David stared at them. “When you’ve worked with experimental animals as long as I have, that’s no surprise.”
Lisa moved her laptop computer before them and inserted the DVD. As David watched the video, they studied his reaction.
Afterward, David shook his head. “That’s just the kind of behavior we see on occasion in mice treated with anything, even placebo. It’s nothing.”
“I’m not prepared to say it’s nothing,” Lisa said. “We’re into human trials. Anything extraordinary deserves our full attention.”
“Have you reviewed the pathologic examination of these animals? What did they find?”
“Nothing, yet,” Evan said.
“’Nothing, yet’, means you expect something. What is it?”
“No, I just...” Evan said.
“What would you have me do?” asked David, obviously irritated. “I don’t think anything we see here justifies stopping the phase I study. Do you?”
“No,” said Lisa. “I just want us to be particularly careful with patients.”
“Is there anything else?” David asked.
“I’d like to contact Alamand Labs in France to see if they’ve seen anything like this with their BCG.”
“That’s a good idea,” David said. “I’ll give them a call in a day or so.”
Back in their lab, Lisa turned to Evan. “You’re happy with that?”
Evan ran his hand over his enormous head. “Frankly, I don’t know what to do. Think of how much good this can do for patients who have failed all other means of treatment. That’s what we have in the Phase I studies— people who are going to die if we don’t offer them treatment.”
Lisa shook her head. “I don’t like it. I don’t trust David or Kendall. I don’t know what to make of this Alamand Labs situation. We don’t know much about them. Let’s discuss it with Amanda and Greg or with somebody at the university.”
“Greg and Amanda are fine, Lisa, but don’t talk with anyone outside PAT. These people are serious about security. You don’t want to place your future in jeopardy.”
“I’m going to ask my advisor at Genentech Hall to find me someone with expertise in behavioral abnormalities in laboratory mice. Maybe he or she can make some sense out of these observations.”
At 4:40 that afternoon, Lisa sat at her computer composing an email to Greg and Amanda. She wrote of her concerns about her work at PAT, especially the willingness of David Birch to ignore their observations on the unexplained deaths of some mice and his manipulation of their data. She also vented her frustration with the oppressive security and on the behavior of Karl Muller. Before Lisa hit “send”, she copied the email to herself at work and at home, and to Evan Klack. After she sent it, she checked her own inbox and her sent files to assure that it went out. It was then that she saw that her sent box had only one entry, the email she’d just sent.
What’s going on?
Someone had deleted her emails. Lisa checked the backup files on the server, and they were missing as well. She looked at her purse and visualized the USB flash drive tucked safely inside the rabbit’s foot.
Hiding in plain sight. Thank God I copied my emails to this drive just yesterday. I have them here and at home, I hope.
Lisa moved to Evan’s computer. When she reached his email password box, she smiled then entered, “midget1”. His email screen appeared and when she searched his inbox and his deleted files for her emails to him, they too were gone.
This must be Karl Muller. The man’s a lunatic!
Before Lisa left for the day, she called Terri at San Francisco General. “How’s it going, sweetie?”
“Busy as usual. What’s up?”
“How are our first patients in the study doing?”
“It’s way too early to tell. Why do you ask? Is something wrong?”
“Have you seen any side effects?”
“Only what we’d expect. A little low-grade fever and a few rashes.”
“Nothing else?”
“Lisa,” said Terri, now concerned, “is something going on that we should know about?”
“I don’t know. Will you be at the clinic tomorrow morning?”
“Yes.”
“I’ll be over around ten. I have some concerns and a video I want you to see.”
Back in his office later that evening, Karl Muller was about to review the security tapes from bugs planted at PAT, when he turned to a soft knock on the door.
“Come in.”
David Birch entered and sat next to Karl. “You asked me to keep track of our BCG supply.”
“Yes.”
“Unless there’s an unreported spillage, one vial is missing.”
“Missing?”
“I went through the entire batch, recounted and checked the sign out records. One vial is unaccounted for.”
Lisa Gomez, thought Karl. That bitch!
“I’ll take care of it, Doctor. Thanks.”
When Karl returned to the tapes and listened to the conversation between Lisa and Evan, he tightened his jaw and clenched his fists. When he played back Lisa’s conversation with Terri, he picked up the phone and dialed a Chicago number.
“We’ve got a problem, Eddie,” Karl said.
“I’m putting you on the speaker phone,” Eddie Macy said. “Woody’s here. Now, what is it?”
Karl repeated the series of conversations ending with today’s recordings, and then said, “David Birch thinks one vial of the original BCG supply is missing.”
“What do you mean missing?” Woody asked.
“It’s not there,” Karl said. “It could be a mistake, or a spillage, or someone took it.”
“Lisa Gomez?” Eddie said.
“I wouldn’t put it past her,” Karl said.
“Richard Kendall’s going to blow a gut if anything fucks up this clinical trial,” said Woody. “Any suggestions?”
“Can you put the fear of God into her, Karl?” asked Eddie.
“I can try, but it’s probably a waste of time. She’s one stubborn bitch.”
Eddie looked at Woody, who nodded once.
