from face to face. His fear and panic had disappeared. Anger and contempt remained. “Where are my lab books?” he asked with a tired voice.

  “Safe and sound in the vault,” said Dr. Ibanez. “They are the property of the institute but you will get them back as soon as you finish Canceran. You see, we want you to concentrate on Canceran and we feel that having your own books might be too much of a temptation.”

  “We can’t emphasize enough the need for speed,” added Joshua Weinburger, Jr. “But as an added incentive, if you can have a preliminary study done in five months, we’ll give you a bonus of ten thousand dollars.”

  “I’d say that is very generous,” said Dr. Ibanez. “But you don’t have to decide right this moment. In fact, we have agreed to give you twenty-four hours. We don’t want you to feel coerced. But just so you know, we will be making preliminary inquiries into finding your replacement. Until then, Dr. Charles Martel.”

  With disgust, Charles whirled and headed for the door. As he reached it, Dr. Ibanez called out: “One other thing. The board of directors and the administration want to convey their condolences regarding your daughter. We hope she recovers quickly. The Institute health plan, by the way, only holds while you are actively employed. Good day, doctor.”

  Charles wanted to scream. Instead he ran the length of the administrative department and thundered down the metal fire stairs to his office, but once there, he didn’t know whether he wanted to stay. For the first time he felt that being part of the Weinburger Institute was a disgrace. He hated the fact that they even knew about Michelle. On top of that they were using Michelle’s illness as leverage against him. It was an outrage. God!

  He looked around his laboratory, his home for the last eight years. He felt as if he knew every piece of glassware, each instrument, every bottle of reagent. It didn’t seem fair that he could be rudely plucked from this environment at whim, especially now that he was making such progress.

  His eye fell on the culture he’d set up with Michelle’s leukemia cells. With great effort he went over to the incubator, peering in at the rows of carefully arranged glass tubes. It appeared to be progressing well, and Charles felt a much-needed sense of satisfaction. As far as he could tell, his progress of isolating and augmenting a cancer antigen seemed to work as well with human cells as it did with animal cells. Since it was already time for the next step, Charles rolled up his sleeves and tucked his tie inside his shirt. Work was Charles’s anesthetic and he bent to the task. After all, he had twenty-four hours before he’d have to bow to the demands of the administration. He knew but did not want to admit to himself that he had to give in for Michelle’s sake. He really had no choice.

  NINE

  Coming back from Beth Israel Hospital where she’d paid an unsuccessful visit to Marge Schonhauser, Cathryn felt she was being stretched to the limits of her endurance. She’d guessed that Marge must have been bad off or she wouldn’t have been hospitalized, but she was still not prepared for what she found. Apparently some vital thread had snapped in Marge’s brain when Tad had died, because she had sunk into an unresponsive torpor, refusing to eat or even sleep. Cathryn had sat with Marge in silence until a feeling of tension drove Cathryn away. It was as if Marge’s depression were infectious. Cathryn fled back to Pediatric Hospital, going from the casualty of one tragedy to the beginning of another.

  Rising in the crowded elevator to Anderson 6, she wondered if what happened to Marge could happen to her or even to Charles. He was a physician and she would have guessed he’d be more capable of dealing with this kind of reality, yet his behavior was far from reassuring. As difficult as she found hospitals and illness, Cathryn tried to gird herself against the future.

  The elevator arrived at Anderson 6 and Cathryn struggled to reach the front of the car before the doors closed. She was impatient to get back to Michelle, because the child had been very reluctant to let Cathryn leave. Cathryn had talked Michelle into letting her go after lunch by promising she’d be back in half an hour. Unfortunately it was now closer to an hour.

  Michelle had clung to Cathryn earlier that morning after Charles had left, insisting that Charles was angry with her. No matter what Cathryn had said, she’d not been able to change Michelle’s mind.

  Now Cathryn pushed open Michelle’s door, hoping the child might be napping. At first she thought perhaps she was, because Michelle didn’t move. But then Cathryn noticed the child had kicked off the covers and slid down in the bed with one leg tucked under her. From the doorway Cathryn could see that Michelle’s chest was heaving violently and worst of all, her face had an alarmingly bluish cast with deep maroon-colored lips.

  Rushing to the bedside, Cathryn grasped Michelle by the shoulders.

  “Michelle,” she cried, shaking the child. “What’s wrong?”

  Michelle’s lips moved and her lids fluttered open but only whites showed; her eyes were rolled up in their sockets.

  “Help!” cried Cathryn, running for the corridor. “Help!”

  The charge nurse came from behind the nurses’ station followed by an LPN. From a room beyond Michelle’s came another RN. They all rapidly converged on Michelle’s room, pushing past the panic-stricken Cathryn. One went to either side of the bed, another to the foot.

  “Call a code,” barked the charge nurse.

  The nurse at the foot of the bed sped over to the intercom and yelled for the clerk at the nurses’ station to call a code.

  Meanwhile the charge nurse could feel a rapid, thready pulse. “Feels like V-tack,” she said. “Her heart’s beating so fast it’s hard to feel individual beats.”

  “I agree,” said the other nurse, putting the blood pressure cuff around Michelle’s arm.

  “She’s breathing but cyanotic,” said the charge nurse. “Should I give her mouth-to-mouth?”

  “I don’t know,” said the second nurse, pumping up the blood pressure cuff. “Maybe it would help the cyanosis.”

  The third nurse came back to the bed and straightened o
ut Michelle’s leg while the charge nurse bent over and, squeezing Michelle’s nose shut, placed her mouth over Michelle’s and blew.

  “I can get a blood pressure,” said the second nurse. “Sixty over forty, but it’s variable.”

  The charge nurse continued to breathe for Michelle but Michelle’s own rapid respiration made it difficult. The nurse straightened up. “I think I’m hindering her more than helping her. I’d better hold off.”

  Cathryn remained pressed against the wall, terrorized by the scene in front of her, afraid to move lest she be in the way. She had no idea what was happening although she knew it was bad. Where was Charles!

  A woman resident was the first doctor to arrive. She came through from the hallway so quickly that she had to grab the edge of the door to keep from falling on the polished vinyl floor. She ran directly to the bedside, grasping Michelle’s wrist for a pulse.

  “I think she has V-tack,” said the charge nurse. “She’s a leukemic. Myeloblastic. Day two of attempted induction.”

  “Any cardiac history?” demanded the woman resident, as she leaned over and elevated Michelle’s eyelids. “At least the pupils are down.”

  The three nurses looked at each other. “We don’t think she has any cardiac history. Nothing was said at report,” said the charge nurse.

  “Blood pressure?” asked the resident.

  “Last time it was sixty over forty but variable,” said the second nurse.

  “V-tack,” confirmed the woman resident. “Stand back a second.”

  The woman resident made a fist and brought it down on Michelle’s narrow thorax with a resounding thump that made Cathryn wince.

  An extremely young-looking chief resident arrived followed by two others pushing a cart filled with all sorts of medical paraphernalia and crowned with electronic instrumentation.