Race Across the Sky

by Derek Sherman

  • • • • • • •

  Shane went back to work that Monday. Almost immediately, he felt different.

  Walking through the halls, he noticed specific products that had not before caught his attention. Helixia’s product line was like taking a course in incomprehensible human suffering. Dozens of types of cancers, Parkinson’s, and to his dismay, rapid onset childhood disorders that had been rare during his youth but were now exploding.

  Neurofibromatosis, up 45 percent in the last five years. Childhood leukemia, up 110 percent. Asthma. Cushing’s disease. Marfan syndrome. All up by astounding percentages in the past decade.

  Helixia’s researchers possessed many theories as to why: the average American mother’s breast milk contains fifty toxic chemical compounds not known a generation earlier, baby formulas which fail to fully develop the infant immune system, constant exposure to low-level radiation from cell phones and airplanes. Whatever their root causes, these diseases were each the subject of long decks, all of which contained a section entitled “Early Symptoms.”

  When Shane returned home each night, his eyes would wander to the slight widening of the base of Nicholas’s head, a tiny red dot on his leg, all bullet points on those pages. At night he would listen to the bassinet next to their bed. Was Nicholas snoring? Did he have infant sleep apnea? Would his resulting moodiness be misdiagnosed as ADHD, and Nicholas end up lost in a swirl of psychotropic overmedication?

  The universe was revealed to him as a forest at night, with spirits hiding behind the trunks of wicked trees. But Shane shook these off with relative ease. Environmental concerns could be mitigated: he and Janelle used no products with artificial scents of mountain breeze, cleaned using only the vinegar their grandmothers had used. It did not go unnoticed that neither of their grandmothers had died of cancer.

  But there was nothing he could do to protect his boy from genetics. What happened there had been embedded deep in code, far beyond him.

  That week, the annual sales conference for Sorion was to be held at the Union Square Sheraton. Shane was responsible for a presentation on the drug’s past, current, and future, and the status of prescriptions in his region. Besides getting up to speed, simply learning Helixia’s style of presentation took attention. He could feel his promise to Caleb drifting out to sea.

  On Wednesday, sitting at his desk, he scanned the guest list. Investor Relations, Corporate, Physicians, Patients. He noticed someone missing.

  “Hey, it’s Shane Oberest,” he said when Prajuk answered his phone. “What are you doing today?”

  “I am working. Did you have some more questions about this thing?”

  “Actually, I’d like to invite you to join us at the Sorion sales conference.”

  “You’re kidding. Science is never invited to these things.”

  “Science is the Star. Says so right on my mouse pad.”

  He heard the doctor laugh.

  “Come on, I’ll drive you. You should see this.”

  After a pause, Prajuk’s nearly falsetto voice returned. “This thing, when would we be back?”

  And so on Thursday morning, Shane stood in the courtyard between the two Helixia buildings, watching an astonishing mix of people emerge from Research. South Asians, Africans, Nordic blonds. There seemed to be no cultural lock on the study of enzyme proteins. And here came Doctor Acharn, lighting a Parliament. He had a manner of smoking Shane had never before encountered: he gripped a lit cigarette in his fist an inch away from his lips and sucked loudly at his hand. It seemed an utterly foreign act.

  “What do you want to listen to?” Shane asked, as they drove the blue Civic out of the lot.

  “The Giants are playing.”

  Shane’s radio was already preset to it. They hit the 101 to the sounds of the second inning. Half an hour later, the unsightly Union Square Sheraton appeared, hovering over the low-end pornography shops. Shane and Prajuk made their way past tourists in college football sweatshirts toward a ballroom. The hotel’s beaten carpeting and stained floral furniture had clearly been abused by conventioneers for generations.

  In the hall, a group of older people congregated by the main ballroom. They seemed displaced, called to come, but unsure where they were supposed to be. They wore yellow cotton sweaters, tennis shoes, a specific look on their faces; even if Shane had not known what this conference was about, he might have guessed. There is a look in the faces of cancer survivors that causes them to stand apart from the earth.