“We can’t afford any of this right now,” Eddie said. “I want you to take care of this.”
“Don’t worry, Boss. It’ll be my pleasure.”
Lisa sat at the kitchen table that evening sipping on a glass of chardonnay. She’d spread her data books on the table and was replaying the mouse DVD on her laptop for the tenth time.
Something’s not right here.
She was alone. Mandy had called saying that she was going to spend the night with her boyfriend.
At ten, Lisa was exhausted. She tossed in bed for almost thirty minutes before she fell asleep.
The knob on Lisa’s front door wiggled back and forth slowly, then after some irregular scraping sounds, the lock clicked and the door opened.
The figure dressed in black moved silently through the living room, then stopped at the bedroom door to listen. Lisa’s soft snores told him what he needed. He pushed open the door and walked quietly to her bedside. He stared a moment then grabbed the pillow from the empty side of her bed.
He watched as she slept in peace. When she turned over on her back, he pushed the pillow against her face.
Lisa awakened and began to struggle. She grasped his thick arms then stretched her fingernails toward his ski-masked face trying to find his eyes.
After a minute, he pulled the pillow off.
Lisa, in panic, gasped for breath then tried to escape from his powerful hands.
“If you want to get out of this alive, you’ll answer a few questions.”
“Fuck you!” she screamed and struggled.
He muffled her scream with his large hand. “Some people have to learn the hard way.”
He again placed the pillow over her face and pressed down. After a minute her struggling stopped and he released it again.
Tears ran down Lisa’s cheeks as she again gasped. She tried to fight, but she’d reached exhaustion.
“I think by now, you can answer a few simple questions.”
Lisa nodded.
“Good girl. You took a specimen of the BCG, didn’t you?”
She shook her head, no.
“You’re one stubborn bitch.”
“Fuck you, Muller—I’d never forget your voice and your disgusting breath. I’m not telling you anything. You’re going to kill me anyway.”
Karl removed the ski mask and smiled.
“You can still get out of this alive, Lisa, if you cooperate. You can accuse me all you want, but I have the perfect alibi...no one will believe you.”
“The vial of BCG?”
Lisa spat in Karl’s face. When saliva ran down Karl’s cheek, he flushed with uncontrolled rage.
He crushed the pillow into her face, and then pushed well beyond her weakened struggle.
Regaining control, he lifted the pillow from her ashen face.
Shit, he thought as he slapped her face and then placed his mouth over hers and delivered three deep breaths. Afterward, he felt for her pulse.
Lisa Gomez was dead.
Karl stared at her mouth then searched under Lisa’s sink, discovered a bottle of bleach and wiped Lisa’s mouth to destroy his DNA.
Chapter Nineteen
Jennifer Howe’s only exposure to hospitals was having babies. She recalled the lively, clean, and creatively decorated Pacific Medical Center where she had Lizzy and Brad. Now, she was sitting in the dingy and spare surgical day care room as she awaited the operation to widen the excision around the melanoma and explore her surrounding lymph glands.
You explore a continent, she thought, not a person!
Mickey grasped her hand. “The surgeon said he’d take skin from your abdomen as a graft over the skin he has to remove.”
“I don’t care that much about the cosmetics, Mickey,” she said grasping his hand. “I think you’re going to like me anyway.”
“You won’t give a guy a break. I’m doing the best I can to be upbeat.”
“I know, sweetie.” She caressed his cheek as the nurse approached.
“It’s time, Jennifer. Mr. Howe, why don’t you go to the waiting room. She should be out in about an hour.”
After ninety minutes, Mickey stood and paced the room. After another ten minutes, the surgeon entered. “Everything went well. I won’t know the results for sure until the pathologists look at the lymph glands I removed. I did an extensive dissection, and except for that sentinel node, everything looked clean. That’s good news.”
“Can I see her?”
“Of course. She’s back in her room.”
They met the next day with Jason Beckman.
His face remained enigmatic.
He looks like a manikin, thought Mickey. He must be the life of the party.
Jason caught their gaze. “You got me,” he smiled. “Patients look into my handsome face for answers, encouragement, or signs of trouble. It’s just a face, after all.”
Jennifer took a deep breath, smiled back at Jason and relaxed.
“The area around the original resection was clear of disease as were the lymph nodes in the region. Only the sentinel node showed the presence of tumor cells. It’s what we expected.”
“Do I need to take my last trip around the world?” Jennifer said. “See it now or never?”
“I’m afraid you’re going to be busy for the next year. First, we’ll do x-rays, CT scans, and MRIs for future reference, and then I’ll start you on Interferon.”
“How will that work?” Mickey asked.
“You won’t be moving in, but you’ll be here a lot. The first series will be intravenous infusions five days a week for a month. Then, you’ll be here three times a week for forty-eight weeks.”
“Will the treatments make her sick?” Mickey asked.
“Some patients do feel bad. Mostly it’s fatigue. You can never tell about medications. Some patients get sick with aspirin; others take powerful chemotherapy like it’s nothing. Whatever happens, we have ways of dealing with it.”
Mickey dropped Jennifer off at UC the next day in a light drizzle. “Will you be okay?”
“I’ll be fine. I have my cell. I’ll call you after they start the treatment.”
