A Simple Cure

by Lawrence Gold

  Terrible mistake? Look what happened to Raymond Fish.

  I can’t leave PAT now—not with these fantastic results. This is the stuff that makes a career. Security is one thing; this is something else. What’s going on?

  Lisa pressed the digits on the specimen refrigerator’s combination lock and entered the chilled room. She went to the BCG bin. Fifteen or so vials remained. She lifted one and saw the pink fluid at the bottom.

  Who knows what they’ll do next.

  She reached into her lab coat pocket, removed a typed label, placed it on the vial and placed it in another section of the refrigerator.

  At least now they can’t destroy all the evidence.

  Chapter Sixteen

  Terri was early for her meeting with Lisa. She sat in the conference room at Genentech Hall, staring out over a hazy San Francisco Bay.

  When Lisa entered the room, they hugged. They’d become friendly over the last year. She threw her purse on the table and placed her keys alongside.

  Terri smiled at the keys. “A rabbit’s foot? That’s a little retro, don’t you think?”

  “Only if you don’t look deeper,” Lisa said, grabbing the rabbit’s foot and pulling it apart. She extracted a tiny USB flash drive from within. “My secret compartment. I use it to move files from work to home and back.”

  “Cute,” said Terri. “This is the oddest relationship I’ve had. I don’t mean personally. It’s the professional part. We’re both working with BCG and its use in cancer, especially melanoma, yet we never talk about it.”

  “It’s not because I don’t want to. It’s Kendall’s oppressive security. Limiting the exchange of information among research scientists is an anathema.”

  “We’re going to fix that today.”

  “What’s going on?”

  “Didn’t they discuss this with you at PAT?” Terri asked.

  “The only things I hear at PAT are circumscriptions—the prison camp mentality.”

  “David Birch approached the university with a proposal that we conduct the first Phase I studies with your modified BCG in advanced malignant melanoma.”

  “That’s fantastic,” Lisa said. “I’d love to work with you. Where will you conduct the study?”

  “At San Francisco General Hospital. That’s my home base. Now that we can talk, does your project have a name?”

  “We call it Project Rosetta, after the stone.”

  “I like it, the hint of unraveling a problem. Who came up with it?”

  “Evan Klack. He’s the force behind the research.”

  “Do you think Rosetta is ready for Phase I clinical trials? Any misgivings?”

  “The animal results were so striking that I can’t see a reason for not going forward. The only concern I have is the origin of the BCG material. Where did you get your material?”

  “We got it from Laval University in Quebec. They’re the prime supplier of all BCG strains in the world. Where did PAT get theirs?”

  “Have you ever heard of Alamand Labs?”

  “No. Where are they?”

  “They’re in France. I haven’t found out much about them. I guess it’s another example of the depths Kendall will go to protect its proprietary research. Anyway, it’s a remarkable strain. Thank God we got to work with it.”

  After the meeting, the group decided to fast track the study. Lisa would work with Terri to design the protocol. They’d bring it to the university’s committee for the protection of human subjects and with luck, they’d enroll their first patient in six months.

  It’s all happening too fast, thought Jennifer Howe as she trembled on the icy table in the radioisotope laboratory at UC Medical Center. As the isotope counter moved slowly over her body, Mickey held her hand.

  “I’m trying the best I can, Mickey, but I feel that I’m going to lose it.”

  “So lose it. Big deal. It’s a hell of a lot better than trying to hold it in.”

  “I don’t know how people go through this. It’s so frightening, especially not knowing what you’re up against.”

  “We’ll know soon enough, and whatever it is, we’ll deal with it.”

  Jason Beckman had injected the isotope near the site of her melanoma and watched the computer screen. When the isotope was clearly accumulating above Jennifer’s collar bone, he said, “Enough. We’re done.”

  Back in the office, Jennifer sat before Jason’s desk holding Mickey’s hand.

