The Cure

by Geeta Anand

  Running back inside, he shouted, “Aileen, call the police.” As she picked up the phone, the day nurse, who’d also been looking for the little boy, called out from upstairs, “Guys, guys, calm down, guys—he’s in his bed.” Aileen and John looked at each other in astonishment. Upstairs, they found their son curled in a fetal position under a mound of bedding at the foot of his bed. Neither John nor Aileen had seen him asleep under all the covers.

  Collapsing onto the bed, John pulled his son into his arms, tears of relief spilling onto his cheeks. Aileen knelt beside the bed and wrapped both arms around the two of them. “Hi, Mom and Dad,” the little boy said, opening his eyes sleepily, looking from his parents to the nurse. “Why is everybody in my room?”

  Three hours later—soap suds washed off and hair neatly gelled—John sat at the head of the table in Morgan Stanley’s top floor conference room, overlooking lower Manhattan. Light streamed in through the big windows that looked over the city, the soaring Twin Towers of the World Trade Center marking southern Manhattan a few blocks away. Dennis and Steve from Perseus Soros sat to his right, Gus to his left, and beside him, Josh Phillips and his senior partner, David Hendren, of Catalyst. The two other board members—Stuart Kornfeld, the brilliant scientist, and David Albert, the Oklahoma inventor—dialed in. Canfield, still hiking, didn’t participate. In front of every board member lay a navy blue, hard-covered spiral-bound book containing Morgan Stanley’s financial analysis.

  John began with an abbreviated PowerPoint presentation to summarize the arguments in favor of each of the deals. Then he moved into his personal recommendation to go with the Genzyme offer.9

  “The Genentech deal offers the potential for more upside, but the investors keep all of the risks of drug development,” he said. “On the other hand, the Genzyme deal gives us a big, immediate return to investors, and the potential of still more money. If our technology works, this is a good deal, not a great deal. But if our technology doesn’t work, the Genzyme deal is the deal of the century.”

  “I don’t know,” Josh said, shaking his head. “I just feel like we’re stepping away from a great deal of value.”

  “Well, I’m sorry you’re disappointed,” John said a little sarcastically, the tension of the past few weeks spilling over. John knew it was a good deal for the venture investors as long as they didn’t get too greedy. “I hope all of your deals are as disappointing as this one.”

  Josh backed off immediately, saying, “I am disagreeing, but we understand that when management unanimously thinks it’s time to sell, we can’t stand in the way.”10

  Dennis jumped in. “Do you think there’s any more value on the table? Can we get Genzyme any higher?”

  “This is as far as we’re going to push Henri,” John said, firmly.

  “Could we use the Genentech term sheet as leverage?” Dennis pressed.

  “It would imperil the deal and cause bad will. I could never go work at Genzyme after pushing Henri any further,” John said, even more adamantly. He was certain he’d pushed Henri as high as he would go, and he didn’t want to imperil his relationship with Myrtle Potter by using Genentech as a stalking horse.

  “It’s a good deal and we should take it,” Gus said. Dennis, finally convinced, nodded in agreement. There was no need even to take a vote.

  “I want you to know you did a really, really good job,” Dennis enthused after the meeting ended, patting John on the back. When the room cleared, Gus came up to John, smiling, and said, “I think you will be happy. I think this will be good for you and your family, John.”

  John stepped outside to the sunny spring day and grabbed a cab to Penn Station. It was early afternoon—the meeting that decided the fate of his company, and caused him so much sleeplessness, had only lasted a single hour. As he rode the New Jersey Transit train home, he sat back and thought about how, two years earlier, he could barely get managers at Genzyme or Pharming to return his calls. In a few weeks, he would be in charge not only of Canfield’s experimental medicine—but also of all other drugs in clinical development for Pompe disease in the entire world. How far he’d come from the days when he had struggled even to gain entrance to Randall’s Pompe research conference!