  Shane walked over with a friendly nod. “Are you Sorion patients?”

  Each of them nodded.

  “This man”—Shane gestured to Prajuk—“invented it.”

  A stocky woman in her sixties exclaimed, “Oh, my Lord.”

  She took a step forward and hugged Prajuk. Shane watched him accept uncomfortably.

  An older man, with a head full of thick white hair and eyes that registered honor, stepped forward. This man, thought Shane, had served. His watery hazel eyes never left Prajuk’s, and he clasped his shoulder as if there were some secret history between them.

  A well-appointed woman, possibly his daughter, spoke softly. “He was wasting down to nothing. He had pneumonia, he couldn’t walk. Then he started on your drug. Now you just look at him.”

  Shane asked, amazed, “Did it work right away?”

  “Oh no,” she shook her head. “When he first took it he got a bad fever. A hundred and four, the doctors wanted him off of it.”

  “That is a good sign,” Prajuk nodded. “That is the cancer cells dying in the millions. The body just cannot process all of these dead cells at once.”

  She went on, “He still has his tumors, but they stopped growing. He plays golf. He does the yard.”

  The man finally spoke. “I know you saved my life.”

  And then overhead lights blinked, signaling the start of the conference. Shane presented an overview of Sorion’s sales, projected growth. He ably charted Asia-Pacific projections and gracefully handed the stage to the finance team. Patients spoke, some of them moved to tears, then oncologists, and one medical school dean from San Diego. Afterward, the trade reporters began to drink at the hotel bar. At Orco, he thought, he would have laid down a corporate card and suggested some stories on his other drugs. Now, he just went to find Prajuk.

  On the drive back, Shane watched the slight scientist look out at the orange electric buses.

  “Thank you for inviting me. This thing, I am very . . .” he seemed to be searching for a word. “This mattered to me.”

  Shane smiled. “That’s really, really good.”

  “We never see the patients.”

  “We’ll do it again.” As he hit the on-ramp, a thought occurred to him. “So, do you know anything about lung disease?”

  “Lung cancer?”

  “No, more inherited genetic diseases?”

  Prajuk raised his eyes. “A bit.”

  “My brother knows a baby who has one called alpha-one antitrypsin deficiency.” His mouth stumbled over the syllables. “It’s pretty rare.”

  “I know it. How old is the baby?”

  “About four months.”

  “In infants the prognosis is fairly poor. Is that what they told your brother?”

  “That’s right.”

  “Of course we’ve been quite involved with immune-system-sponsored lung disease for a long time.”

  “Helixia, you mean?”

  “My team.”

  “You work on lung diseases?”

  “We developed this thing Airifan.”

  Shane slowed behind a truck and looked at him. “You worked on Airifan?”

  “This thing is going to save quite a lot of lives.”

  “It’s out of trials, right?”

  “It resides in a lovely limbo between FDA approval and Marketing. One is understaffed,
and the other is busy designing golf shirts with the logo.”

  Shane took the hit with a grin and changed lanes.

  “It must feel incredible,” he said quietly, “to create something that saves people.”

  “Oh, definitely. Airifan will save many lives. It will also prevent other suffering. Current childhood asthma medication is steroids, and there are many concerns with steroids in children. Airifan has no steroids at all.”

  “What are projected sales?”

  “Oh, you would need to ask the finance people but it’s blockbuster for sure. A billion a year, probably. But asthma is just a part of it. The real target is emphysema, which is fatal one hundred percent of the time. The technology we developed for Airifan is the key to a treatment. We believe it will be prescribed off-label for emphysema fairly quickly.”

  “My wife’s grandfather died of emphysema.”

  “Big smoker?”

  “He’s Chinese.”

  “Ah,” Prajuk said flatly.

  Shane’s eyebrows raised. “Children with alpha-one antitrypsin deficiency get emphysema.”

