Virtually Undead

by Robert I. Katz

  Finally, they began their approach to the runway and twenty minutes later, exited the plane. Michael breathed a sigh of relief. It took another ten minutes to pick up their luggage and twenty more to check out a reserved Infiniti Q50 from Enterprise.

  The FBI had made things as smooth as possible. A few minutes later, Michael pulled into the private garage of a ten-story building a block from the Mississippi and only a mile or so from the Medical Center, where they took an elevator to the top floor. They had been given a three-bedroom apartment, with a fitness center on the mezzanine and a pool up on the roof.

  “Very nice,” Stephanie said.

  They stowed their bags in the largest bedroom. A few minutes later, Michael was inspecting the numerous bottles in the liquor cabinet when they heard a knock. Michael glanced at his watch. “Just on time,” he said.

  Stephanie peered through the keyhole, then opened the door. A man stood there, dressed in a tan, lightweight suit. He was thin, with a weathered face and sandy hair. “Ms. Seymour,” he said, and glanced at Michael. “Dr. Foreman. I’m Special Agent Greg West. May I come in?”

  “Please do,” Michael said.

  Special Agent Greg West seemed acquainted with the apartment’s layout. He sat down at the kitchen table, opened a brown leather briefcase and pulled out a folder. “I’ll leave this with you,” he said. “It contains background on the medical center and all the principal players. You should look it over, once I’ve gone. Call me if you have any questions. Now…” He smiled. “Anything else I can help you with?”

  Michael and Stephanie both sat down at the table. “I’m still wondering how you arranged this,” Michael said.

  “Every university of note in the United States receives millions of dollars in federal funding, every year, including Selwyn College of Medicine and your own facility in New York. Both institutions are fully aware that such funding can be curtailed at the whim of the financing agency.” He shrugged. “A couple of phone calls. It wasn’t a big deal.”

  Which explained nothing at all. Numerous departments at Selwyn, including the Department of Bioengineering, had recently placed advertisements in academic journals seeking qualified individuals for Research Fellowships. A man named Hans Bleeker, from Rotterdam, had applied for and been offered such a position. However, Hans Bleeker had been suddenly offered an Assistant Professorship at the University of Oregon, a much better position than Research Fellow. At the same time, Thomas Henderson, MD, Chairman of the Department of Neurosurgery at Staunton College of Medicine in New York, had picked up the phone and called his old buddy Dave Caskill, the Chairman of the Department of Neurosurgery at Selwyn College of Medicine, in New Orleans. It seemed that one of Tom Henderson’s bright young boys, a talented up-and-comer named Michael Foreman, was looking to buff his resumé with a visiting scholar position, and also to do a little research with a group that shared his own interests. Could Dave Caskill help him out?

  A few other phone calls were made. A quick agreement was reached regarding salary swaps from the various involved departments, clinical productivity bonuses, grant contributions, and appropriate titles, and within a couple of days, Selwyn was ready to roll out the red carpet for Michael Foreman, MD, Visiting Assistant Professor of Neurosurgery and Associate Research Fellow, Departments of Bioengineering and Neurology, Division of Neurophysiology. A confidential communication from someone in the FBI to the Louisiana State Board of Medical Examiners resulted in a temporary license to practice medicine and surgery.

  Not a bad gig, if you could get it, Michael thought, and an excellent title. It really would look good on his resumé, if the whole shoddy edifice didn’t blow up in his face. Amazing that he, Mother Foreman’s little boy, neurosurgeon and one-time musical genius would be infiltrating a nest of bad guys, like some junior grade James Bond.

  Stephanie coming along was an unexpected bonus. A little early in the relationship for them to be spending extended time together, but Stephanie hadn’t taken a vacation in four years. She wanted to see New Orleans, and so here they were.

  Michael looked at Stephanie. She looked back and gave a minute shrug.

