What’s wrong with me, she thought?
“The HIV research is going well, but my money’s on the DNA viruses. These are more common like the adenoviruses that cause the common cold, herpes virus that causes cold and genital sores and poxvirus that cause smallpox, chickenpox, and most recently SARS (severe acute respiratory syndrome).”
“How will it work?” she asked.
“We simply use these viruses to carry the new genetic material into the cells. Some day we will remove disease causing genes and insert therapeutic ones.”
Elizabeth stared at Andre. “There’s something frightening about deliberately infecting the body’s cells with a virus and creating an internal epidemic, a plague within. The theoretical possibilities of doing great good or disastrous harm have made, and will always make for great science fiction in books and on the screen.”
Andre frowned. “The ill-informed will always resist new scientific methods and approaches to diseases. That may be the single most frustrating barrier to progress.”
“How do you know that these viruses will infect the right cells and avoid infecting the germ cells in the ovaries and testicles? If they infect these cells, can’t the gene changes pass on to future generations?”
“We know which cells they affect, and you must know that for years, there have been germ line alterations in bacteria, farm animals, and crops. We’re already getting insulin, treatment for hemophilia, and treatment for cystic fibrosis from genetically altered bacteria. We’re also getting better farm animals and a whole range of improved crops.” Andre paused for a moment in thought, and then continued, “I’ve heard all the nightmare scenarios of genetic engineering gone wild. It’s a lot of crap. We have more than enough, probably too many, safeguards in place.”
Andre’s speculative juices were flowing. He stared at Elizabeth. “If you really want to blow your mind, listen to this; we know that human cells die after dividing a number of times. That may be a major part of how we age. Some cancer and some virus-infected cells are immortal. Think of it, viral infections that make our cells immortal!”
Roy Ostrow was Andre’s a research associate. He sat trapped in the chair before Andre’s desk sweating and gripping its arms. “I can’t do it. I just can’t do it.”
Tap...tap...tap sounded the top of Andre’s mechanical pencil as it rapped repeatedly against the wooden desktop. Andre grasped the stack of data sheets before him, and, with his yellow highlighter, slashed through a half dozen data columns.
“This data does not fit the clear trends you’ve so brilliantly demonstrated, Roy. I’m marking the ones that have got to go.”
“You can’t omit data just because it doesn’t fit with our theory, Dr. Keller, and I see no need to abandon data actually obtained through experimentation. Data is data, sir.”
Andre stood. His face red, his best plastic smile a sneer. “Mr. Ostrow, I’ve been in this business a lot longer than you and I know how to handle research data. There’s not a researcher alive who would allow spurious data to muddle the main thrust of his findings. If you feel that I am compromising your scientific integrity then perhaps this research program is not the place for you.”
Ostrow was two years into the research that was to be the basis for his own Ph.d. Andre’s pronouncement shocked him. This was no idle threat.
Andre grasped the data sheets and extended them to Roy.
Roy hesitated a moment before accepting them. “I’ll make the changes, Dr. Keller.” He turned, retreating from Keller’s office.
Andre smiled—his genuine smile this time.
Chapter Twelve
The sealed FedEx overnight box from the University of Maine sat at the ICU nursing station when Jack arrived the next morning. Through the west facing ICU windows, the morning sun spilled over the hills and into the east bay and onto the low clouds covering the San Francisco Bay. The only features visible in this billowing thick mist were the towers of the Oakland-San Francisco Bay Bridge and the Golden Gate, and a few spires of the tallest buildings in the city.
Beth lifted the box. “It came at six this morning, Jack.”
Jack opened the package containing ten glass multiple dose bottles about one quarter filled with white powder. He read the accompanying instructions then injected sterile water to reconstitute the medication in the first bottle.
Tom and Maxine stood beside Rachel. She was pale and gaunt, but smiled brightly as Beth and Jack approached.
“How are you feeling today, Rachel?”
“Tired and nauseated, just like every day this week, Jack. How do my tests look?”
“Your white blood cell count remains elevated reflecting ongoing infection and you’re still anemic. No real change.
“Let me have my say, and then we’ll get down to business. I’ve reviewed all the data the University of Maine provided on CT1356, and I must admit that the drug looks promising. My main objections remain that once abscesses form, the body reacts by surrounding them with thick tissue, a barrier that makes it difficult for any antibiotic to get in. Secondly, time is not on your side. The more we delay, the more it’s likely that the infection will progress or spread to other parts of your body.”
Tom looked at Maxine and Rachel. “We’ve been over and over it, Jack. We want to go ahead with the new drug.”
Jack took the thirty-page experimental drug protocol then read the informed consent document to Rachel. The list of potential problems and side effects were extensive, but probably not much different from the list of adverse effects you’d see on even the most established drug if you looked in the PDR (The Physician’s Desk Reference) or the information sheet that accompanied any medication.
Rachel fumbled with Jack’s pen, looked up at Tom and Maxine, and then signed the document. Beth witnessed her signature.
“The nurses will inject CT1356 into your IV every six hours. I’m ordering more frequent lab tests just to be on top of things in case we have a problem.”