  “Definitely.”

  “So they’re linked?”

  Prajuk began slowly, as if deciding exactly what he wanted to say. “Drugs are like houses, Shane. They have many doors. We open each door to see where it leads, but we can’t go wandering around. If a door leads to the room we intend to visit, say asthma, we go through it. If it does not, if it leads to a detour, we close it behind us. The question is always, which doors should we go through, and which should we shut?”

  Shane nodded, picking up speed.

  “Emphysema is a Helixia priority. A few years ago, Amgen put a treatment on the market, but it only worked for ten percent of patients. Anthony feels that Airifan may work for eighty percent. It took us six years in the lab to get there, and then another eight years of trials. Fourteen years. A hundred million dollars. In terms of my career, this is a huge project. We cannot afford any detours.” Prajuk swallowed. “This thing, alpha-one antitrypsin deficiency, is a door we opened and closed some years ago.”

  “Closed?”

  “The protein in Airifan affects alpha-one antitrypsin production in the liver. But we do not use it that way in the drug. Our goal was asthma and emphysema, two of the major diseases of our time. We could not step through a door into that room.”

  “What are you saying?”

  “I’m saying, we have it.”

  Shane pulled over and stared at him. “You have what?”

  “A protein that solves for alpha-one antitrypsin deficiency. We have it,” Prajuk assured him. “We just left it behind a door.”

  4

  • • • • • • • • • • • •

  In August, Caleb fell off of Engineer Mountain.

  He was thirteen thousand feet up in the air, just underneath the belly of the clouds, seventy-one miles into the Hardrock 100.

  The race had begun in the antediluvian mining town of Silverton, Colorado. It looped counterclockwise through Lake City, Ouray, Telluride, and back to Silverton, over thirteen peaks of the San Juans. Last year, his descents from the snowcapped summits had given him trouble. The trick was to slide down the snow on one hip, but the powder hid sharp rocks, and Caleb never managed the necessary abandon. He had finished twenty-seventh. All last winter, he had practiced proper glissades.

  So at dawn Caleb stood in front of the Silverton high school along with 140 other runners, from their twenties to their sixties, staring ahead at the mountain range. A few hopped up and down to warm up in the mist; most conserved their energy. Just ahead of him he recognized Julien Chorier, Betsy Nye, a few other top-ten finishers from last year. He also spotted other runners whom he had witnessed sobbing and vomiting along the trails.

  In his hand Caleb gripped lightweight trekking poles for the snow and ice. Across his shoulders he wore a small orange backpack filled with energy gel, sunblock, shades, and water. Everything else he would need lay in drop bags strategically placed inside the aid stations.

  Mack had called them together in the dark, held their hands, and gave them some Whitman: “‘Not I, nor anyone else, can travel this road for you. You must travel it by yourself. It is not far. It is within reach.’” He nodded, then burst into a wild grin. “‘Each of us inevitable! Each of us limitless!’”

  They had held each other, heads bent. A runner named Joel Zucker had died of a brain aneurysm on this course in 1999; Rae reminded them all to stay alert. When the gun sounded, Caleb sprinted through the narrow streets of Silverton, past Runner’s World magazine photographers, cheering fans, and curious townsfolk. Behind him Kyle Meltzer, who had won more than a few ultras, shook his head at whoever was so foolish as to run off the start. But Caleb never walked the start of a race, he knew no other way than to gallop into the distance, as he had in Issaquah as a boy, until he had no choice but to slow.

  A few miles into the mountains, Caleb plunged into Little Giant Basin. It was like running down the inside of a deep bowl of jade. Caleb found his rhythm, breathed deeply, and trotted across the lush green field and up the other side of the basin.

  He was the first to the Arrastra stream. The smell of salmon filled the frigid water. It felt good to be shocked alive. When he emerged and began jogging up the trail in his wet shoes, and his calves awoke, Caleb felt as happy as he guessed was possible in the world.

