“In that case, beta Vasclear it is. Art will deliver a week’s supply to you tomorrow.”
“I’m very grateful.”
The esteem in Carolyn Jessup’s eyes yielded to a steely coolness.
“I hope so, Brian,” she said.
CHAPTER SEVENTEEN
THE BOSTON GLOBE
Boston Pharmaceutical House
Nearing Billion-Dollar Bonanza
Until this month, the largest profits realized by Boston-based Newbury Pharmaceuticals were from the export of vitamin products to Russia and the other breakaway republics of the former Soviet bloc.
Now, it appears, the privately owned firm is on the verge of a bonanza that experts say could easily reach ten billion dollars in the next three years. The impetus for the huge windfall is the anticipated FDA approval later this month of the drug Vasclear. The drug has demonstrated seventy-five-percent effectiveness in melting away hardening of the arteries, sources at the manufacturer report.
“The money will begin rolling in the moment the trucks begin rolling out,” one industry analyst reports. “The profits could be unprecedented in an industry already famous for unprecedented profits.”
UNTIL A SATURDAY IN NOVEMBER NEARLY EIGHTEEN years ago, autumn had always been Brian’s favorite season. Since then, although the scent of mulching leaves and damp soil, the splendid colors, and the cool, crystalline New England air still pleased him, autumn inevitably brought bittersweet feelings as well. From the beginning of his life, he had been raised to play football, and it was rare that any experience off the field, even in medicine, could match the rush of dropping back to throw the first pass of a game.
Today, however, Brian was feeling everything special about autumn, plus an additional excitement as well. Teri Sennstrom had called, and in less than an hour, he would be meeting her for dinner. It was time for a break—time to put some things on the back burner, if only for a few hours.
The days following Jack’s official beginning on full-dose Vasclear had gone smoothly enough, but Brian seriously doubted that his father had improved. And now, ten days had passed since he had actually received his first beta dose. Brian had started keeping a careful count of the nitroglycerin tablets and had set up a log book so that the home health aides and neighbors could record Jack’s level of activity each day. The emotional ups and downs were exhausting—grasping at the slim, subjective straws of improvement one moment, then fretting over the equally subjective setbacks the next. Three more days, Brian had decided. Three more days would bring Jack to Nellie Hennessey’s magic mark of two weeks. After that, he would begin pushing for a visit to Laj Randa.
Teri had requested that they meet someplace where it was unlikely anyone from BHI would be. Brian had chosen a small blues place that had just opened in Burlington, one town over from Reading. It was nearly six when he signed out at the hospital and made a check-in call to Jack.
“How’re you doing, Pop?”
“Not so well tonight.”
The roller coaster took a downward dip.
“Chest pain?”
“Not really. I don’t know what’s wrong. I just, I don’t know—I feel scared.”
Jack Holbrook, the undersized lineman who had once broken a bone in his leg during a game and played an entire quarter on it, was not only frightened about his condition, but was admitting it. He was wearing down.
“You want me to come home?”
“I thought you were going out to dinner with someone.”
“I was. But it’s not that important if you’re not feeling well.”
“Nonsense, I’m fine. Just a little bored and jittery is all. The playoffs are on in an hour. You have a good time.”
“You sure?”
“Of course I’m sure. I have Sally from next door here, and a lasagna someone dropped off. As long as I get my Vasclear tonight—”
“As soon as I get home. Ten-thirty, eleven at the latest. Last chance. You sure you don’t want me to come now?”
“Positive.”
“I’ve got my beeper.”
“Perfect. You don’t have to worry. I won’t be calling.”
“Okay, enjoy the game. And Pop?… I love you.”
There was a brief silence.
“You have a great time,” Jack said.
Brian listened to the dial tone for half a minute before setting the receiver down. I love you. His recovery program encouraged fearlessness when it came to expressing feelings, but this was the first time, the absolute first time, he had said that to his father since … since ever, maybe.
I love you.
Why now?
Feeling excited at the thought of seeing Teri again, but at the same time strangely drained by the brief conversation with Jack, Brian changed into jeans and a plaid shirt, and headed for the hospital garage.
Teri was waiting for him at a table inside the Blues Barn, a rough-hewn space rehabilitated from what remained of an old farm. Looking absolutely at ease in a denim jacket and gold T-shirt, she greeted Brian warmly and kissed him on the cheek.
“No trouble finding the place?” he asked.
“Nope. You give great directions.” She gestured at the crowded, gritty place. “This is just the sort of restaurant I wanted to be at tonight.”
“The music starts at eight,” Brian said. “I never heard of the group.”
“It doesn’t matter. I’ve been working nonstop on you know what. This evening is equivalent to a two-week vacation for me.”
The bar waitress came over. Brian ordered his staple, Diet Coke with lemon. Teri ordered the same.
“I hope you’re not avoiding alcohol because of me,” he said.
“If I am, it doesn’t matter. I can take alcohol or leave it.”
“That’s one thing I really can’t say. I can’t remember ever having a drink that wasn’t a step on the pathway to a buzz, or, just as often, oblivion. That was true even before my problems with painkillers began.”