  “This is the most difficult part of my job,” he sighed. “It’s hard to deliver bad news in a realistic, yet balanced way. The melanoma has spread to a lymph gland at the base of your neck. We call that a Sentinel node and its involvement means we must be aggressive with your treatment.”

  Mickey grasped Jennifer’s hand. “What do you mean by aggressive? What does it all mean? You must lay it out for us. We’re the kind of people who will do better once we know what we’re facing.”

  Jennifer studied Jason. Even a hint of a smile would have helped. His face remained impassive.

  “First, we’ll need to remove the area around the melanoma and explore the Sentinel node region. Once we’re sure that there’s no tumor remaining, we’ll see how many lymph nodes are involved with melanoma. The next step is a series of tests to find out if there’s any evidence of spread to other areas of your body.”

  “How long do I have?” Jennifer whispered.

  Mickey tightened his grip on her hand.

  “I can’t tell you until we complete these tests.”

  “I need to know my odds, Doctor. It’ll only be worse for me if I have to guess. Will I see my kids graduate from high school? Will I see them married? Will I ever get to be a grandmother?”

  Jennifer reached for the box of tissues strategically placed on Jason’s desk and blotted her tears.

  “I don’t like to put numbers to this,” Jason said. “Each year we’re doing better than the one before. New treatments are becoming available all the time.”

  “We need to know,” Mickey said. “Please.”

  Jason shrugged. “I’m not comfortable with this, but if you insist...”

  They said nothing.

  “Please understand that what I say today can change tomorrow. Okay?”

  “We understand,” said Mickey, “and thank you.”

  “Based on what we know today, the size of the melanoma, the fact that it wasn’t ulcerated, the involvement of the Sentinel node, your chance of living five years is anywhere between 20 and 70 percent.”

  Jennifer placed her hand across her mouth.

  Mickey paled.

  “That’s the problem, you see,” Jason said. “Citing statistics, like between 20 and 70 percent, is crap. It doesn’t mean a damn thing when you try to apply it to an individual. Once we complete your tests, we’ll have a better grasp on where this is going. Whatever you do, don’t let this or anything we find later, interfere with our treatment plan. Over and over again, we see the positive effects of a life affirming attitude in cancer patients.”

  “I have too much to live for,” said Jennifer, grasping Mickey’s hand. “There’s nothing I won’t do to get through this.”

  Chapter Seventeen

  Matt Hollis sat before his computer screen paging through his copious notes trying to pick up the thread of his complex plot line. He missed those spans of time where ideas jumped to the page effortlessly. He understood his problem.

  He wasn’t a slave to typical male insecurity, but when each call to Terri received an “I’d love to, but I’m too busy,” he wondered if he had misread this relationship. He prided himself on his ability to read people; it was one thing that made him a good cop, so he had trouble with the mixed messages. He felt a bond developing with Terri. He knew she wanted to get together, but she couldn’t or wouldn’t find the time.

  He dialed her number at work, and after the requisite small talk, he let it out. “I don’t want to be a pest, but if you’re not interested in getting together, please just tell me.”

>   Why so juvenile and manipulative, he thought, ruing his words. Maybe I’m not so secure after all.

  “God, no...I mean, yes...I really want to see you but I’m so busy with this new phase I study.”

  “I’m talking about myself. If I want to do something, I always find the time. Why don’t you think about it and give me a call when you can squeeze me into your busy schedule.”

  Terri felt herself getting angry.

  All this work. A single working mother. A daughter. Who needs this extra pressure?

  “Sure, Matt. Let me see when I can fit you in.” Without waiting for a response, she hung up the phone.

  What’s the matter with you? she thought afterward, regretting her flare of anger.

  Matt returned to the keyboard and stared at the blinking cursor. After twenty minutes, he gave up and decided to go to the gym and work out.

  He returned home tired, sweaty, and relaxed.

  As he exited the shower, he heard the phone ringing. He raced to pick it up and stood in the kitchen in a small pool of water.