  Now, one way or another, with Canfield’s drug or with some other enzyme, he felt certain his children would be treated. All he had to do was keep the pressure on Genzyme to move quickly into clinical trials. He had already done the hardest part—he was part of the Pompe world, in a position of influence; he had given the science the necessary funding boost and steered Canfield’s enzyme toward trials and FDA approval. The rest, he was sure, couldn’t be any harder than that. He picked up the phone to tell Aileen about the meeting.

  “Hey honey,” he said. “Do you still like clam chowder?”

  “So you got the board to go with the Genzyme deal,” Aileen said, picking up on the reference to Boston. “Honey, you are amazing.”

  “How’re the kids?” he asked.

  “Oh, just great,” she said, with the merest hint of sarcasm. “Patrick just finished speech therapy. Megan’s in physical therapy. Their vents are acting up today. Sharon and I have been running between them trying to figure out what all the beeping is about. It’s just another great day in the Crowley household. What time are you going to be home?”

  21

  Genzyme

  Fall 2001

  Cambridge, Massachusetts

  At 8:30 A.M. on September 26, John strode across the brick courtyard at One Kendall Square in Cambridge to begin his first day of work at Genzyme. He wore a navy suit and carried his old leather briefcase over his right shoulder. It was a beautiful fall day, and students from the nearby MIT wandered by in shorts and T-shirts. Other than his suit, John thought he could easily pass for one of them. He was only thirty-four, but he still looked years younger with his short, trim physique, full head of hair, and unlined, olive complexion. Almost every time he introduced himself, the other person registered shock that someone so young was Novazyme’s CEO. John’s standard response was to laugh and say, “Well, if it’s any consolation to you, I feel a hell of a lot older.”

  In truth, John thought, he couldn’t be further removed mentally and emotionally from the young man he’d been when he graduated four and a half years ago from Harvard Business School, across the Charles River and only a couple of miles away from Genzyme’s headquarters. His life had been so different then, so carefree, it seemed someone else had lived it.

  John remembered the day he’d graduated from Harvard—and remembered thinking that nothing could get between him and his plans for a great life for himself and his family. How could it? Not with a Harvard MBA, a Notre Dame law degree, Annapolis training, and the strength of his and Aileen’s tight-knit extended families. Perhaps his class’s choice of graduation speaker—Ray Gilmartin, chief executive of the drug company Merck & Co.—was a signal of the direction his life would take. Perhaps it was more than coincidence that in his own Class Day speech, he had asked his fellow students to use their Harvard MBAs “to combat disease, to fight racism, to promote the entrepreneurial spirit in your own countries.”

  John stopped at Bean Town breakfast shop for tea and a bagel with peanut butter before heading into the long brick 1400 Building, Genzyme’s headquarters at the time. In his briefcase, he carried a legal notepad covered in his distinctive longhand scrawl—his plan for taking over the company’s Pompe program. During the three agonizing months since his board had agreed on that June day to sell to Genzyme, John had steamrolled his way through negotiations on all the finer points of the deal, including the positions he and Canfield would assume at Genzyme after the acquisition. As of today, they were both senior vice presidents at Genzyme. Canfield would manage research operations in Oklahoma; John would direct the companies’ combined programs to develop a treatment for Pompe disease, which would soon become not only the most expensive drug development program in Genzyme’s history, but among the costliest in the history of the biotechno
logy industry.

  On his way to Henri Termeer’s fifth-floor office, John passed the same conference room where they had haggled over a price a few months earlier. Even after agreeing on the deal, the negotiations had been fraught with turmoil, and John knew that Henri had repeatedly overruled his senior scientists in deciding to sign the final papers. John, worrying about how these scientists and others at Genzyme would receive him, had been strategizing for weeks about how to get along.

  It was September, the month when he had once hoped to get the trial started—the one that would treat and save Megan and Patrick. Instead, he was beginning a new job. Doctors had repeatedly told him that children with the nonclassical infantile form of Pompe, like Megan and Patrick, could survive until age five—maximum. Megan would turn five in December, which was only three months away. If his children were to survive, he needed to quickly build a cohesive team and drive a treatment into a clinical trial. He was running out of time.