  “Review the package,” Greg West said. “We’ll talk again tomorrow night, after you’ve met your co-workers, but briefly, Silas Munro’s research at DARPA, as nearly as we have been able to determine, was an attempt to develop implantable control devices for animals a bit higher on the evolutionary chain than an insect, like rats or monkeys, a variation of the HI-MEMS project. He has continued that research here.” Greg West shrugged.

  “Okay,” Michael said. “I’ll read it this evening. The only other thing we could use is the location of the nearest supermarket and a list of restaurants in the area.”

  Greg West smiled. “An annotated map of the neighborhood and a list of dining establishments are both included in the package.”

  “Well, then, I guess we’re all set.”

  The file on Silas Munro contained nothing that Michael did not already know. His years at DARPA were mentioned but unsurprisingly, no details were given. Michael knew a bit about James Garrett, of course, having attended his lecture at last year’s conference in San Diego, but was otherwise unacquainted with his career. James Garrett was a full professor, with an MD/PhD from Harvard, the PhD in Neurophysiology, followed by a neurosurgical residency at Hopkins. He had bounced around from medical center to medical center, never lasting for more than three years, before landing at Selwyn twelve years ago. The reasons for leaving his prior positions was not specified, but reading between the lines, Michael got the impression that James Garrett was a pompous jackass. Michael knew the type. Neurosurgery was full of them: brilliant, entitled, convinced that they were God’s gift to the medical profession, if not the world at large.

  Apparently, Garrett had finally wised up, at least enough to keep his ego in check. He had two ex-wives and was currently married to a woman much younger than himself. A picture of wife number three was included. Blonde, buxom, beautiful. Whether or not she had a brain was not apparent. He had two kids with wife number one and three with wife number two, one of whom, a boy and the eldest, had suffered massive injuries in a car crash twelve years prior, and was currently confined to home. The nature of the injuries was unstated.

  The folder contained brief summaries of all the personnel working in the Division, post-docs, mostly, with the rank of assistant instructor, about as low on the academic totem pole as you could get. Michael skimmed through. None had a record of deviant behavior and all seemed normal enough. Good schools, ambitious would-be drones in the academic beehive. Michael felt sorry for them. No scientific department in any university in the United States could exist without people just like them, but no matter how bright and talented they might be, the pay was lousy, the benefits poor and the hours long, and in the end, there were not enough positions on the ladder for more than a small percentage of them to climb upward. Every university lab in the United States churned through post-docs, a new class every season, almost all of whom would spend a few years, come to realize that they were going nowhere, and finally give up. Some would wind up in industry. Some would teach high school science. Some would sell used cars.

  It was a racket. The academic establishment took them in, promised them careers, used them, abused them and spat them out, bitter and disillusioned.

  And of course, the situation for the so-called “Humanities” was even worse. There was nothing a PhD in Sociology or English Literature could do with his expensive degree except teach, and the number of available teaching positions was less than a tenth the number of available PhD’s.

  For the successful, it was a great life. The promise of that great life was how they lured you in.

  Michael sighed and sat back. Nothing in the folder jumped out. Nothing pointed to criminal background, behavior or intent. He looked at the clock. It was already past midnight and Stephanie had gone to bed. He rose to his feet, stretched his back and padded in to join her.

  Tomorrow,
he thought. I’ve only just begun. Tomorrow, maybe I’ll learn a little more.

  Chapter 19

  Selwyn University Medical Center was a multi-building complex, comprising a six-hundred bed hospital, an ambulatory surgery center, two small research buildings made up entirely of labs and a ten-story adjacent school building—which contained classrooms, lecture halls, a library, administrative offices, study halls, student lounges, a faculty lounge and more labs. A four-story covered parking lot with a bridge to the hospital sat across the street. It was a standard design for an integrated, modern health center.

  “You know, all of us are wondering what you’re doing here. It’s sort of a nebulous position.” Abby Saunders and Jake Aioki had walked up to where Michael was sitting at a small table in the hospital cafeteria, smiled, re-introduced themselves and sat down. He had met them only an hour or so before, at a meeting of the Neurophysiology Research Division.