  “It’s me, Terri.”

  “Terri who,” he said, smiling, happy that she’d called back.

  “Mea culpa...mea culpa,” she said. “I’m sorry.”

  “I’m sorry too. Patience isn’t one of my virtues.”

  “I want to explain myself to you...”

  “That isn’t necessary.”

  “I think it is. It’s not just that I’m compulsive—I’m certainly that, but I hate to leave anything undone. I’m the type who’ll work her ass off to finish a project, and then take the time to play. What I’m into now makes that impossible, plus...”

  “What?”

  “I really like you. I think this relationship can go somewhere. I torment myself wondering if I’m ready. Can I do it all, and God forgive me, can I do it all well?”

  Matt laughed. “I’m not sure I want to spend too much time in your head. I’m bad. You’re impossible.”

  “Meet me for lunch tomorrow, at Genentech Halls cafeteria. The meal’s on me.”

  “Cafeteria food,” he laughed. “How can I refuse.”

  Matt glanced at his watch as he drove over the San Francisco-Oakland Bay Bridge into the city. He was running a little late and gave thanks for little traffic. He followed the Highway 101 to Highway 280, exited into the Mission Bay area. He parked in the Third Street garage of the 43-acre campus of the University of California and rushed through the barrel-vaulted entrance to Genentech Hall and into its bright atrium. He walked to the second floor terrace café and using his hand as a visor, looked for Terri in the midday sun. After a moment, a white-coated arm waved and he moved toward her table.

  Matt hugged her.

  Terri returned his embrace, nearly taking his breath away.

  Matt smiled. “I guess you really are glad to see me.”

  “I hope you won’t mind, but I got us something to eat before the feed line got too big.”

  “As long as it’s not good for me, I’m okay.”

  She pushed the chicken Caesar salad into his place. “Sorry about that. I’ll remember the next time.”

  “No, I’m kidding. I generally eat healthy, although about once a month, I yield to the call of the Golden Arches.”

  “How goes the writing?”

  “It’s going.”

  “What does that mean?”

  “It means I’ve perfected the screen stare. My mind has been elsewhere.”

  Terri remained silent, staring into Matt’s brown eyes.

  “I thought that we had something going,” he said. “It disappointed me, that’s all.”

  “I’m so stupid,” she said. “Sometimes I don’t know how I get through the day without help.”

  She reached across the table and grasped Matt’s hand. “You’ll give me another chance?”

  “You’re kidding. I’ll give you all the chances you need, Terri. I really like you, but I need to know that I’m not wasting my time.”

  She smiled, and then went to work on her salad taking in large mouthfuls.

  “You’re hungry, I see.”

  “I’m always hungry. You’d better take me to cheap places if you want to protect your wallet.”

  After she finished, Matt said, “What’s happening with your research?”

  “I know it’s unprofessional and I’m supposed to remain objective, but I think we’ve really hit on something important in the treatment of advanced malignant melanoma.”

  “Can you tell me about it in one or two syllable words?”

  Terri smiled. “I doubt that’s necessary. I read your books. You’re no stranger to science, bioengineering, and forensics.”

  Matt shrugged.

  “Let’s see how smart you are. Do you know about immunotherapy?”

  “Don’t ask me to spell it. It’s stimulating the body’s immune system to fight disease.”

  “Perfect. Do you know about BCG?”

  “The army gave it to me before we went to Somalia to protect against TB.”

  “Can I tell you a great story?”

  “I could listen to you all day.”

  Terri smiled. “In 1854 two French scientists discovered the bovine form of tuberculosis and tried to use it as a vaccine. Unfortunately, the bovine form was just as deadly as human TB. The French scientist Calmette, and the veterinarian Guérin made the organism less virulent, and in 1921, BCG was first used in humans. In Lubeck, Northern Germany, they vaccinated 240 infants in the first 10 days of life; almost all developed TB and 72 died. It turned out that the vaccine had been contaminated with a virulent form.”

