Flawless

by Joshua Spanogle

  “Jenna, it’s Nate McCormick. How is she?”

  “Uh, hi, Nate,” she said, probably scanning through her mental patient list as to who “she” was. “Brooke’s doing well. We may be able to extubate her tomorrow.”

  “Listen—I need a huge favor. I need you to transfer Brooke to another ICU. Santa Clara Valley or Sequoia or wherever is easiest.”

  “She’s in serious condition, Nate,” Jenna reminded me primly.

  “I know that. I can’t really get into this, but she’s in danger. The people who beat her up will be back.”

  “And you’ve told the police about this?”

  “Of course,” I lied. “They told me to get her a transfer. And, Jenna—don’t tell anyone who doesn’t need to know where she’s going.”

  “This isn’t done.”

  “I know that. But it’s to protect her, you understand that?”

  “Who’s going to pay for this?”

  “Her insurance. Me. Have Billing call me if there’s a problem. Just do it, Jenna. You don’t want something bad to happen to her on your watch.”

  She thought about that. “I’ll see what I can do.”

  “Don’t see. Just do it and do it fast.” I added, “Please.”

  I hung up the phone, hoping that I had generated some get-up-and-go in the neurosurgeon with a bunch of talk pulled straight from ancient pop culture. Just do it. Christ.

  Tim hadn’t reached the darker recesses of the pet store, the place where the tarantulas nested, but was stuck a few feet inside the door, waylaid by a large wire cage. His finger was in the cage, and a puppy—a yellow Lab, by the look of him—licked at it furiously.

  “You done?” I asked. “I have to go over there and use their computer.” I pointed to a café that advertised a few Web-ready computers.

  “Can’t I stay here?”

  “No. We have to stay together, you and me. Come on. I’ll get you a latte.”

  Tim gave me a weird look. Right. The kid’s eight. “I’ll get you a soda.”

  “I think I’ll just stay here,” he decided.

  “You can play on the Web over there. You can look at—I don’t know—look at puppies on the Internet. Play video games. I’ll pay for it.”

  “I want to stay here,” he repeated. So this is what it means to be a parent—constant negotiations, the constant sense of being outmaneuvered.

  The puppies, the kid, the wildly flicking tongue. Hell, when it gets right down to it, I’d rather stay here. “Don’t move, then,” I told him. “I’ll only be ten minutes.”

  As I made my way across the street, I tried to piece together what we had.

  The Mings, a charred clinic, a bunch of people chewed by fibrosarcoma but too terrified to seek treatment. Murph, who’d been getting massive infusions of cash from somewhere and paid for it with his life; I couldn’t even begin to make sense of that. Not yet, anyway.

  We had samples of what was probably Beautiful Essence. As long as the substance didn’t denature in the heat of Ravi Singh’s pocket, it would be a start. But it would take too long to track from a molecule to a manufacturer to a distributor to Wei-jan Fang. Too long for Dorothy Zhang, anyway. Too long to ensnare any bad guys who were already closing shop with massive Molotov cocktails, guns, intimidation, and mutilation. And too damn long to explain why Murph was dead and why he’d forked over two hundred grand to his parents.

  “Damn it, Paul,” I said aloud.

  We had the tissue, the biopsies. The analysis of these would be faster, but still too slow. And the results of any tests on them might not change what we did. Generally in medicine, you only order a diagnostic test when it promises to have some bearing on treatment. If we waved our analytical wand over the tissue and it showed dermatofibrosarcoma protuberans, what would really change? Not much, I decided. But I hadn’t really thought that through when I sent Ravi off to the lab. It would keep him busy, though. And you never know what things like that might yield.

  Most importantly, I had a name and I had a cell type. Dragon East and fibroblasts. Now I needed to get to a computer.

  I forked over a couple bucks for a coffee and a half hour of time on one of the small boxes they had at Jazzin’ Java.

  First thing I keyed into Google was “Dragon East Importers.” Nothing. Not a website, nary a link. I shifted the quotes to “Dragon East” and “Importers” and got a Google-spray of bullshit: “—tail of the dragon, east through the valley…” and “Dragon: East Coast Champs…Mumbai Treasures, Importers of fine…” That sort of thing.