  Henri, gracious as ever in a dark suit, button-down shirt, and bright red tie, greeted John warmly. “It is so wonderful to see you. I am so thrilled to have you here,” he said, reaching for John’s hand. But if John was expecting any direction on how to do his job, he didn’t get it that day. Instead, as they sat briefly together, Henri asked for John’s thoughts on transitioning into a leadership role at Genzyme. Drawing from the notes he’d jotted down, John told Henri he wanted to meet one on one with all of Genzyme’s senior staff working on Pompe disease over the next few weeks. During that time, he hoped to keep a low profile and hold off bringing in his own management team. Only after he’d met the key players and developed an action plan would he bring on his team.1

  Henri nodded approvingly. “Yes, John, that makes sense. I like that.” He said he had only one piece of advice, for now: “Keep your people at Novazyme motivated.” He wanted to avoid a frequent casualty of acquiring a company, which is to lose some very talented employees who fear their roles will be substantially diminished. Then Henri’s secretary appeared, telling him he had another meeting waiting. He stood up, patted John on the back, and said, “Go get ’em. Let me know if you need any help.”

  A minute later, Genzyme’s newest senior vice president and director of the Pompe disease program stood outside the CEO’s office with absolutely no idea of where to go next. He hoped someone had remembered to find him an office.

  Trying to look as if he knew where he was going, he strode confidently down the hallway, turned right into van Heek’s office, and asked his secretary if she happened to know where he was supposed to sit. After a flurry of phone calls, she led him through a maze of hallways, into another building, and to a tiny corner office she’d secured. John thanked her and stepped inside, trying to keep his expression composed—he’d seen attic bedrooms that were bigger. The ceiling was so low on one side that he could barely stand up.

  So much for his hope of wielding power and influence from an office near Henri’s and van Heek’s; he wasn’t even in the same building. John shrugged it off—for the moment, anyway—and sat down to get right to work.

  Van Heek had given him a list of phone numbers of the company’s employees involved in Pompe disease. The first person he should meet, John had been told, was the newly hired medical director of the Pompe program, Dr. Hal Landy. John dialed his number and set up a lunch for that very day. John told Landy he would come by his office to pick him up. “I’m looking forward to it,” Landy replied politely.2

  Somehow, despite knowing that Landy’s office was on the floor below Henri’s, John still got lost trying to find it. He wandered through four different floors in three different, interconnected buildings before finally finding himself outside Landy’s door.

  He was waiting, his door ajar. About ten years John’s senior, Landy was of medium height and was square-faced with a big forehead, tightly cropped dark hair, and an intense expression. He wore his shirtsleeves rolled up and his collar open, and his tie hung loosely like a pendant. “It’s so nice to meet you, John. I’ve been hearing you were coming,” he said, shaking hands.3

  As they walked outside, Landy filled John in on his background: He was a pediatric endocrinologist who had spent years coordinating clinical trials for a Swiss biotech firm, Serono. Under his direction, Serono had won government approval to sell a synthetic version of human growth hormone for children with a deficiency. He said he had joined Genzyme only two weeks earlier.

  The two men agreed to try a nearby Mexican restaurant. They settled into chairs on the outdoor patio on Kendall Square, with Genzyme’s headquarters on the left and the brick building housing Gus’s venture firm on the right. After the waiter took their order, they exchanged a few pleasantries, and then John began peppering Landy with questions about his experience thus far at Genzyme.

  “So who’s in charge of the Pompe program?” John asked.

  “There is someone—a very nice man, in fact,” Landy said. “He’s not very senior at the company, though.”

  “Does there seem to be any kind of comprehensive plan for developing a Pompe treatment?”

  “Not that I can tell,” Landy replied. Aside from the Novazyme enzyme, he said, Genzyme was working with three other potential treatments for the disease. There were the programs to develop the Pharming and the Chen enzymes, as well as a recent effort John hadn’t known about to produce an enzyme similar to Chen’s but easier to manufacture.