  He drank his water and ran past a cairn toward steep beige cliffs. He ascended up to the scree fields, rock crumbling beneath him; he might slip and shatter his legs with any step. Below, he saw the magnificence of Cunningham Gulch, its ribbons of white snow winding through dark brown granite.

  The first aid station appeared on his left. A good crowd wearing Gore-Tex shells of various neons stood by the blue nylon tent, clapping for him. A few held video cameras, and there seemed to be lots of parents and children. It looked like a stranger’s family reunion, and Caleb had the mind to run past it. But then Alice appeared, beckoning him inside.

  “Nice race. But slow down,” she told him, handing him a banana milkshake.

  Caleb nodded, sat on a bench, and stared down at his wet Montrails. Alice rubbed sunscreen onto his reddening shoulders and refilled his water bottle.

  “I’m pacing you this leg,” she informed him.

  He nodded.

  “Meltzer,” Alice gestured.

  Caleb watched him approach. He was walking quickly, apparently taking in the glory of the day. He must have run and jogged to be here this quickly, but he did not seem to have broken a sweat yet. Caleb found a baseball hat in his pack, grabbed his poles, and ran out with Alice onto the trail toward Green Mountain. Leaving, he heard someone say something about sleet.

  The course grew steeper, punishing his quads and calves. Butterflies brushed against his shoulders. Alice held him back as they ascended toward the white snowpack; anytime he began to move faster she touched his shoulder. Some miles later they were confronted by a herd of goats ambling across the path. Just to their left was a sheer four-hundred-foot drop, and on their right a granite wall. There was nowhere to go, Alice said, flattening her back nervously against the rock. Caleb plunged straight through the herd, causing a braying that echoed down into the valley.

  As the trail rose, he concentrated on his heart rate. Monitoring his body took all of his attention, leaving none for such tangents as the contemplation of pain. Even as he starved, he felt his soul being fed. He took his first steps on snow.

  And then the course shot steeply downward. At Maggie Gulch he ran through a summer field covered in orange wildflowers, while a microclimate of a snowstorm drifted just ten feet away. Alice handed him an electrolyte gel. His stomach clenched unhappily; he had the experience of these gels causing him trouble.

  They reached the end of the first leg, two hours under the cutoff. Caleb checked in with race officials at the Sherma
n station. He had lost three pounds; seven was an automatic disqualification. Alice kissed his cheek, and Leigh, willowy and red-faced, walked over with climbing equipment and called to him as to a puppy, “Come on, Caley!”

  Some miles later they moved into a grove of aspens, where black flies flew from the conifer and bit his neck. He watched Handies Peak materialize ahead of him.

  Leigh whispered, “I dropped here last year.”

  He recalled it. A severe thunderstorm had swept in, crushing the trail to mud, pelting the climbers with hail. Luckily, he had been on his way to Telluride by then.

  They stopped to pull crampons from their packs and over their shoes. He shook loose his trekking poles, and their points plunged through wet tufts of frozen grass and snowpack, scattering loose stones beneath him. He called a warning to Leigh behind him and pushed himself skyward. It was not his job to worry about her.

  The ascent up to fourteen thousand feet took longer than he had anticipated. Below them the approaching runners seemed to be coming at him in one large pack. He began to visualize his old flowcharts from his days at InterFinancial, going over them as his legs pushed against the granite, lost in math and equations.

  At the summit the air around him was as pure as newborn breath. Fluttering orange flags pointed them toward a narrow natural bridge, made of rock, covered in snow, which connected them to the south face of the next pass. The drop below them was astonishing. They crossed carefully, hovering eleven thousand feet in the air with no guardrail, suspended above the world.

  On the other side, the trail dropped abruptly into boulder fields. Without thinking about it he executed a perfect glissade down the snow, ice lacerating his cheeks. Halfway down, he turned his head, saw Leigh just behind him, and Kyle Meltzer at the top.