  Sifting through this kind of crap wasn’t my strength. In the lab, sloshing antibodies over tissue, that’s where Nate McCormick was meant to be. Or out beating the streets, wearing out his shoes, chasing down viruses. He was not meant to be in Jazzin’ Java, pursuing who-knows-who through websites and bills of lading. My abortive search on Dragon East proved that.

  So, I returned to science. I ran a search on fibroblast stem cell transplants and jotted down some of the names of researchers working with the cells. If Dr. Fang had been playing in this field, I supposed it wouldn’t hurt to contact them…

  Still, I felt, I was missing something. To wit: Beautiful Essence was not stem cells—those super-powerful progenitors that could differentiate into any cell in the body. Sure, it involved stem cells, but that drew only half the picture. The incubator in the shotgun lab at Fang’s clinic suggested incubation, and not just the warming of cells. Something had been mixed with the fibroblasts and allowed to cook for a while before being injected. But what was being mixed with the cells? Run-of-the-mill cell culture media? Something else?

  I stared at the computer screen, grew tired of looking at the burning pixels, and turned to look out the window. I saw myself reflected in it, let my eyes drift over the ghostly contours of my face. It hadn’t been gnawed by cancer; it hadn’t been hacked by knives. The wounds I’d suffered thus far had been emotional ones, not physical. Something to be grateful for.

  And I let my mind drift to Murph, whose wounds had been plaguing me since this began. He knew about the sick people, of course, through his affair with Dorothy. What else could he have known? And where would the knowledge have come from?

  Tissue is the issue, I told myself.

  Tissue, fibroblasts, tissue regeneration, cosmetic application. Then, I thought: tissue regeneration, wounds, wound healing.

  Tetra Biologics.

  I turned quickly to the computer.

  One of the hallmarks of science, at least science in the last century and a half, is that it is open. You don’t hold on to your discoveries anymore. You show them to the world, allow others to read what you’ve done and build on that. In other words, you wave your own flag. The bulk of the modern scientist’s compensation comes from that: recognition and honor. As such, all of the foundational work for everything that was going on in Tetra would be public, detailed in the literature.

  I started at the beginning, with a PubMed search on Tom Bukowski, founder of Tetra Biologics. Forty-seven articles popped up. I zeroed in first on the mid-nineties papers, when the professor still called the University of Illinois at Chicago his home. Bukowski, it seemed, had interest in a protein called fibroblast growth factor-1 or FGF-1, which, per its name, stimulated fibroblast cells to grow. The titles of the papers were arcane—“Fibroblast growth factor-1 stimulates collagen scaffold in mouse models,” for example, and “Recombinant fibroblast growth factor-1 and tissue growth in vivo”—but intriguing. Seemed too coincidental that we were dealing with a cancer of fibroblasts and Bukowski had been working on fibroblast growth factor. Still, the connections were tenuous.

  Until they weren’t.

  When my eyes fixed on the title of the paper, I felt the way a prospector might when he glimpsed the first glint of gold. “Fibroblast growth factor-1 and fibroblast stem cells: a controlled approach to tissue regeneration.” Only two authors. The second was Tom Bukowski. The first was Peter Yee.

  And both of them had been kill
ed by an explosion on a boat.

  Excited now, I followed the trail, searching through the rest of Bukowski’s and Peter Yee’s articles. I broadened the search to Jonathan Bly, the scientist who headed up the Regenetine project at Tetra, the guy with the handshake of a dead man. I found another nugget: “Fibroblast growth factor-1 causes dysregulation and mutagenesis in fibroblast stem cells.” Put more simply, FGF-1 can cause cancer.

  Christ, I thought, it’s coming together.

  Fibroblast stem cells in a clinic in the Richmond. FGF-1 at Tetra. Tissue regeneration, wound healing. The same goddamned thing. All at once, the puzzle began to assemble.

  Tetra’s blockbuster product wouldn’t be a blockbuster because of wound healing; I’d been correct to think that the market was too small for a billion-dollar molecule. Tetra’s blockbuster drug wasn’t even a drug at all—it was what the industry calls a biological. And that biological, Regenetine, blended with fibroblast stem cells, was poised to find its way into every cosmetic dermatologist’s and plastic surgeon’s office in the country.