  Michael had expected that he would be an item of popular interest. Unlike most of the research group, he wasn’t hurting for money and he wasn’t struggling to make a name for himself. “My position in your department is only a small part of what I’m here for.”

  “Pretty good gig, anyway,” Abby Saunders said. “How did you get it?”

  “I’m a genius,” Michael said. “They rolled out the red carpet.”

  Jake Aioki blinked at him over the rim of his coffee cup, then shrugged. “Yeah, well, all of us have high IQ’s, but that and two bucks will get you a ticket on the metro.”

  Michael nodded. “I have heard that before.”

  Jake Aioki shrugged. “Never mind. We just wanted you to know that everybody is wondering what the deal is. What are you going to contribute?”

  “To you? Probably not much. Mostly, I’m here to learn. I won’t be here long enough to get any research of my own going. Part of my time, approximately two days per week, will be spent on patient care. The rest will be spent in the laboratory.” Snooping, Michael thought. “My principal interest is in the development of devices that can accurately interpret cortical activity.”

  Abby Saunders nodded. “All of us have read your papers. They’re okay but they’re not cutting edge, more engineering than any fundamental advance in the science.”

  On one level, Michael felt that he should be offended, but Abby Saunders was not wrong. Years ago, while still a resident, Michael had attended a lecture entitled Medicine and the Academic Career. The lecture had been given by an old timer on the verge of retirement, whose name Michael no longer remembered. “Genius is all well and good,” the old guy had said, “but you can’t ever forget that an academic career is built from the ground up.”

  The first thing you need to do, the old guy went on to say, is prove yourself. Prove that you can get the job done, that you can take an idea, write up a proposal, get the needed funding, carry out the project on time and within budget, analyze the data, write the paper and get it published. All of this takes time and effort, and at least some of that time will inevitably be at night and on the weekends. It doesn’t happen right away. The time between getting an idea and getting a publication out of it is typically two to three years. Getting published is key. Publish or perish. Not a new concept.

  A study is an attempt to answer a question, and it’s important, particularly when starting out, to come up with a question that’s worth answering, and then get answers that are worth publishing, no matter where the data might take you or what that answer might be. The old guy had smiled out at the room, “You want to avoid asking questions where only one answer is worth publishing. For instance, suppose that you get the bright idea that two glasses of orange juice a day will cure HIV. Let’s say that you design a study, spend six months to a year gathering your data, analyze it and discover that, yep, orange juice will cure HIV. Obviously, you’ve got something publishable. You’ll get famous and probably win the Nobel Prize. Now let’s say that the data shows that your idea doesn’t work, that orange juice will not cure HIV. You’ve spent a lot of time and money and you’ve got nothing to publish, because nobody on Earth would ever expect such a stupid idea to work.

  “Do you regard that example as absurd?” The old guy had fixed the audience with a beady eye. “Let me give you a couple of similar, and very real examples. For many decades, stomach ulcers were assumed to be caused by excess stomach acid, sometimes related to spicy foods and stress. Then Barry Marshall and Robin Ward postulated that they were caused by a bacteria, Helicobacter pylori. Marshall and Ward were ridiculed. The theory was considered absurd. Bacteria, it was assumed, could not survive in the acid environment of the stomach. Their papers were rejected. Then Marshall drank a solution containing Helicobacter pylori and within two weeks, he developed erosive gastritis, a precursor to stomach ulcers. Now, the world took them seriously. They got famous. They won the Nobel Prize.

  “The same thing happened with prions. The idea that scrapie, kuru, Kreutzfeld-Jacob and mad cow disease could all be caused by a self-replicating protein was greeted with utter derision. The theory was obviously wrong, until Stanley Prusiner proved that it was right. Prusiner and his colleagues got their papers published, and they won the Nobel Prize.”

  The old guy smiled out at the room. “See, this is something that all scientists, sooner or later, come to learn, the successful ones, at least: most brilliant, new ideas are wrong, and wrong ideas aren’t publishable. If you get such an idea and you decide to spend your time on it, the probability is that your career will crash and burn.