“Thank you very much, Dr. Byrnes,” came Maxine’s impassive response, “we appreciate all that you’ve done.”
Her comment hit Jack like a facetious “have a nice day.” She’d won. Jack had lost. Had he been overcautious? Had he sought to deny Rachel a better way out? Jack prayed not.
Jack continued to obsess over Rachel’s bewildering decision as he returned to his office. He glanced at his appointment book. Harmony Lane was due in ten minutes.
“Why is Dr. Lane on my schedule, Janet?”
“Ben sent her credentials folder and asked if you’d do the honors of an interview.”
All new physicians coming on staff had a face-to-face interview with the department chief or his/her surrogate. This was a final step in the too long process of approval and gave the chief the opportunity to evaluate an applicant on a personal level. It also gave both the chance to explore any unanswered questions. Ben had asked Jack on occasion to substitute for him when he was unavailable.
Jack had just finished working his way through his daily morning mail. Although Janet had eliminated the obvious junk mail and come-ons, some still made it through. Janet was good at keeping out the unwanted mail and the unsolicited phone calls, 90 percent of which were to either get Jack to invest in something or buy insurance. We laughed at the more innovative phone calls that went on like: “Is Jack in? It’s his old buddy Fred and I just got into town...” or “Dr. Byrnes told me to call this morning...” or “How would Dr. Byrnes like a free trip to Hilton Head...” etc.
“I have Dr. Lane for you. Should I show her in?”
Jack rose as Harmony entered. They shook hands and Jack offered her a chair.
“I’m sorry, but Ben couldn’t see you today. He likes to see the new docs, but he’s tied up and we don’t want to hold up your appointment any longer.”
Harmony Lane was nearly six feet tall and rail-thin as a fashion model. She’d side-parted her shoulder length blond hair and wore an earth-toned, knee-length box-pleated skirt with a cream-colored satin b
louse.
“I appreciate that Dr. Byrnes. None of these staff application processes are easy or quick.”
“Call me Jack. What do friends or associates use for your name?”
She smiled. “Call me Harmony or Harm, or hey you, I answer to anything. You can guess by my name that Mom and Dad were ‘60s refugees.”
She’s charming, Jack thought.
“Do you have any questions about the hospital, or how the medical staff or our support office can help you?”
“No. I have a good lay of the land. I’m setting up my office and getting ready to roll. Do you have any questions, Jack?”
“Well, one thing did come up when the credentials committee reviewed your application and that was your interest in alternative medicine. No one is prepared to say anything’s wrong about looking at alternative ways of treating patients, but it shouldn’t surprise you to discover that certain less-than-responsible physicians have pushed alternative medicine into realms which endangered their patients.”
She smiled again. Her eyes sparkled bright blue. “If you’re wondering if I’m some kind of kook, Jack, put your mind at ease. I look at different ways of approaching medical problems for two reasons, curiosity, and practicality. I have an interest in the group of patients that drives many internists and family practitioners bonkers, you know them. We label them as fibromyalgia, chronic fatigue syndrome, chronic headaches, among others. I’m good with these patients, usually women, and alternative approaches are part of the game in treating them.”
Jack felt instant relief. “I might have one or two of them in my practice that I may send to you.”
Jack stood and shook her hand again. “I’m going to grant you temporary privileges to practice. Welcome aboard.”
Chapter Thirteen
Greg and Amanda Wincott started People for Alternative Treatment (PAT) on a shoestring, relatively speaking. They’d put in $500,000 of their own, and had received many contributions through people at Stanford University, both individuals and funds identified by contributors in support of rare diseases and orphan drug development.
Amanda put down the phone. “I’ve been on the line to dozens of university programs. I never knew how dedicated researchers could be to such rare and unusual disorders.”
“I know,” Greg said. “If we’re to have any chance of success, we must narrow our focus to the few disorders with the most promise.”
Greg negotiated the long-term lease on a set of commercial buildings in Emeryville, in the east bay of San Francisco. Its sole tenant had been a commercial laboratory, now defunct. The terms were attractive and the physical facility, having been a laboratory, had many built-in features they required. Greg hired national executive and research scientist recruiting firms, and soon talent inundated them.
Nine months later, their executive and research staff was in place. Research, fund-raising, and marketing began.
Two years later, they had their first success with treatment of a rare disease where children grew up lacking an immune system to protect them from infection. It was a big victory for the few with the rare disorder, but a small one for PAT, though for the first time, they did receive press attention.
One morning, a week before Christmas, Amanda’s secretary entered her office excited. “You won’t believe this, but I have one of Katie Couric’s producers on the line. She wants to speak with you.”
Startled, Amanda picked up the phone. “Amanda Wincott speaking. How can I help you?”
“My name is Marcia Albert and I’m a producer for The Katie Couric show. I have good news; Katie’s selected you and Mr. Wincott to receive the FDA’s Scientific Achievement Award for the work you are doing on orphan drugs. We’d like you both to appear with Katie and receive a cash award, and of course you’ll have a chance to pitch for support for orphan drugs to millions of Katie’s viewers.”