“I love you.”
“I love you, too.”
The oncology treatment room was a basketball court, but half as wide. The dread Jennifer had in the oncology waiting room returned.
Jennifer sat in a soft recliner with a hospital gown over her pretty dress and looked around. Some patients looked healthy. Others—was there a way to be kind, looked dreadful. She saw at once why they placed an emesis basin within reach, as many held them to their mouths vomiting. Just the sight and the smell turned her stomach.
The young nurse looked at Jennifer’s arms and smiled. “You have good veins. Let’s keep them that way.”
The nurse put a tourniquet around Jennifer’s arm and placed a small butterfly needle into her vein. She checked the plastic medication bag, checked Jennifer’s arm band again, and began the IV infusion.
“It’s a piece of cake,” she smiled then walked away.
She means well, thought Jennifer, as she stared up at the bag and traced the course of the IV line carrying salvation into her body. Not a terribly religious person, Jennifer said a prayer.
Jennifer did well the first week, but by the second, she was exhausted. She could tolerate the aching and the low grade fever, but the fatigue was profound.
It’s sapping the life out of me.
After the first month, they started the injections. They were quick and easy, but she became convinced that all these efforts were for nil. Her ready smile rarely appeared, she slept poorly, and cried a lot.
“It’s depression,” said Jason Beckman, “we see it in most patients. It’s part of the side effect profile of Interferon, but many cancer patients don’t need an excuse. We can wait it out or try to treat it with antidepressants.”
Jennifer looked at Mickey. “What do you think?”
“I hate to see you down this way. If medication can help, I say go for it.”
After the third week of treatment with Prozac, Jennifer felt as if something had removed a heavy cloak over her sense of joy. “I’m back,” she said, hugging Mickey.
“I want to see you every six months,” said Jason after she completed the series of injections.
“What can we expect?” Mickey asked.
“I can’t tell anyone how to live. If it were me, I’d live my life as a normal person, whatever that means. Keep your checkups and don’t hesitate to call if you see or feel anything that bothers you.”
“Thank you for everything,” Jennifer said.
“One more thing,” Jason said as he stood behind his desk.
“What now?” Jennifer asked.
“Keep an eye on your skin.”
“Keep an eye?” asked Mickey.
“The mirror, Jennifer. It’s your friend.”
Jennifer frowned.
“And Mickey, I don’t think you’ll find it too painful to check out her naked self in bright light. People who get melanomas may have a predisposition to form them. About 8 percent of patients with one will develop another.”
“You’re just full of good news, doctor,” Jennifer said.
“And Jennifer, if you do see something, the earlier we know, the better.”
Chapter Twenty
“No chance,” Terri said as Matt nuzzled close to her and caressed her breasts.
“We have time,” he said.
Terri looked at the clock. “It’s 5:30. Time for you to go before Abbie wakes up.”
“You still think we’re fooling her? She’s a smart girl...she must know, and,” he hesitated, “approve.”
“You’re right, but maybe it’s me who’s not ready.”
“I’m sorry about last night,” he said, deadpan. “I’ll do better the next time.”
Terri smiled then punched him in the arm. “If yo
u were any better, I might not have survived.”
Matt reached over and pulled her against his chest. “Let me save us a lot of problems, the questions, the subtle probing. I’m crazy about you and Abbie, too. I’d never do anything to harm either of you, but especially Abbie. She’s suffered enough.”
Terri caressed his dark stubble as he’d finally shaved his beard. “I’ve been frightened for me and for Abbie. I never thought I’d be so lucky to find love again, but here you are—I couldn’t be happier.”
“Why don’t I cook you breakfast,” Matt said. “I’ll drive Abbie to school.”
“The school part’s okay, but you’re not stepping into my kitchen.”
Matt showered then shaved using Terri’s Lady BIC that she used on her legs. He had pieces of tissue paper covering several razor cuts on his face. “I’ll bring over the essentials so next time, I don’t kill my face.”
He sat at the kitchen table with a mug of coffee, and was reading the morning paper when Abbie walked into the room rubbing her eyes.
“Matthew,” she said smiling. “I’m glad you didn’t sneak out again this morning. That was getting a little old.”
“Are you sure you’re not a teenager?”
“I’ll be there soon. Maybe you can drive me to school this morning, Matthew. The girls will love that.”
He smiled and looked at Terri. “If it’s okay with your mother.”
Terri nodded. “Eat up or you’ll be late.”
“What’s on your schedule today?” Matt asked.
“The usual, except Lisa Gomez called. I’m meeting her at ten. She said she had something to show me...very curious.”
“We’re still on for dinner with Lisa this Friday?”
“Yes. I don’t like matchmaking, but if you know anyone...”
“I’ll think about it. I’ll see you tonight.”
Terri was sitting in her office at Genentech Hall filling out a stack of request forms as she waited for Lisa. She didn’t know Lisa was late until she looked at the clock which read 10:45.
That’s odd, Terri thought. Lisa would call if she were going to be late.
At 11:00 a.m., Terri dialed PAT and asked for Lisa’s extension. Evan Klack answered.
A Simple Cure Page 9