“You’re doing something about it with meetings and counseling. That’s all that matters.”
“Oh, yes, the file. You already know my life’s history.”
“I’m very embarrassed about that.”
She brushed a wisp of hair from her forehead, but it instantly fell back. Brian had to battle his instinct to reach over and repeat the gesture for her.
“Well,” he said, “maybe you should play catch-up. Tell me about yourself.”
“If my file really does exist somewhere in D.C., it’s much less interesting than yours. Younger of two girls from Indiana. First in my family ever to go to college, much less medical school. Father still works his butt off in a steel mill, drinks way too much, gets verbally and physically abusive when he does. Mother cooks and cleans and smiles a strained smile all the time, takes most of the abuse, and never has a harsh word for anyone.”
“Mayhem and martyrdom. Sounds like a fun household.”
“Oh, yeah. My older sister, Diane, was pregnant and married before she was eighteen. The old escape route.”
“Nice guy at least?”
“What do you think? Give him thirty years and change his brand of beer, and he’s Dad.”
“And you?”
“I waited until I was almost nineteen to run off and get married. He was a med student. That’s how I got interested in it all.”
“What happened?”
“Everyone in a skirt happened. Peter was incredibly insecure. He needed more reassurance than he could get from me—or from the Rockettes, for that matter. I’d catch him, he’d lie, I’d catch him again, he’d get abusive and blame me. I had been accepted at Princeton out of high school and turned them down to go with Peter, work in a department store, and take courses on the side at the local community college. The admissions people at Princeton were kind enough to accept me again when I contacted them. They even offered me a scholarship. When Peter found out, he decided he needed someone with more time to fold his socks.”
The waitress ca
me to take their orders.
“You look too healthy for this,” Brian said, “but I recommend the ribs.”
She reached into her purse and held up a pack of chocolate chip cookies.
“For emergencies,” she said. “In case I’m trapped in a mine cave-in. I’ll take the ribs and an order of fries.”
Waiting for dinner, they watched the band set up and talked about Boston and Washington, music, books, and movies, and traded stories about their jobs. Then, for a time, they ate in a pleasant, comfortable silence.
“So, what about you?” Teri asked finally.
“What about me? Isn’t the file complete enough?”
“How did you get hurt?”
“Playing football. You know that from the file.”
“No, I mean how? I think it’s only fair to warn you that a girlfriend and I own two nosebleed-seat season tickets to the Redskins. I love the game.”
“I believe I’ve died and gone to heaven.”
“So, how did you get hurt?”
“First, you need to know that my father was my coach. In peewees, in high school, and in college. I went to UMass because they hired him. Black Jack Holbrook. I don’t know how he got the name, except that he likes to bet on things.”
“Father and coach. I imagine the line can get a little blurred.”
“That’s an understatement. I still don’t even know what to call him. We were—are—both pretty headstrong. Sometimes, especially when I was younger, I’d purposely misthrow a pass if he said something that upset me. But mostly, I lived and died over what he thought of me and the way I played. I got hurt during homecoming my junior year. I was a preseason all-American mention in some magazines even though I didn’t go to a big football factory. And I was having a very good year and a very good game, even though we were losing by five points and there were only six seconds left in the game.…”
As he talked, in spite of himself, Brian’s mind locked on to that perfect fall afternoon. He is having a typically brilliant day—three touchdowns, no interceptions. But now there are four yards to go for the winning score, and time for only one more play. Six seconds … five …
“Time-out,” Brian cries.
He heads toward the sideline, wincing each time his right knee bears weight. Try as he might, he is unable to hide the limp. The instant he took the hit in the second quarter, he knew that something in the knee had stretched or frayed or popped. But he kept going, reminding himself over and over that Coach Holbrook had once played a quarter of a game on a broken leg. The coach pulls him aside.
“I don’t like the way you’re walking. Can you do one more play?”
“Why would you even ask that?”
“Because I’m your father, that’s why. Okay, if you’re going to stay in, I want you to take a three-step drop and get rid of the ball as quickly as possible. A quick-release pass to Tucker. Two-six-slant-eagle.”
“Coach, Tucker has dropped two passes already. What about faking the pass and letting me run it in—a quarterback draw?”
“I don’t want you putting that leg at risk. Two-six-slant-eagle. Is that clear?”
“Clear.”
Brian walks back to the huddle.
“Loop left, z-out, patch QB draw,” he tells the team. “On two.”
The knee wobbles slightly as he approaches the center. A jagged spear of pain shoots up through the marrow of his thigh. But the leg holds. Brian glances over at his father. Their eyes connect. The coach claps once and gives a thumbs-up sign. It’s time. As always at these moments, everything begins to move in slow motion for Brian. The sound from around the stadium grows faint, then mutes altogether. The position of each of his opponents, their eyes, their stances, their slightest movements, are cataloged in his mind. It is clear they have taken the bait—the deceptive offensive formation that says a pass is on the way. They are badly out of position for the play that is about to be run. The pass Coach wants him to throw might work or it might be dropped. But Brian’s quarterback run is a lock.
