Miracle Cure

by Michael Palmer

  “If you can be patient just a bit longer, Mr. Weisman, I think you will have your answer. Now, Doctor, can you give us the same sort of capsule summary about AZT that you did for lovastatin?”

  Baird searched for a trap behind the question, but could find none.

  “AZT is an antiviral agent developed by Burroughs-Wellcome and Company, now Glaxo Wellcome, and has been a valuable treatment against the virus that causes AIDS.”

  “And when were clinical studies begun on that drug?”

  “I’m not sure. Sometime in the mid-eighties.”

  “Actually, Doctor, Phase One trials of AZT began in June of nineteen eighty-five. Phase Two began seven months later. The human testing was terminated in September, nineteen eighty-six, just eight months after Phase Two studies were begun. There never were any Phase Three studies.”

  Baird was aware of his bladder now and silently cursed himself for not addressing that situation during the break. Just the same, whether out of fatigue, irritation, anxiety, or some combination of the three, he took several swallows of the ice water Teri had poured for him, and then motioned for her to respond to the statement.

  “We’re not certain we follow you, Senator,” she said. “The FDA is certainly proud of the speed with which we got both lovastatin and AZT approved for public use.”

  “And well you should be, Doctor Sennstrom. Because both those drugs had huge lifesaving potential for a large number of people.…”

  Louderman paused, looked up at the bank of cameras, then once again shuffled the papers in front of him.

  Here it comes, Weisman wrote, filling the O in with a frowning face.

  “… Dr. Baird and Dr. Sennstrom,” Louderman said finally, “are you aware of a drug named Vasclear currently under Phase Two clinical studies?”

  “We are aware of the drug, yes,” Baird responded.

  “Could you tell us all what the drug does?”

  “I can tell you what it’s purported to do. It is being investigated for properties it may have that reportedly enable it to dissolve arteriosclerosis.”

  “Dissolve arteriosclerosis.… Do you mean it can cure hardening of the arteries?”

  At that moment, Baird remembered that Newbury Pharmaceuticals, the small drug firm developing Vasclear, was based in Boston, Louderman’s home turf. Suddenly, he understood the why and wherefore of the entire session. An ambush, indeed. He covered the microphone.

  “Barry,” he whispered, “we know where Louderman’s going now. If we feel he’s squeezing us too tightly on this, I want you to go out in the hall, see if you can reach the President, and have him put a stop to it.”

  He turned back to Louderman.

  “From what I know of the drug, Senator, and I admit that is not a great deal at this point, curing hardening of the arteries is a possibility. I would caution you and everyone watching this hearing that research on Vasclear is quite preliminary.”

  “A drug that cures hardening of the arteries and you don’t know a great deal about it?”

  “A drug that may cure hardening of the arteries, Senator. We have literally hundreds of investigational new drugs we are currently following. And as I said, research on Vasclear is quite preliminary.”

  “I beg your pardon, sir,” Louderman countered, “but the research on this medication is actually quite far along, and the American people should know that the results to date have been astounding. I know for a fact that the scientists of Newbury Pharmaceuticals have twice submitted a new-drug application to your agency requesting the same sort of consideration that was given to that AIDS drug, and twice they have been turned down by your people.”

  Go! Baird wrote on the legal pad. Barry Weisman took the cellular phone from his briefcase, slipped it into his jacket pocket, and hurried from the hearing room. Baird stalled with another sip of water. From what he knew, the Vasclear research did hold great promise. But he also knew that Louderman’s staff had been pressuring the team assigned to evaluate Newbury Pharmaceuticals Company’s clinical data.

  The income from a drug that could eliminate arteriosclerosis would be staggering. Louderman was angling toward the Republican presidential nomination. His early public support of the drug would be a huge political coup, and somehow, profits from the drug were sure to find their way into his campaign coffers.

  However, from what Baird had been told by his staff, as remarkable as the early Phase Two data on Vasclear was, more study on humans needed to be done.

  “Excuse me, Doctor,” Louderman was saying, “but would you please answer my question?”