  “There is a ‘core team’ for each enzyme. I’m going to be assembling my own team to bring all of them together. You can be on my core team if you’d like,” he declared, taking a swig of iced tea.

  John didn’t reply at first, shocked that Landy seemed to think he was the one who was taking over leadership of all the Pompe programs. As the waiter plopped their meals in front of them, John wondered—should he set Landy straight right now or wait until he had more information? John grabbed his burrito with both hands and bit into it. He decided it would not be prudent to pick a fight now and tried to make a joke of Landy’s comment.

  “Maybe I’ll form my own ‘core team,’ too. Then we’ll have six core teams,” he quipped, flashing his boyish grin. “And we all won’t talk to each other. That couldn’t be any worse than what it is today!”

  But Landy wasn’t laughing, sensing the murky territory between himself and this young hotshot CEO. He moved swiftly to claim it.

  “John, you do drug development for the Novazyme program—I don’t need to know anything about that,” he said, frowning, deliberately imparting to John his subordinate position—as a leader of only one of the four potential Pompe treatments under development.

  “You do need to know about that,” John retorted, sarcasm flooding his voice, shoving the crumbling bits of his burrito around his plate with his fork. “I would think as medical director of the Pompe program, you would need to know about all the programs, Hal.”

  There was nothing but tension at the table as the two men finished their entrées. All John could think of was that he needed to get out of there, to find out what was going on, before he alienated Landy any further. Pointing at two wasps that were now circling, he joked stiffly, “Let’s get back to the office before I get killed by these things.” The discussion—and the lunch—ended before the waiter could even ask if they wanted coffee or dessert.

  Back in the safety of his office, John closed the door, sat at his desk, and put his head in his hands. One day into the job and he was already being challenged for his job title. His status at the company—to judge from his office—appeared to be nonexistent.

  Should he call van Heek or Henri and demand that they set Landy straight? He thought back to a class he’d taken at Harvard Business School called “Coordination, Control, and Management of Organizations.” An inexperienced executive would go running to the boss for help, he decided. A seasoned player would lay low, gather more information, and go to the boss with a clear plan of action. He would stick to his original plan.

  Reluctantly, John picked up the ph
one and scanned down the list of employees he’d been told played significant roles in the company’s Pompe programs. The next name was Bob Mattaliano, a senior scientist, and John sighed, hoping that he would be more accommodating than Landy. Moments later, he was back on the line, making another lunch date. And so began John’s marathon of interviews over the next three weeks, during which time he talked at length to almost fifty people.

  Several people John interviewed were on the “core team” that was developing Dr. Chen’s drug. This was the same enzyme John and Aileen had been so hopeful about after it showed promise with baby John Koncel, who had subsequently regressed when he built up antibodies. A second group of employees that John spoke with were part of a core team in Europe, handling the development of the Pharming enzyme. Scientist Bob Mattaliano led the third core team, trying to develop a Pompe enzyme grown in a more productive line of Chinese hamster ovary cells (CHO cells) from the one Chen had chosen. Mattaliano and his team had begun this project only a few months ago, but they had some early, encouraging data in mice.

  From all these interviews, John concluded there was no overarching drug development plan. Including Novazyme, the four groups developing potential Pompe drugs operated almost independently of each other. “It would be comical if my children’s lives didn’t rest on the outcome,” John muttered to van Heek in disbelief.

  Genzyme itself was large and unwieldy. Founded in 1981 by a Tufts University Medical Center researcher, the company had experienced exponential growth based mostly on revenue from its first drug, the treatment for Gaucher disease. Even though Genzyme now had about five thousand employees spread over the world, Henri had preserved the same freewheeling culture the company had had at its inception, believing it essential to retaining the entrepreneurship that had made his firm successful in the first place. John, who lined up his shoes in his closet and color-coordinated his sock drawer, found the structure difficult to understand, let alone navigate.