“Down … set … hut one … two.”
The ball snaps up into his hands. Brian holds it so his opponents can see that he is ready to throw. He takes two steps backward. In front of him now, a lane has opened up—a clear path to the goal line so wide that he almost smiles. He hesitates one more fraction of a second and then bolts forward. With the first plant of his right foot, two of the ligaments holding together his upper and lower leg rip apart. The lower leg bends outward at a grotesquely unnatural angle. Pain unlike any he has ever experienced explodes from the knee joint.
Brian begins screaming even before he hits the ground. He gasps and cries out again, then again. He grabs a fistful of turf and jams it into his own mouth, biting down on it with all his might. Even so, he can still hear his agonized groans. Through a sickening haze, he hears his father’s voice calling his name.
“Brian … Brian …”
Embarrassed, Brian suddenly recognized Teri’s voice. Her hand was over his, gripping it tightly.
“Whoa,” he said, shaking his head, then brushing a bit of sweat from his upper lip. “I don’t think we’re in Kansas anymore, Toto. I sure haven’t gotten lost like that for a while. Did I make any sense?”
“You made perfect sense, Brian. Perfect. Do you think if you had passed like your father wanted you to that you’d have ended up playing pro ball?”
“And not being strung out on painkillers? My father does, and that’s really all that matters. He’s never gotten over it.”
He began drifting again.
The band, not half-bad, had started playing, and was into a slow, rumbling blues.
“You like to dance?” Teri asked, snapping him back.
“You know, that’s the second time this week someone’s asked me that question. You carry foot insurance?”
They joined three other couples near the band. Teri, very naturally, reached her arms around his neck and set her cheek against his chest. Brian was instantly lost in the sensations of her hair against his face, her body pressed against his, and his hands filling the hollow at the small of her back. He realized, perhaps for the first time, how tense his life had been since the moment of Jack’s chest pain at the Towne Deli—a constant state of red alert. He closed his eyes. They were all still out there waiting for him—the job, the patients, the monitoring, the drug, his father. But gradually, there was only the music and the woman.
They held each other for a time after the music had stopped, then Brian led Teri back to their table as the band launched into an upbeat number showcasing the harmonica player.
“I don’t think I’m ready for dancing to the up-tempo stuff,” he said. “In fact, I don’t think the world is ready for that.”
“Nonsense. You’re an athlete. Athletes have a special grace that translates well into any movement.”
“Correction. I’m a cardiologist. And a six-foot-three-inch cardiologist with thirteen-D shoes at that. Could there ever be a more awkward combination?”
“Bah! I’ll be patient with this misplaced modesty for now. But I warn you, with you or without you, I dance.”
“Warning noted.”
“And since you brought up cardiology,” she added, “I really didn’t want to talk business tonight, but I also don’t want to stand in line waiting for my unemployment check—or worse, read headlines proclaiming that a drug that I helped get into early release has wiped out the population equivalent of Iowa. Have you thought about my request?”
Brian sighed.
“Only constantly,” he said. “I wish there were some way this process could go through Dr. Pickard and Dr. Jessup.”
“That just wouldn’t be wise. Brian, this is not the first time our agency has dealt with a drug or product that was going to make some people very wealthy. And it would hardly be the first time respected researchers had kept information from us. We have no reason to suspect anything is being held back from us as far as Vasclear is concerned, and Pickard and Jessup have
spotless reputations, but you know what’s at stake as well as I do.”
Brian flashed on the warning from Jessup following his filing of the MedWatch report, and on the realization that she and Weber had, in fact, lied to him. They had told him flat-out that “not once” in three years had protocol been broken.
“You did say that Jessup and Pickard agreed to the idea of confidential reporting to your agency?”
“Absolutely.”
“Well, okay. I’ll keep my eyes open.” He hesitated, then added, “And I guess I should say that there’s a potentially interesting case I’m looking at right now involving one of the early Vasclear patients.”
“Go on, please.”
“There’s not much to tell, yet. And I would never divulge his name, even to you, without a release.”
“I understand.”
“He’s an older guy I just saw in the Vasclear clinic, one of the first treated with the drug.”
“Phase One?”
“I think so, yes. It looks like he responded well initially, then he regressed. Now, after two years of treatment, he’s quite ill. I haven’t gotten any labs back on him yet, but I think he might have pulmonary hypertension.”
Teri’s eyes brightened with interest.
“Pulmonary hypertension. Has he been on diet pills? Or eating salad oil in Spain recently?”
Brian smiled.
“You know your medical-disaster history. No obvious precipitating factors that I can tell. But I’ve only just started the workup. For the moment, PH remains a long shot.”
“When will you know something?”
“A few more days.”
“And you’ll keep me posted?”
“Provided I can do it in person.”
“I promise.”
“But Teri, there’s one more thing I want to tell you. My father has bad coronary disease. He had a coronary ten years ago and the bypass he had six years ago is failing. I’ve gotten him into the Vasclear study. That’s how much confidence I have in this drug.”
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