  “I … um … I’m afraid I’ll have to ask you to repeat it, Senator.”

  “Your agency pushed through both lovastatin and zidovudine because they were lifesaving drugs. Wouldn’t you call Vasclear, a cure for a horribly costly, often-fatal illness, lifesaving?”

  “At this point, Senator, I wouldn’t call it anything but a drug with a great deal of potential.”

  “And you would be wrong!” Louderman pounded his fist on his desk for emphasis. “You obviously have not reviewed the research data on this drug personally. If you had, I believe you would be a darn sight more enthusiastic.”

  “Perhaps,” was all Baird could reply.

  “This committee is going to reconvene a month from today, Dr. Baird. By that time, I hope you will be ready to tell the American people why a lifesaving, life-giving, life-sustaining drug—”

  One of Louderman’s aides had come up behind him and handed him a phone. Louderman listened to the caller for thirty seconds, said a few words, and then handed the phone back. His smile was icy. Baird thought he saw a tic fire off at the corner of his eye.

  “Well, now,” he said. “It seems you have a dedicated protector in the large white house down the street. His wishes are that you be given as much time as you need to evaluate the Vasclear situation, with the understanding that you will make it your highest priority.”

  Baird met the senator’s gaze evenly.

  “I will do my best, sir,” he said.

  “I hope so,” Louderman countered. He hoisted himself up as rigidly as he could and looked more at the cameras than at Baird. “And, sir, I also hope that all those bedridden people out there with chest pains and stroke symptoms are as patient with you as our President is.”

  Without waiting for a rebuttal, Louderman gaveled the session to a close.

  Baird waited until the dais had emptied, then turned to Teri.

  “I didn’t want to tell him that you were the group leader on this project.”

  “It would have been okay if you did. We’ve been on top of this drug.”

  “I know you have. What do you think about what Louderman said?”

  “I don’t like the subliminal message about how we would go to any lengths to cure AIDS, but we’re withholding the miracle cure of the century from Mr. and Mrs. Middle America. Sounds too much like Louderman’s running for president.”

  “Which everyone knows he is. But you agree we should be speeding this drug along?”

  “I can’t make that judgment yet. But it does look very promising. And there’s no question it falls into the lifesaving-drug category.”

  Baird studied her face for several seconds. Weisman was right, he thought. Teri Sennstrom’s intelligent good looks couldn’t help but put the agency in a positive light.

  “Okay, then,” he said. “You know what you’ve got to do. I don’t like anyone pushing me around, but I knew this job was political when I agreed to take it. I’m going to make this drug one of my top priorities, but I’ll need your help in bringing the pile of data down to some sort of manageable size for my review.”

  “You’ve got it.”

  “Start putting things together, and we’ll meet in, say, a week.”

  “Fine.”

  “And Teri?”

  “Yes?”

  “We can let Louderman flex his muscles all he wants to. That’s just politics. But in the end, we’ve got to remember where our
responsibilities lie. I don’t want another Kinethane. I don’t want another thalidomide. If this drug has problems, we’ve got to keep it away from the public, Louderman or no Louderman.”

  CHAPTER SIX

  MAIL ROOM, COMMUNICATIONS CENTER, SECURITY, PERSONNEL, payroll. One by one, Brian ticked off the items on an efficiently designed checklist as he worked his way through the maze of corridors, buildings, and offices that made up White Memorial Hospital. It had been more than a decade since his last hospital orientation, and he was feeling as keyed up and nervous as he had that day in Chicago when he began his cardiac fellowship.

  At the laundry, Brian tried to explain that he would be functioning largely as a cardiology fellow, but his title—postdoctoral fellow—put him a notch above that. After prolonged deliberation, the bewildered woman at the uniform window settled on two short clinic coats for the cardiac fellow part of him, and two knee-length lab coats for the faculty part.

  “No white pants,” she said in a thick Asian accent. “White pants for resident babies.”