  So why all the secrecy? Why the obfuscation about Regenetine? Why not parade the fact that it was a fibroblast growth factor? Why not just fess up and say the promise of the treatment was that it would erase ten years from your face?

  Because they didn’t want anyone to do what I was doing. They didn’t want anyone to connect the dots between an illicit clinic, fibrosarcoma, and the promising new product from a company slated to become the next big thing in biotech, the next Genentech, the next billion-dollar gold mine.

  Immediately, I called Ravi Singh. “Make sure fibroblast growth factor-1 is on the protein arrays,” I said.

  “I’m still in traffic, man. Bay Bridge is way backed up. People getting out of the city, I guess. That explosion is all over the news.”

  “Don’t even bother with the microarrays. Just run an ELISA.”

  “You found something?” Now I had Ravi’s interest. Bless his glory-seeking little heart.

  “They’re adding it to the fibroblast stem cells,” I said. “They’re using FGF-1 as fertilizer for the fibroblasts.”

  “What the hell does that mean?”

  “Beautiful Essence,” I said, savoring this victory. “We’ve nailed Beautiful Essence.”

  97

  I DON’T KNOW WHETHER OR not you can trust the dead, or whether it really even matters. I guess it mattered, though, since the decedent in question was the guy who sucked me into all this in the first place. Paul Murphy.

  The Boy Scout was in deep with Tetra and with the bad guys behind Beautiful Essence, deeper than Dorothy Zhang suggested when she’d told me she and her beau were putting together a misguided, naive exposé of what was happening. Though Murph’s involvement had killed him, I hoped it wasn’t also paying him. Dying like he did is bad enough. Dying like that because you’re shilling for someone is unforgivable.

  In any case, the noose was tightening around Murph and around Tetra. Beautiful Essence was FGF-1. The connection between the two was strong—too strong to be coincidental—but the reasons for it were unclear.

  Just as I crossed the entrance to the pet store, my phone vibrated. It was Millie Bao at CDC.

  “Nate, what’s going on?”

  “I’m leaving the trade, Dr. Bao,” I said, looking into the recesses of the store for Tim. “Got a big idea. Pet supplies on the Internet. Think I’ll call it Pets.com. I’ll make billions.”

  “I’m serious here,” she said. “What’s this I hear about you impersonating an EIS officer?”

  “Oh, that. That was just a joke.”

  “Well, the folks here don’t think it’s so funny. They’re pissed, Nate, especially Dr. Lancaster. He started swearing again.”

  Dr. Lancaster, my former boss at CDC, was famous for his almost-swearing: f-this and GD-that. I’d actually provoked him into profanity the year before. That time, he nearly fired me. No firing possible this time. Prosecution, imprisonment, maybe.

  “Lancaster flipped when he heard you abducted a child, Nate.”

  “I didn’t abduct any child.”

  “Good,” she said, “because I couldn’t stand the thought of you in jail. And I really need that babysitting time you owe me. The health of my marriage depends on it.”

  “So, you found something.”

  “Maybe, possibly something. My friend in Hong Kong said they’ve found a slight uptick in reported cases of dermatofibrosarcoma protuberans. Weird thing is that most of the people they have on file were diagnosed postmortem.”

  “The patients died from DFSP?”

  “No. That’s the weird thing. They were killed by other means.”

  “Killed?”

  “Accidents, violence. There wasn’t enough to establish a pattern, but my friend said his suspicions are up.”

  “My suspicions are up,” I said. “There are at least four confirmed cases here; two who died violently: a woman with the fibrosarcoma was murdered, a man who had it and was killed in a hit-and-run.”

  Millie was silent.

  I said, “It’s there, Millie. It’s in Hong Kong.”

  “Prove it,” she said.

  “Give me a day to confirm something. Then you can throw a giant bone to your Hong Kong pals. If I’m right, they’ll babysit for you for the next year.”

  “You’re worried, aren’t you?” Millie knows me well.