  “How did they get past such a great start, and what has this to do with cancer?”

  “I’m getting there. In the late 19th century, they first noted the lower incidence of cancer in patients with TB. They confirmed this observation by autopsy studies. Clinical researchers tried BCG in various cancers, but they abandoned it when chemotherapy came on the scene. In 1976, physicians used it successfully in the treatment of bladder cancer. They tried it with some early success in melanoma, but the promise went unfulfilled, until now, we hope.”

  “What’s different?”

  “We’re working with a new strain of BCG and we’ve been manipulating its environment to make the organism provoke a greater immune reaction. Getting our own cells to fight the cancer is the answer, we hope.”

  “You guys make the vaccine?”

  “No, but we get it from a company in Emeryville called PAT, People for Alternative Treatments.”

  “They must stand to make a bundle if this thing works out.”

  “The participation with PAT is okay, but its parent company, Kendall Pharmaceuticals, is the one element that bothers me.”

  “Why?”

  “Listen. I have no problem with drug companies making money. Often they’re the best source of research dollars, but it comes with a price. They’re so single-minded about the bottom line that I think they’ll stop at nothing to get their drugs approved.”

  “Are you just being cynical or do you have a reason?”

  “Both, I guess. I work with Lisa Gomez who’s at PAT. She can tell you stories about security and a lack of candor when it comes to explaining some of their actions.”

  “You want me to look into it?”

  “No. Don’t bother. The university reviews their work periodically, like an Inspector General surveillance.”

  “I’d like to meet Lisa sometime,” Matt said, smiling.

  “She’s not your type.”

  “She’s female, isn’t she?”

  “If you find me too dedicated, Lisa is Mother Theresa. I’ll ask her to dinner next week, okay?”

  “You’re on.”

  “I must get back to work. Come by tonight after I put Abbie to bed. I have some etchings to show you, that is, if you have the energy.”

  Chapter Eighteen

  PAT was abuzz about the genetically modified mouse experiments. Almost 80 percent of treated mice,
even those with extensive and widespread melanoma, showed no sign of disease.

  On rumor, they presumed, Kendall stock had increased 40 percent. Speculation outside the company was rampant.

  There’s going to be a SEC investigation, thought David Birch, if we’re not careful.

  While Karl Muller lounged in the corner clipping his fingernails, Lisa sat with Evan Klack reviewing videos of their mice.

  “Look,” Evan said, pointing to a video sequence in real and elapsed time. “About 5 percent of the mice are showing unusual patterns of behavior. The melanoma’s gone, but look at how these animals show alternating insomnia and what appears to be the mouse equivalent of panic attacks. You don’t want to be around when a mouse has a panic attack,” he laughed.

  He pointed to the next sequence. “Look at how they race around their cages with their eyes bulging. Afterward, it’s prolonged sleep followed by hallucinations, weight loss, and death.”

  “What is it?” asked Lisa.

  “Don’t know. Maybe this strain of mice has picked something up. So far, the pathologist hasn’t discovered anything.”

  “What do you think of the Phase I trial?” Lisa asked.

  “I’m concerned,” Evan said.

  “Concerned,” Lisa said. “That’s a sterile word.”

  Lisa and Evan brought the reams of data and the DVD video to David Birch’s office.

  David stood. “Let’s put everything on the conference room table. We’ll be more comfortable.”

  Evan held the DVD. “We want you to look at this video, David.”

  “We’ll get to that. I can’t tell you how pleased we are at your results. I know that restraint and deliberate assessment is a professional necessity, but who wouldn’t be enthusiastic with your findings. At Kendall headquarters, they’re beside themselves with optimism. They’ve instructed me to issue bonuses to both of you. If this pans out, they’re talking stock options too.”

  Evan and Lisa looked at each other, surprised.

  “We need you to look at the video, David,” said Lisa. “We’re seeing some unusual behavior in a small percent of treated animals.”