  His final stop was at the employee assistance office, which, at Dr. Pickard’s request, had already added Brian to the list of physicians, nurses, and others who were getting random urine testing for alcohol and substances of potential abuse. The nurse running the EAP was kind and reassuring enough, and certainly experienced at dealing with monitoring, but Brian was still quite embarrassed.

  The system was that at least once a week, on a day randomly selected by a computer, he would receive a page to “call Dr. Jones.” He would then have two hours to report to employee assistance for a test. The only excuse for coming later than two hours to leave a specimen was his being involved with a procedure in the OR or the cath lab.

  Unpleasant, but not unmanageable, he acknowledged. And certainly not undeserved.

  Brian signed the appropriate waivers and assurances, took the copies and instruction sheet, and headed up to meet Phil Gianatasio at the conference room for a tour of the facility. Phil was there with a small cake in the shape of an anatomically correct heart, and a very pretty, slender brunette in her early thirties. Carrie Sherwood was the unit secretary for the clinical-research ward.

  “I brought her here to meet you because she runs the clinical service and I wanted you to start off on her good side. The last resident who did something to get on her bad side ended up throwing himself off the top of the Cromwell Building.”

  “Philip, stop that.”

  Brian could tell by the way the shapely secretary reacted to the tease that she and Phil were lovers. After a few minutes of small talk and some cake, she headed back to the research unit, giving each of them a prolonged look at her from behind. Brian nodded his approval.

  “Fine lady,” he said.

  “Best thing about her?” Phil replied. “She doesn’t seem to give a shit that I’m waistline-challenged. She’s also loaded with friends. I can think of two right off the top of my head who wouldn’t mind being fixed up with an M.D. who was a cross between Joe Montana and Alex Trebek.”

  “I wish.”

  “Seriously—you seeing anyone?”

  Brian shook his head.

  “I’ve been out a couple of times, but my heart just hasn’t been in it.”

  “Well, from what Carrie tells me, these friends of hers sound like they’d manage to hold your attention for an evening or two.”

  “First things first, okay?”

  Brian couldn’t believe he was responding to his friend’s offer by quoting a twelve-step banner. Had he really become that dull?

  “What I mean,” he added, “is let me put in a little time here. Then we’ll talk to Carrie.”

  “Great. Well, Dr. Pickard suggested we make our way around the research ward, the labs, and finally the Vasclear clinic. But first, since you’ll be covering the Vasclear clinic a lot of the time, he wanted you to see the video.”

  “Video?”

  “The staff calls it Vasclear Uber Alles. It’s an informational video we show to the house staff, visitors, and even the patients. It’s pretty good, actually, except it’s a bit simplistic for doctors and at least a bit too complex for most of our patients.”

  Brian’s interest immediately perked up.

  “I’d like to see it.”

  “Then see it you shall, my man, provided you excuse me while it’s running. After a dozen or more screenings, I’ve just about got the dialogue of this film memorized. Speaking of Vasclear, though, have you heard anything from Jessup about your father?”

  “Not really. I thought I’d speak to her tomorrow when I scrub with her in the cath lab, even though I don’t want to start off my first week here by bugging the associate director. She called once after Jack’s discharge to see how he was doing. That in itself was really kind of her, but she didn’t say anything about Vasclear. Before Jack was discharged, she did promise that she’d speak to Dr. Weber about getting him into the study.”

  “Well, I’m not sure you should hold out much hope,” Phil replied. “Weber’s a decent enough guy for someone without a bit of detectable humor. But he’s absolutely committed to seeing that every aspect of the Vasclear protocol is followed to the letter. I suppose if I had medical immortality on the line, to say nothing of a few billion dollars, I’d be pretty obsessive, too. So where’s Jessup right now, as far as Jack’s treatment is concerned?”

  “Her recommendation is still surgery.”

  “Will your father go along with it?”

  “Frankly, Phil, having lived through that eight-week nightmare with him last time, we’re both still holding out for Vasclear.”

  “As long as it’s the beta group.”

  As long as it’s the beta group. Brian wandered to the window and gazed out across the river at Cambridge. If there was no way he could get his father into the beta group, was he desperate enough to steal the drug? The question burned in his thoughts. He wasn’t aware he was clenching his teeth until his jaws began throbbing.