  “Yes,” I confessed. Worried that each passing minute was another in which a needle could be slid into the skin in San Francisco, in Hong Kong, and God only knew where else. Twelve billion dollars—twelve billion—spent on cosmetic procedures in the past year in the U.S. alone. The lure of beauty was irresistible, immutable, and, in this case, lethal. Not even the warning signs of underground clinics and shady physicians would scuttle the quest for the perfect face. That much was already clear. Beauty’s call was too seductive.

  “Tomorrow, Millie. Meantime, tell Hong Kong public health to start looking for a connection between the cases and any new cosmetic procedures. Injections, especially. The name here is Beautiful Essence. Millie—tell them to be discreet.”

  She laughed. “Discreet. I didn’t know that word was in your vocabulary.”

  I ended the call.

  So, probably a dozen cases of the fibrosarcoma in the Bay Area, an unknown number in Hong Kong. This is not the kind of thing a public health guy liked much. We like our outbreaks—our clusters—to be localized, not sprayed across the world. It’s why we hate flu so much, why we hate AIDS and SARS. It’s all a question of numbers and geography and spread. It’s all a question of control. And when something’s stretched across the ocean, you got sucker’s odds of controlling it.

  Tim was no longer at the puppy cages. At the front of the store, I saw an older white woman in a rubber apron brushing scum from the inside of a fish tank. She looked matronly, like she’d be able to detect kid-presence with some sixth sense. I liked the look of her, and asked her if she’d seen a small Asian kid wandering around.

  “I wondered who left him,” she said. “I don’t know who’s so irresponsible to leave a child that age alone.”

  “He’s very responsible,” I answered, not, actually, liking her anymore.

  “It’s good that he is, at least,” she said as she pulled the dripping brush from the tank. “You leave him alone in the car on a hot day, too?”

  “Um…”

  “Lord, that poor boy—”

  “Where is that poor boy? Do you know?”

  She sighed. “Over near the arthropod tanks.”

  The tarantula terrarium was the perfect height for Tim to gaze into, and he stood with his nose a couple centimeters from the glass. I squatted down, put myself on his level. To me, the black furry things looked like moldy pieces of pumpernickel roll.

  “I just got a talking-to for leaving you here by yourself.”

  He kept his eyes on the tarantulas. “You’re not supposed to leave kids alone.”

  No one—absolutely no one—cut
s me a break. “Who says? I was left alone a lot,” I said defensively.

  This was the perfect time for Tim to say something like “And look how you turned out.” Thankfully, he hadn’t yet mastered the art of the cutting retort.

  “They’re not man-eaters,” Tim said, concentrating on a spider in the tank’s corner. “The pet store man said. They eat insects and some eat mice, but not people.”

  “Every time you see one of these things on TV, they have a man’s foot hanging out of their mouths,” I said.

  “No they don’t.”

  “In the movies they do.” I flicked the glass with my fingernail.

  “Don’t do that,” Tim said. “They don’t like it.” He pressed his fingers to the glass. “I’m hungry.”

  “Okay, we’ll get something to—”

  “And I’d like to see my mother now.”

  The kid had a lot of needs. “I would, too. We’ll find her.”

  “Where is she?”

  “I don’t know that yet. We’re trying to figure that out.”

  “Uncle Tony took her.”

  “Maybe. Hey, you remember in The Hobbit when Bilbo and his friends got attacked by those spiders? What did they say to scare them off? ‘Attercop’?”

  “Don’t say that. Spiders hate that.”

  “Attercop,” I whispered loudly to the spiders. “Attercop.”

  “Stop it!” he shouted, real anger in his voice. Customers turned. The matron at the fish tank glared.

  “Okay,” I said. “Sorry.” I began to flail. “You want to talk about microarrays some more?”

  “I want to see my mother.”

  “Let’s go,” I said to Tim. He didn’t move. “Let’s go, Tim.”

  I touched his shoulder, and he twisted away from me. “Tim…”

  “I want to see my mother!” he yelled.

  “And I’m trying to find her. Give me—”

  “I don’t care what you’re doing. They’re going to hurt her!”

  “You calm down, young man.” The sentence felt strange in my mouth—the words stiff and tacky—but sounded familiar. This time, when I grabbed his hand, he tried to tug it away, but I didn’t let him. “We’re leaving. Right now, Timothy.” That was it: now I sounded just like my mother. Appalling.