“It was surreal,” she later told friends. “First class tickets, limousines, cameras everywhere, and all the personal attention. They really spotlighted PAT and our work. I know Ian’s story was moving, but I was uncomfortable telling it on national television. Once I began answering Katie’s questions, the dam broke and all the emotion spilled out. In retrospect, it felt good to unload, and to have the audience share with me their heartfelt reaction. Greg growled throughout. If it weren’t so beneficial to the company, he’d never have participated.”
Immediately afterward and for months to come, People for Alternative Treatment received donations. Several national charities placed them on their list for a yearly contribution, a tribute to the goodwill generated by Katie’s name.
Greg and Amanda were pleased with their accomplishments, but naive to the slow pace of research. Impatient, they wanted quicker and more dramatic results.
Archie Blake looked out his window as the Davis police car pulled in front of the Molecular Research Center.
Moments later, his intercom buzzed. “The police are here. They have a search warrant.”
“I’ll be right down.”
When Archie entered the reception area, one of the two uniformed officers handed him a folded sheet of paper.
The officer said, “This is a search warrant, sir, for the offices and locker of Payton Wexler.”
Archie studied the paper. “What’s this all about?”
“Can we speak in private, sir?” the officer asked.
“Of course.”
In Archie’s office, the officer paraphrased the warrant. “We have reason to believe, that, Mr. Wexler has downloaded from the Internet homoerotic child pornographic material and has distributed it.”
Archie stared in disbelief. “Reason to believe?”
“We have an anonymous source.”
Archie tightened his jaw. “I hate this crap. Anyone with a grudge, legitimate or not, can be anonymous.”
The officer shrugged his shoulders.
When they arrived in Payton’s office, he was shocked and terrified. “You can’t let them do this Archie. This is Davis, not Nazi Germany!”
Forty minutes later, Payton reappeared in handcuffs. One officer carried a box they found in Payton’s locker and thick folders from his desk. He was under arrest.
Andre smiled as he watched the officers place Payton in the police car.
Good riddance, Andre thought.
Reuben Trask always began his informational lectures for new recruits to Evangelicals For Life with Proverbs 31:8: Open your mouths for the speechless, in the cause of all who are appointed to die, and he ended with Psalm 58:10: The righteous shall rejoice when he seeth the vengeance: he shall wash his feet in the blood of the wicked. Reuben flushed with joy when he spoke the phrase, blood of the wicked.
He rambled through the standard rhetoric. “We are unalterably opposed to abortion under all circumstances; we oppose homosexuality as open rebellion against God’s laws; life begins at conception; we oppose in-vitro fertilization, embryonic stem cell research, gene therapy, and cloning in all its forms as the murder of children in their earliest stages of development. We find especially heinous the use of cloning by homosexual individuals as a means of procreation.”
Reuben went on to show his media presentations, especially his beloved videos. These included Body Parts for Sale, Christie’s Choice (a young woman has an abortion and complications put her in a persistent vegetative state), and his favorite, Hard Truth. The latter, the most brutal and graphic of all, showed scattered fetal parts, aborted fetuses in garbage cans and laboratory containers. “These are the details, the horrors rendered by those who choose to ignore God’s moral law. We are called upon by God to solve the societal and medical problems of our culture. We’ll not become the Nazi experimenters of World War II.”
Reuben traveled with his Evangelicals for Life group to cities all over the United States. Their acts of conscience, of civil disobedience, had put him and his group in jail many times. With numbers of abortions declining in the early 2000s, and antiabortion activity levels falling, Reuben tur
ned his attention to the struggle against embryonic stem cell research and genetic engineering. When he read about the firebombing of a Watertown, Massachusetts stem cell lab, he smiled. “Too bad none of the murderers died.”
Chapter Fourteen
The conflict over Rachel Palmer’s treatment made her care infinitely more difficult for the staff. The entire sequence of events in her illness, the efforts expended, the dedication, and the personal commitment of the staff, plus the dire nature of her condition, changed a healthy preoccupation with her care into obsession.
When Jack’s ICU patients were stable, he rounded on them twice daily. But with Rachel, he visited four or five times a day, interspersed with phone calls updating her condition and laboratory findings.
After twenty-four hours of therapy with CT1356, Rachel’s condition hadn’t changed. She still had low-grade fever and mild signs of ongoing infection. It was six-thirty in the evening and Jack was preparing to leave for the day when his phone rang. “Jack, it’s Carla. You’d better get up here to see Rachel.”
Jack skipped the elevator and ran up the five flights of stairs to the ICU.
Carla was standing next to Rachel. “Something’s happening, Jack. Look at her skin and the labs that just came back.”
Jack caught his breath and walked to the bedside. Tom and Maxine stood nearby clutching hands. He turned to Tom. “If you could give me a moment.”
Tom paled. “What’s wrong, Jack?”
“Please, Tom. Just a few moments then, we’ll talk.”
“I’m not leaving,” spat Maxine.
Tom grabbed her by the arm and forced her to leave. “Haven’t you done enough, goddamn it?”
Jack returned his attention to Rachel. She was groggy and mumbled, “Hey, Jack. What’s up?”
“I’m checking on a few things, Rachel. How are you feeling?”
The Plague Within (Brier Hospital Series) Page 7