  “Roll the film,” he said, pulling the drapes. “And give my best to Carrie.”

  Phil tossed him the remote and left. Brian settled into one of the high-backed, oxblood leather chairs, tilted back, and put his stockinged feet up on the table. Yesterday’s Globe had had a small article about Senator Louderman pressuring the FDA head to get Vasclear approved for public use. Even if Jack was refused admission to the study, maybe the standard medical management Jessup was using could buy him enough time, provided, of course, Louderman won his battle.

  His mind tied in knots, Brian punched play.

  To say the twenty-five-minute informational video was glossy and big-budget would not have given proper credit to the graphics, music, sound bites, animation, and a script that might have been done by an evangelist.

  VASCLEAR

  The Search Is Over

  The Answer Is Here

  First some footage of paintings and lithographs of Ponce de León, searching for the fountain of youth. Next a speed-flight over the jungle, backed up by a score that sounded straight from an Indiana Jones movie, and a litany of some of the most important drugs to come from jungle plants. And finally, a few almost gratuitous shots of South American natives—meat eaters who had found the secret to staving off arteriosclerosis and living, according to the paternal voice-over, a century or more.

  Next came a smooth segue to Newbury Pharmaceuticals—a tribute to their modest accomplishments in the past, a tour of their gleaming, refurbished plant in an industrial area of Boston, and a shot of their research laboratories. Finally, to explain the miracle of Vasclear, the voice-over introduced Dr. Art Weber, project director.

  Weber, tanned, sandy-haired, and blue-eyed, had a youthful face that was handsome in a Hollywood sort of way. His accent sounded Eastern European. With the help of animation and operating-room footage, Weber described the genesis of arteriosclerosis and modern medicine’s efforts to combat what he called the ravages of the number one killer in the civilized world—the diets, the drugs, behav
ior modification, and finally, the surgical approach.

  The bypass operation they had chosen to show was a particularly bloody one, Brian noted. Clearly not Laj Randa. A patient facing such a procedure would have been happy to volunteer to participate in any alternative that offered a chance at avoiding the knife.

  “Arterial clearing with Vasclear has been steady,” Weber continued. “Here is the actual arterial X ray of one of our patients, and here are the films of that same patient twelve months after the onset of Vasclear therapy. Note the clearing of the blockages of the left main coronary here, the right in these spots, and the circumflex. And did the patient’s symptoms respond? Well, let’s just ask her.”

  Strings, angelic horns, and dramatic camera angles, accompanied a cheery woman’s voice saying, “I had pain up here in my shoulder and neck. It was pure luck I saw my doctor and had my heart tested. I was a disaster waiting to happen. They gave me a choice: undergo bypass surgery or become part of the Vasclear study. I still don’t know what Vasclear concentration the treatment group I was in received, but I suspect it was a good dose, because my symptoms vanished almost immediately, and they haven’t returned.”

  By now the camera had made its way to the subject’s face. She was everybody’s dream grandmother—expansive, nurturing smile, sparkling eyes.

  “At this point,” Art Weber was saying, “we cannot claim that Vasclear will work for everyone. But our human trials are suggesting that up to seventy-five percent of patients may derive considerable benefit. At present, Newbury Pharmaceuticals researchers, in cooperation with the physicians at the world-renowned Boston Heart Institute, are searching for ways that even this remarkable percentage might be increased.”

  The video rounded out with a dramatic projection of what the world had in store with Vasclear. By the time it was done, Brian was obsessed with the drug. Vasclear was the candy that beckoned from the porcelain bowls in Aunt Bea’s living room, and Brian was the child forbidden by his father from taking it.

  The driving late-afternoon rain had Bill Elovitz and a dozen others pinned in the doorway of Filene’s department store. With a week until Devorah’s birthday, he knew it had been foolish for him to come into Boston on such a day. But a sale was a sale, and his wife had never been so specific about a gift—but only if he could get the robe in pink and at forty percent off.