  “So, don’t forget—you have to have papers, and to get papers, you need data that’s worth publishing. Obviously, some great scientific advance is going to be publishable, but if you spend your time on an idea that seems to be new and brilliant but turns out to be baloney, you’ll wind up with nothing. So, getting back to reality, aside from some brilliant leap into the unknown, what sort of data is always going to be publishable? Say somebody else does publish a paper showing that orange juice will cure HIV. Great. Now you can reproduce the study. If you show it works, it’s confirmatory evidence. It will get published. If you show it doesn’t work, it refutes a prior study. That will get published, too.

  “The easiest thing to do, when looking for things to study, is to study what we do. It’s a sad commentary on the so-called science of medicine that many of the techniques we use, things that we do routinely, are either not well documented as being useful or are done differently at other institutions. For instance, at one institution, they’ll use running sutures to close an incision and at another, they’ll use interrupted sutures. At one institution, they’ll use nipride to lower the blood pressure and at another, they’ll use nicardipine. Why? Why not? If you want to compare interrupted sutures to running sutures, or compare nipride to nicardipine, you’ll get a paper out of it. Whatever you find will be publishable.”

  The old guy had waggled his eyebrows at the audience. “See what I mean?”

  Michael had never forgotten that lecture. He suspected that the old guy’s advice might have been scorned by some of his more ambitious colleagues, but to Michael, it sounded very smart indeed. So, yeah, Michael’s research was interesting but it wasn’t cutting edge. Plenty of time to be cutting edge once you’ve got tenure and they can’t fire you. EEG analogues had proven to have plenty of uses, from identifying the site of a tumor to measuring cortical activity. Investigating the functionality of small, cheap, disposable probes was something that everybody in the field would find interesting. Michael’s data was publishable.

  Onward and upward. A respectable academic career was built brick by brick. So, he wasn’t going to be lauded the world over and win the Nobel Prize, not yet, at least. Right now, all Michael really wanted to do was take care of a few patients and play the piano. Oh, and solve a few murders for the FBI.

  There was Eddison Robb, a small guy and the youngest member of the Division faculty, who the rest of them treated with amused disdain. Eddison Robb spoke fast, tended to spray his food, and go
suddenly still, as some new idea fermented to the top of his brain. There was Jefferson Dumont, a big, balding guy with a ready smile, and Sarah Ronson, a small, washed out woman with a perpetual frown, who showed up to work every day wearing a stained white lab coat. Dumont and Sarah Ronson worked together, their particular interest being the construction of filamentous artificial matrixes along which bioartificial organs, cultured from a patient’s own stem cells, could hopefully, theoretically, one day be grown. There was Silas Munro, established, with six million in NIH funding and his own, very large lab, and, looming over them all, was James Garrett, the head of the Division, whose lab was the largest of all.

  Each of these had their own post-docs and research assistants, plus mini-armies of student volunteers needing research credits to either complete a course requirement or to impress graduate programs to which they were intending to apply. All-in-all, a large, successful, well-established group, which produced nearly a hundred papers each year in high impact journals. They were proud of themselves, as well they should be.

  The Neurophysiology Division had possession of an entire lab complex consisting of one large room, shared by Robb, Dumont and Ronson, plus two smaller, though still sizeable series of rooms accessed either from doors in the back of the main lab or from secondary doorways on an adjoining hallway. These belonged, respectively, to Garrett and Munro.

  Michael’s position in this group was unclear. His salary while at Selwyn would be largely supported by his clinical work. Back home, he had NIH funding to the tune of $900,000, shared with two co-investigators, both PhD’s, spread out over three years. It wasn’t a large amount for a senior researcher, but enough to be independent. He had no intention, however, of trying to set up his own lab and run his own research program here at Selwyn. There was just no point. It was clear from the beginning that his presence in New Orleans was temporary, two months at the most. No. Michael was supposedly here to observe, to help out where he could, but mostly, to pick up whatever techniques and ideas his own research could use in the future. That was the story, at least.